Words that Matter in Healthcare


Healthcare Intelligence Network » Blog Archive » Eight Steps to a Culture of Safety

I think words matter. Action matters, also, but the words we use do matter (not that I always choose them well here).

Hospitals often use different words in describing their visions for improved quality and patient safety.

I like language that aims for perfection. The Lean approach is all about striving for perfection. Some hospitals use phrases like this:

“Striving for zero defects”

I think that's the only goal you can shoot for. Zero defects might seem hard to achieve, but it's the only worth promoting (especially in public).

Some organizations (hospitals and advocacy groups) talk about phrases like the “best results possible”. Possible under what circumstances? If we're just shooting for the best possible quality under the current system and processes, that might not be very good, compared to the ideal. I think language like “possible” is a cop-out. We have to aim higher.

The page I linked to at the top of the post delves into this, one person's story:

1. Develop a Vision
This is our vision for medication safety: We are perfecting the medication delivery system to be safe for every patient, every time, while making it easy for the caregiver to do the right thing, and impossible to do the wrong thing. You do this by building reliability into your system. I was on the committee that helped to develop this vision statement. I initially had a problem with the word “perfecting,” because I thought “perfecting” was unrealistic and we should set a less lofty goal. However, our administrative leader suggested that this is a vision, and we have to look at where we would like to be when we've completed the process. So, “perfecting” stayed in the vision statement.

Just because it's not realistic doesn't mean it can't be a goal. There's a strong parallel to factories (such as Alcoa under Paul O'Neill's leadership) that set “Zero Injuries” as a goal. Picking numbers like “0.25 injuries per 100,000 hours worked” send the wrong message that an arbitrary number of injuries is somehow acceptable. Now, based on past performance, some range and number of injuries might be predictable. That doesn't mean the goal should be anything other than zero.

What do you think? What stance does your organization take in terms of language or quantitative goals?

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Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.

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