Safety and Quality In Health Care and Construction
February 7th, 2007 by HalThe CBS follow-up story to Katie Couric's interview, One Doctor's Crusade For Hospital Reform is a good read. CBS highlighted the everyday benefits of high capability processes on our lives. The interview opens this way with Dr. Berwick saying,
"Hospitals are very dangerous places. I don't know how to explain this to the public in a way that doesn't create too much fear. But they need to be realistic, and the technologies that help you can also hurt you — and they do it every single day."
Improving process quality and safety creates more time for engaging with people.
Studies indicate that 15 million patients are injured or get some sort of insufficient care each year. Some where between 44,000 and 96,000 die unnecessarily. Dr. Berwick and the 3,100 IHI partner hospitals have set out to change that. They are making their improvements in the same way that Toyota and other high-capability companies make their improvements. IHI is adopting Lean Six Sigma. Dr. Berwick goes on to say,
"We need to build a hospital like you build an airplane, so that everything works right and there's a kind of automatic excellence in the system instead of relying on human effort."
But Dr. Berwick understands the real value of human effort. It's the deep engagement with the patient. In the interview he says that working on process frees up healthcare professionals to engage more with patients1. That extra unhurried time is the opportunity to notice the subtleties expressed in the interactions with the patients. That, he says, leads to better judgement and better care.
We can learn a lot from Dr. Berwick. At the same time, Dr. Berwick is learning from the lean community…just a little faster than we've been learning. 1,200 people died in construction-related incidents in the USA for each of the last 15 years. That is in the face of significant investments in safety education along with increased OSHA penalties for offending firms. That effort has not worked. It's time we do something different. It's time construction learned from others. Maybe we need to learn from Dr. Berwick.
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