Why Do Patients Have to Do This?


The Informed Patient – WSJ.com

Good column in the WSJ today, as always, from Laura Landro. She writes about the need for patients to take an active role in their care and their own safety.

I'll try to keep with the Toyota philosophy of asking “why?” We could go through each of these in “the 5 Whys” problem solving method.

  • Why do patients have to ask their surgeons if they are following proper surgical safety protocols?

The focus of my question is on the patients, why is it necessary to ask patients to take such an active role in the quality of care delivery, not “why is it important to properly clean your hands?”

Do we ever hear food safety advocates suggest, “You should ask your restaurant to confirm that the meat was cooked to the proper temperature”?? Are car buyers encouraged to nag Toyota or GM about whether the car is safe to drive off of the lot?

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. Interesting comparison with the restaurants – They are required to inform the customer of risks and, in places like California, post their health rating on the entrances.

    From one perspective, empowering the individual (in this case the patient), arguably the lowest “level” of authority in health delivery, is a tenet of lean.
    From another, this represents a horrible gaffe in the efficiency and efficacy of delivery of health care.

  2. I don’t know how “empowering” it is to the patients. One hospital did a survey that showed patients were pretty unlikely to speak up and ask questions about hygiene or their care. Patients might feel uncomfortable or fear how they’ll be treated if they speak up. It’s a tough position to be in, as the patient.

    Still, I like what the advocates say about buying a giant bottle of hand sanitizer and leaving it next to your hospital bed as a signal… and for convenience!


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