“Use only reliable, thoroughly tested technology that serves your people and processes.”
Too many organizations, across multiple industries, think that software, robotics, or other forms of technology will be a “silver bullet” or what some call a “siren song.” I’m not anti-technology – I love gadgets and new technology in my personal life. But I think organizations and leaders are wise to follow the Toyota Way example of not using technology for technology’s sake. For example, too many hospitals invest millions in automation (including in pharmacies and labs, only to see things not improve) and Lean provides an alternative.
In this post, I’ll cover topics including GM and tweeting cars, technology approaches to preventing texting-and-driving, and a hospital that is using video cameras as a high-tech workaround to the problem of nurses not having enough time at the bedside.
I heard a story on the radio (NPR, I think) recently about a GM concept vehicle that will send you a text message when your gas tank is running low. I believe this was something being shown at the Detroit Auto Show, but I can’t find a web reference. A text message when your tank is low? What’s wrong with the fuel gage right in front of you behind the steering wheel? What am I missing here? I’d rather trust an analog gauge than my iPhone, especially since prompt delivery of text messages isn’t always assured (regardless of what AT&T ads claim). Is this a real need for some customers or a gimmick that sounds cool?
Texting while driving (or emailing) while driving is certainly dangerous, even while sitting at a red light (as I was reminded in a recent community email from the Keller, Texas police department). A number of companies are working on apps or built-in cell phone features that would disable your phone while the GPS sensor senses you are moving. Many GPS navigation devices have this safety feature built in.
But what if you are a passenger? Then the phone, like some GPS nav units, would need an override of some sorts. So a well-intended technology solution might be circumvented by some drivers (much as some nurses find clever ways to bypass the patient wristband barcodes that are supposed to ensure that the right patient gets the right medication).
The email from the City of Keller recommended that drivers put their phones in their trunk to help avoid the temptation to look at the phone. That’s a process-driven approach, but what if you get into an accident (not from texting) and you need to make a call?
I also heard one commentator say recently that every phone has an OFF switch and that could be used by drivers. So what’s the need for apps or potential nanny-state mandates to prevent texting while driving? Now, some want to ban texting and WALKING in New York, if you can believe it.
Another story I heard on WBAP, the local Dallas-Fort Worth news station, was about a Baylor Health System hospital putting cameras in EVERY patient room, sending a feed to the nurse’s station, so the nurses could better monitor patients. I can’t find an online reference to this story either, even on the WBAP website. While this might sound like a laudable goal, keeping a better eye on patients, I asked this question on twitter:
|Mark Graban (@LeanBlog) — 1/21/11 4:06 PM
Baylor putting video camera feed from patient room to RN station: an advance or a workaround that keeps nurses away from bedside?
If the problem statement is defined as “nurses can’t see patients because they are at the nurses’ station too much,” then putting in a video camera feed in to provide visibility might seem like a reasonable countermeasure. But observing patients from afar, via video, might not be preferable compared to the nurse actually being in the room. If you see a fall-risk patient trying to get out of bed via video, the nurse might not be able to get there in time to prevent a fall.
What if we framed the problem as “nurses are at the station too often” and we found ways to get them out of the station? What if we ask “why are the nurses at the station so much?” Maybe their Computers on Wheels don’t get a good wireless signal, so they come back to chart at a PC at the station? Or maybe the carts aren’t holding a charge, so they come back and plug them in at the station? Can we develop a process where nurses do shift handover at the patient bedside instead of at the nurses’ station?
Maybe there are less expensive solutions than putting in video feeds? Just because we CAN put video in each room, that doesn’t mean we necessarily should. Are we getting to the real root cause of the problem? Are there manual approaches, like looking at your dashboard, that could work just as well as the texting solution?
What do you think about any or all of these points?
About LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as the new Executive Guide to Healthcare Kaizen. Mark is also the Chief Improvement Officer for the technology company KaiNexus.