On June 30, the PBS NewsHour program did a 7-minute story on healthcare improvement (featuring Lean and Toyota methods) at Denver Health.
You can also see the video or read the transcript on the NewsHour site: “Denver Hospital Sets the Bar for Patient Safety.”
Some highlights of the video:
- A respiratory therapist demonstrates a device they “cobbled together” that sounds an alarm when a  ventilated patient's bed is lowered below 30 degrees. This has led to a 50% reduction in ventilator-associated pneumonia cases.
- Denver Health has the lowest mortality rate of any academic medical center in the country. They can estimate they prevented the deaths of 213 patients who “would have been expected to die” without improvements like these.
- Dr. Don Berwick said, “They are getting levels of performance that most of the rest of us in health care can only envy… They are showing the rest of us what's possible.”
The story talks about CEO Dr. Patty Gabow bringing in a “team of efficiency experts from the business world” — meaning their Lean program. You can read past LeanBlog stories about their Lean program. I wish PBS wouldn't refer to Lean as an “efficiency” program, since we know the dual pillars of the Toyota Production System are flow and quality. With Lean, better quality leads to better cost and greater efficiency.
The story then highlights a better set of Toyota and Lean principles and the “cultural change” Dr. Gabow wanted:
- Eliminate waste
- Fix problems
- Promote constant improvement
In the video, you can see a group doing a value stream map on the wall.
More importantly, the video shares some improvements that were made to ensure that pre-op antibiotics were given consistently, to reduce infection rates. They also discuss the use of Lean methods to improve emergency department flow (cutting wait times in half and changing thinking on patient safety – focusing on preventing future problems).
A final quote from the story about getting better:
DR. MARK EARNEST: There is a perception that — that smart, dedicated, and doing the things the way I have been trained to do it is as good as it can be. And, so, sometimes, it takes — it takes us being pushed.
If you took your car in and somebody repaired the car, and it broke down again next week, and the garage got paid to fix it the second time just the way they got it the first time, there is not a lot of incentive to get it right the first time. And that's sort of the environment we have in health care right now.
Congrats to Denver Health. What can we do to “push” the rest of healthcare to follow their lead, today?
Key Tweets:
- “America's government was created by geniuses so it could be run by idiots.” (History Channel program) – link to tweet
- Value stream mapping technology for the rest of us: butcher paper, post-it's, and pencils. And and a digital camera when done. (link)
- Editing “#Lean Hospitals” 2nd ed, editor managed to somehow delete an entire sentence. I caught error. Ah, inspection, #Irony #Quality
- Follow Mark on Twitter
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Great post Mark — thanks!
Story brings illuminates a crtical, core Health Care Mental Model:
“How we do it now, is as good at it can get.”
In other words, there can be no kaizen!
Debilitating, and utterly untrue, as the Denver Hospital team demonstrates.
Health Care transformation will hinge on our ability to make such mental models visible.
For more on health care mental models, see chapter 13 of The Remedy, http://www.amazon.com/Remedy-Bringing-Thinking-Transform-Organization/dp/0470556854/ref=sr_1_2?ie=UTF8&qid=1309877315&sr=8-2
Best regards,
Pascal Dennis