By September 23, 2011 19 Comments Read More →

Infographic – The Hazards of Hospitals

Some people might find this graphic inflammatory, if they are feeling defensive about the state of healthcare and if they feel like they are being blamed personally.

The data in this infographic represents the current state, to the best of the ability of researchers to estimate the impact of poor healthcare quality. To improve, we have to recognize the problem.

The title says, “Why US Hospitals Aren’t Nearly as Safe as You Think” but there’s nothing here pointing the finger of blame at the hardworking, intelligent, caring, well-educated healthcare professions. It’s the processes and systems that are broken, not the people. The people can fix this.


The Hazards of Hospitals
Created by:  MedicalBillingAndCodingCertification.net


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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

19 Comments on "Infographic – The Hazards of Hospitals"

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  1. Mark R Hamel
    Twitter:
    says:

    Mark,

    Thanks for sharing that infographic. I knew that there was as lot of improvement opportunity within healthcare, but that one “page” is absolutely loaded. Think of how may A3’s could emanate from it?!

    A staff member at a healthcare client adamantly told me once to, “never go to the hospital unless you have no other choice.” Pretty sobering. And yet, we know we can dramatically improve healthcare. It is really a matter of will.
    Mark R Hamel recently posted..10 Common Lean LiesMy Profile

    • Mark Graban
      Twitter:
      says:

      “A matter of will” is a good way to put it. Are people willing to admit there is a problem, even if the data and estimates about the amount of harm are imperfect. The scale of the problem far worse than it needs to be.

      Leaders like Paul O’Neill, Dr. Pronovost, Dr. Shannon, Dr. Gawande, the people at ThedaCare, etc. are real leaders in this area. They have great improvement data. Why don’t the improvements spread?

      O’Neill says it is a lack of leadership, you can listen here:

      http://www.leanblog.org/124

      He’s frustrated. I don’t blame him.

      Even Dr. Shannon seemed a bit frustrated:

      http://www.leanblog.org/127
      Mark Graban recently posted..Infographic – The Hazards of HospitalsMy Profile

  2. My father, who was a doctor specialized in microbiology, made an study in the main hospital in Las Palmas de Gran Canaria (Canary Islands, Spain): the impact of intra-hospitalary infections was more than 60% of patients in all the floors of the hospital, except one, that had a far lower rate. After a little more investigation of the causes of this lower rate, they discovered that in that section all the personnel was used to wash their hands frequently so they didn’t transmit infections from one patient to other…

    I fully believe that the infographic, even when it is terrific, is realistic.

    Thanks for sharing!
    Antonio

  3. Mark Graban
    Twitter:
    says:

    The 26% hand washing number in the ICU is horrific. There are many structural barriers to address — easy accessibility of gel dispensers and sinks, making sure people have enough time to do this, supervisors and managers who are looking for the right behavior, etc.

    There was one ICU I saw where there was a big sign asking (telling) visitors to wash their hands. Was there a gel dispenser right under the sign? NO!

    That would really make me worry as a visitor about the hospital’s attention to detail.

  4. I agree with the need to address environmental barriers, but I think (and I’m not related to healthcare more than as a simple patient) that there is a huge need to realize the importance to the personnel. They need to know the terrible impact that has to neglect the simple policies. Sometimes people do not think on these things

    • Mark Graban
      Twitter:
      says:

      Yes, there is a role for personal responsibility. But, do healthcare personnel REALLY not know that hand washing is important? I think they do.

      There’s a leadership responsibility to hire people who are properly trained and educated. And there’s an ongoing responsibility to remind people of their obligations and to remove barriers. We need both. But, put educated, responsible, caring people in a bad system and the bad system will almost always win.

      • Antonio valle says:

        Sure! It’s almost impossible they don’t know the importance! But its more proable some people don’t think on the importance… It’s not the same to know than to think and to realize and to keep in mind. The important thing here is to be able (thru leadership) to make important things to become culture, habit, routine… Something you don’t need to think about it.

        I work in the IT sector, and it’s very usual to see bad habits in people and if you ask them, they know the impact, but they haven’t the habit… (I hope I can explain the ideas properly in English :-)

        • Mark Graban
          Twitter:
          says:

          Yes. I think it’s the role of supervisors, managers, leaders to remind people of the importance. And there are more effective ways to do this than just hanging lots of signs in the workplace.

          • Susanne says:

            One of the best ways is to go thru common procedures and identify where hand washing should occur. Believe it or not, it is not always clear to staff when contact will be made especially when carrying supplies or making multiple contacts. Just saying wash your hands more is not always helpful. And as others have pointed out, the means to do this must be in the right place.

  5. Andrew Bishop
    Twitter:
    says:

    A good gaphic presentation, though I might quibble with some of the “solutions”.

    On the handwashing topic: In a hectic, high pressure environment, explicit allocation of time for “out of cycle work” is a critical expression of leadership commitment.

    Whether it is handwashing in the ICU or performing operator daily maintenance routines on the assembly line (similar issues, aren’t they?) if people aren’t given time they will tend to rush to the next step? “Enforcement” is not a solution.

  6. Mark R Hamel
    Twitter:
    says:

    To build upon Andrew’s comment, this is a place where SDCA (standardize-do-check-adjust) can be applied. In SDCA, we check to ensure that standards are being followed and whether they are sufficient. When folks don’t follow the standards (i.e. hand washing), we need to ask “Why?”. It may be a behavioral issue, training issue or possibly it’s a pain in the neck to follow – like if there is no time to do it and/or the hand washing station is not conveniently located, etc. In that last situation, PDCA should follow.
    Mark R Hamel recently posted..10 Common Lean LiesMy Profile

    • Susanne says:

      I would guess it’s not motivation or training but more the trigger.
      Does the reminder happen at the right place in the process and when the reminder does occur is it actionable in the moment.

  7. Dwain says:

    Now I have more reasons to not visit anyone in the hospital. When My son was in the NICU a few months back we had to wash our hands anytime we went in to see him. The problem was there was hardley any of the soap bars there on a regular basis. I would alway contact someone and let them know but how many just bypassed that step and went in anyway. Not including the number of nurses that walked in andout with out washing. Yes they only touched a chart or pen or pencil but always had me thinking about the next person that touched the same item. Makes me want to change my direction in lean and run to my local hospital and see if I can help.

  8. I don’t know how is the situation in the USA; last week I was in a hospital (you know, I’m not from the healthcare industry) and I saw that in each room, the first thing you saw after opening the door was a gel dispenser, so even visitors (not conscienced, not educated) washed our hands instinctively. May be it is a good approach!

    Another observation is that I got really surprised of the difference betweent US hospitals and european ones in terms of infections! Here (Spain) the healthcare insurance companies put as a value added to their offering the possibility to be treated in a US hospital (as a symbol of high quality)… Marketing always win!

    • Mark Graban
      Twitter:
      says:

      There are many definitions of quality, including healthcare. Think of a Lexus and a Corolla. A Lexus has many features and luxuries, you could call that quality. A Corolla might also be considered high quality if it is built well and runs reliably for a long time.

      There seem to be some Lexus procedures and treatments that people will travel from all over the world for, as the U.S. is the place to get some of this Lexus care.

      But the errors and deaths and problems in the infographic seem to be more like not building Corollas properly… Toyota would have a terrible quality reputation if they built great Lexus products, but lousy Corollas.

  9. Richard Chapman says:

    More anti-Lean inventory supporters (owners of warehouses perhaps)

    http://www.smh.com.au/national/health/poor-hospital-supply-lines-endanger-patients-20110928-1kxgq.html

    Rather than solve problems, people just want warehouses full of decaying stock.

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