Has anyone else watched the ABC “news” show called “Hopkins“? I've seen just the first episode (via iTunes) and wanted to comment on it. I believe you can watch the show free using the link above. Putting aside the reality show drama (a doctor getting a divorce, etc.), there are some interesting views into the “process” side of a hospital…. and opportunities for improvement.
Did That Really Fix Anything?
In one scene, a patient with a tumor was trying to get into surgeon's clinic for 6 weeks. The patient called a few times and nobody ever got back to them. The surgeon found out about this and was upset (understandably so, as this was bad for the patient).
On the plus side, the surgeon gathered his team and asked “what happened?” That's a good first question. Not, “who screwed up?”, but “what happened?”
The response was “It will never happen again.” And the surgeon was satisfied and walked away. That's not good Lean problem solving. Was the staff just placating him? Could they have gone through a 5 Whys analysis and looked at the process and standardized work for the office?
It seemed like the surgeon was more interested in “acting tough” than really getting to the root of the process problem. It was a great opportunity for somebody to look at the roles and responsibilities — why did the patient not get called back? Are staff too busy? Is it unclear who is supposed to make the calls and when?
When we hear “it won't happen again,” it's perhaps a bit cynical to think it WILL, if the process hasn't improved. Maybe it was bad editing on ABC's part.
“Sometimes things will happen”
Later in the episode, the surgeon was sprayed in the eye with blood during surgery. He was wearing glasses, but not a face shield. This is where I need some help…. should the surgeon have been wearing better Personal Protective Equipment in the O.R.?.
As the surgeon was washing his eyes out (and probably getting ready to be testing for Hep or HIV), he said
“No matter how good we are, sometimes things happen.”
Again, it seems like an opportunity for process improvement, not this “oh well” attitude. Maybe the surgeon should follow the “universal precautions?” Not so universal, it seems. Again, am I missing something with this one?
“That scared the crap out of me”
A third scenario came up with this same surgeon — he's a top neurosurgeon, actually (Dr. Alfredo Quinones-Hinojosa).
During tumor surgery, there's a loud bump and the surgeon says:
“Be very very careful, please guys… I have instruments in this guy's brain… needless to say, that scared the crap out of me.”
Somebody in scrubs had come in and bumped into a piece of equipment away from the operating table, making a loud noise, startling everybody.
That's a process “defect” that should be discussed and fixed after the fact. The problem solving needs to go beyond glaring at the person who made the noise. How can the layout of the O.R. be improved so people don't bump into things? Oh, I guess that just happens sometimes, as he said….
Don't you think they can do better, from a process standpoint??? I don't mean to be blaming the doctor… this isn't HIS fault. It's the system that he's working within… and his problem solving skills, but again, that's not necessarily just his fault either.
Two great questions that could apply to any of those three situations:
- How did this occur, and why?
- How can we prevent it from happening again?
“We'll be more careful” is NOT an acceptable answer to question #2, in my book. What do you think, as an outsider to the industry, or as a healthcare professional?
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