I've posted a new video on YouTube, about 5 minutes of sections of a presentation I gave at the 2010 Shingo Prize Conference on Lean Healthcare.
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From the video snippets:
The discussion about needing to fix patient flow, not just providing insurance, is all about the question of “access” to care. If you don't have insurance, you can't really get into a doctor's appointment without huge charges, so people understandably go to the emergency room. But, if you HAVE insurance and can't get an appointment because of throughput problems in the doctors' offices, are you really any better off? When I was in Sweden in early 2010, they had long E.D. waits because people couldn't get timely or convenient primary care appointments, even though they all have “coverage.” Coverage does not necessarily equal access.
The story about the MRI room – I've fleshed this out into a new case study for the end of Chapter 6 of my 2nd revised edition of “Lean Hospitals” that will be out in October. When you see a case where poor systems, poor processes, and a daily management system that's lacking in structure could have resulted in patient harm – it's very powerful.
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