Here’s a great essay from Tom Peters, a chapter from his book The Little Big Things: 163 Ways to Pursue EXCELLENCE.
The email that was forwarded to me with this content said “Sharing is permitted,” so if you like this content, please buy his book.
The Little Big Things byTom Peters. Copyright 2010 by Thomas J. Peters.
All Rights Reserved. Sharing is permitted–forward to a friend!
76. It Is Not Enough to Care!
I sure as hell wish this one weren’t necessary. But I’m pissed off. Really pissed off. As pissed off as I’ve ever been.
We unnecessarily kill (very strong term; a little too strong – but I’m pissed off, remember) some 100,000 to 300,000+ patients in hospitals in the United States every year. We wound millions more – and that doesn’t include the numberless victims in doctors’ offices,” as a senior ER doc and exec told me.
And, yes, it is by and large preventable, as any number of hospitals and hospital systems prove, like Geisinger Health System, headquartered in Danville, Pennsylvania. And many, if not most, of the cures are simple, requiring management and systems fixes, not more technology.
For example, Doctor Peter Pronovost at Johns Hopkins Hospital instituted a common checklist, an idea shamelessly stolen from airline pilots’ rituals, and he cut ICU line infections to zero at Hopkins. (FYI, experiment replicated in inner city Detroit.) Now “checklisting,” for any number of things, is becoming a staple in many hospitals. And, yes, many hospital employees are stretched to the breaking pointâ€”but the fact is, stressed out or not, religious hand washing creates, in 2010, near miracles in the world of patient safety.
To be sure, hospitals are “chipping away” at patient safety issues (and so-called “patient-centric care,” Ã la Griffin Hospital in Derby, Connecticut). There are literally thousands of experiments under way.
“Chipping away” is simply … not … enough.
Instead I must disrespectfully ask:
Where are the … radicals?
Where is the … radicalism?
Glenn Steele has pulled off a miracle at Geisinger.
Where are the Glenn Steeles?
My wife recently waited five hours in an ER with a broken ankle – “she described the pain as “second only to labor.” But she isn’t even pissed off – it’s what has happened to all her friends, it’s “what you expect.” As I write I’ve been to a “Top 10” hospital three times in the last ten days for tests. No, I was not left for hours upon more hours on a gurney in a hallway as Susan was. Nonetheless, there was a major error, two errors in one case, associated with each visit. One snafu could have had dangerous consequences for my beloved pacemaker. Yup, they batted a thousand. Three-for-three, an error 100% of the time.
At a dinner with eight guests, I deliberately turned the conversation toward this issue. Each … each and every one … of the guests or their immediate families had had a serious unforced error associated with their most recent hospital incarceration. In all but one case, the error had been life threatening. (And, depending on your interpretation, one may have resulted in an unnecessary death; at the least, it made a bad situation much worse.)
This is not right.
This is wrong.
Of course there are numerous “externalities,” as the economists call it. Still, if I’m CEO of a hospital, this is my houseâ€”and a 100 percent error rate is waaaaay beyond “inexcusable.”
Let me be clear and crude: This shit doesn’t have to happen.
Where is the … Shame?
Where are the … radicals?
Where are the CEOs, systemic externalities or not, who … will not rest until this is fixed?
(As I write in October 2009, health care reform is wobbling through a dozen congressional committees. The outcome is unclear. That fact is irrelevant to this discussion. This is stuff that does not require Washington’s legislative help. This stuff requires … raw, rad-i-cal determination … and an … abiding sense of responsibility.)
(Hospital professionals do care – almost to the woman and man. But, per General Chapman and Winston Churchill, it is not enough to care; you must succeed at what is necessary.)
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