Imagine trying to do a critical, life-in-the-balance job under extreme time pressure while hundreds of random strangers wander around your workplace asking too many questions and getting underfoot. It would be disconcerting to say the least. That is a worst-case perspective of having visitors in a healthcare facility.
Doctor and patient communication has been ubiquitous in the American zeitgeist over many decades in the form of the empathetic bedside manner of television doctors. The likes of Marcus Welby (Marcus Welby, M.D.), J.D. Dorian (Scrubs) and Meredith Grey (Grey’s Anatomy) have modeled our ideal in their demonstration of care and communication with patients.
But what happens in the real world? A portion of doctor/patient communication comes from the personality of the physician or other healthcare provider. The larger part comes from the content of material that must be communicated and the trained skills of the communicator.
“For want of a nail…a kingdom was lost.” That proverb could certainly apply in the healthcare field: “For want of a working piece of equipment, a patient was lost.” Evidence-based studies indicate that in the United States, premature death related to preventable harm to patients may be as high as 400,000 per year. Tens of thousands of these deaths may result from equipment-related issues.
Imagine a defibrillator that doesn’t power up, an operating room laser that fails, a patient monitor that doesn’t alarm, a radiation device that shifts out of calibration, or a digital control system that just shuts down. When any of these situations occurs, it can lead to a bad outcome for a patient, even death. Hospital professionals rely on having working equipment to do their jobs well. Equipment maintenance is critical to make sure this happens.
While managing inventory of patients is a key requirement of healthcare facilities, managing distributed equipment inventory doesn’t fall far behind. Having the wrong equipment, too little equipment, contaminated equipment, or equipment in the wrong spot can mean problems for patients. On the other hand, holding more equipment than you actually need is very costly.
Fortunately, managing equipment inventory and distribution is not a new problem. Many industries have addressed and optimized inventory systems and developed methods to pursue continuous improvements. Let’s consider some of the distributed equipment needs in medical facilities and discuss best practices that might apply.
Do you remember the scene in Cool Hand Luke, where a “failure to communicate” brings pain and suffering to Paul Newman? It’s similar in a hospital, where miscommunications can have significant clinical repercussions. Beyond that, poor healthcare communication can result in poor non-clinical outcomes leading to low patient or staff satisfaction and higher costs.
At the core of a patient’s visit to a health facility is the “patient experience,” an all-inclusive consideration of everything the patient goes through from arrival to discharge and final transport. In truth, the experience extends even farther on either end of this physical journey to include scheduling at the front end and billing at the back end.
One of the most common causes of operational excellence efforts sliding off track is leadership misalignment. This might be lack of agreement between stakeholders and practitioners, strongly differing opinions and direction within the Operational Excellence team, or even nominal leadership alignment that is actually just lip service.
Tags: Operational Excellence
“We are getting ready to deploy our Operational Excellence initiative…but struggling to define the resources needed for success.”
Resource planning is central to any operational excellence deployment path. It must occur at the point at which the work begins to translate from a conceptual to a tactical focus. A good resource plan will consider at least three factors: the number of resources required, the competency and experience of the resources, and the resource deployment strategy.
Tags: Operational Excellence
One of the first steps in applying Lean concepts on a path to operational excellence is identifying and eliminating waste. In the old days of manufacturing, this might have been called scrap. The Japanese TPS system, upon which Lean is modelled, focuses on delivering value to the customer. TPS uses the much broader waste concept of “Muda” as anything that does not add value in the eyes of the customer. In fact, Lean articulates seven different types of wastes identified in TPS. Some use the acronyms of TIM WOOD or WORMPIT to remember each type of waste.
Tags: Lean Six Sigma
If you’re a hands-on operational excellence practitioner or aspiring to become one, choosing your tactics for improvement efforts is probably where you start to get really excited. But wait! First, of course, you need to have your OpEx vision and strategy in place. This includes identification of specific deliverables and metrics, the “what ” that you are committing to achieve in working with teams of operational resources.
Tags: OpEx 101
As I'm sure you know, the 2016 Summer Olympic Games are off to a great start. I know I'm not the only one who gets excited to watch the world's premier athletes compete at the highest level for the right to say that they're the best at what they do. The diverse array of events is a great attraction as it offers the opportunity to reconnect with sports like gymnastics, track & field, and swimming, that aren't necessarily ingrained into our nation's consciousness, and for sports like basketball and golf that do have greater resonance, the Olympics are compelling because the athletes we know are now performing in an entirely different context.
One of the more interesting data points to come out of the Process Excellence Network's 2015 State of the Industry Report was that 52.9% of respondents projected their budgeted spend on operational excellence (OpEx) to increase. This figure represents an improvement compared to a similar study done in 2013 in which less than half of respondents expected such an increase, which is great news for those who make OpEx their profession.
If you’re leading a retail or franchise business, then you know all too well that ensuring all of your various operating locations comply with appropriate regulatory requirements and maintain their industry-based certifications is critical to the business.
At a minimum the consequence for compliance failures is that your brand suffers. At worst it can result in certain locations being shut down.
The United States men's and women's track and field teams are generally considered to be among the best in the world. Some of the greatest Olympians of all time are US track athletes, including Jim Thorpe, Jesse Owens, Jackie Joyner Kersee, Florence Griffith Joyner, and Carl Lewis.
So it was no surprise heading into the 2008 Olympic Games in Beijing that both the US men's and women's track and field squads were expected to perform well. But things didn't exactly go according to expectations that year. And in order for this year's Rio competitors to prevent history from repeating itself, there are some lessons to take away from those that came before them.
I’ve had the opportunity to coach my 7 year old son’s basketball team for a few seasons. If I'm being honest, coaching has been both highly rewarding and exasperating all at the same time.
On the one hand, I love watching these players literally improve their skills before my eyes. On the other hand, I know how much better they can be if only they could learn how to play as a team.
If you don't already know, our offices are located just outside of Washington, DC. Being so close has given us a special affinity for our nation's capital, so we make it our business to stay on top of the latest developments within the public sector.
We believe that affecting change within our own communities, whether at the local, state or federal level, is one of the greatest ways to pursue continuous improvement. Turns out, we aren't the only ones that feel that way.
The race to 'win' at Lean government has already begun, and here's why.
Tags: Continuous Improvement
Tags: Continuous Improvement
In his 2004 book titled Hoshin Kanri: Policy Deployment for Successful TQM, author Yoji Akao writes “The daily crush of events and quarterly bottom-line pressures do not take precedence over strategic plans; rather, these short-term activities are determined and managed by the plans themselves.” In that one sentence, Akao has concisely and eloquently articulated why it’s crucial for organizations to invest in a meaningful strategy deployment process. Too many organizations pay lip service to the concept of strategy deployment but their management approach and daily decision making reveal that they are highly reactive and subject to the so-called “tyranny of the now.”
Tags: Operational Excellence