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Lean Healthcare: Keys to Safer Hospitals


Keys to Safer Hospitals – Health For Life –

Blog reader Mike R. Lopez, from Albuquerque, NM found this and sent it my way for posting. Thanks!

Dr. Donald Berwick, a doctor at Harvard Medical School, wrote a story about “six basic measures that could save 100,000 lives a year if 2,000 hospitals adopted them.” The six basic measures illustrate the power of an often underused and misapplied Lean tool, “Standardization” (with Mike's comments in blue).

1. Eliminate respirator pneumonia by elevating the head of the hospital bed and frequently cleaning the patient's mouth.

2. Prevent IV catheter infections by was done when hospitals “made it easy for doctors and nurses to wash their hands between patients, adopted simple procedures for changing bandages around the catheters and made absolutely sure that no catheter remained in a vein even one hour longer than needed.” (Here is an example of flow, too.) [Mark here — it's also an example of “make it easy for people to do the right thing”, which I think is a good lean concept]

3. Stop surgical site infections by giving only the right drugs at the right time, washing hands, and cutting hair instead of shaving. (Sounds like a pull system.)

4. Respond rapidly to early-warning signs. (Using nurses and visitors as the Andon cord, immediate doctor response has cut Australian hospital death rates 20%.)

5. Make heart attach care absolutely reliable. A South Carolina hospital cut heart attack death rates 10% when they standardized the administration of drugs to all heart attack patients.

6. Stop medication errors. Every transfer of the patient includes a medication check to make sure that the right medicines are with the right person.

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Mark Graban is an internationally-recognized consultant, author, and speaker who has worked in healthcare, manufacturing, and startups. 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 book is the anthology 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. He is currently writing his next book, tentatively titled Measures of Success.

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