Notes from #IHI09 Day 2: Paul Levy


Paul Levy on Transparency, Social Media, and Quality
Following up and continuing this morning's post about MemorialCare. You can also read my notes and comments from Day 1 here.

You probably know Paul as CEO, blogger, and twitter user. I've met Paul and seen him speak a few times, he's always interesting and thought provoking.

Since IHI was actively encouraging the use of Twitter and social media (via their #IHI09 “hashtag”), I didn't take notes on paper like I did during the Memorial Care talk — I “tweeted.” And so did others.

@ClinicalCafe wrote: #IHI09 @Paulflevy on trying to actively police social media practices of employees: “It's a waste of resources–It's crazy.”

Paul makes a great point that, even if you block Facebook and Twitter on hospital computers, employees have mobile devices. If people want to goof off, shouldn't managers ask questions about why employees aren't doing the right things – providing patient care or working on continuous improvement activities? Is a technological fix really getting to the root cause of the behavior that managers might be trying to stop?

Aren't there productive uses of social media?

@dryost wrote: @Paulflevy at #ihi09 session finds employees provide him real-time reporting of issues on Facebook that they wouldn't e-mail.

Imagine that, it's not just goofing off… a productive use of Facebook:

I wrote: @paulflevy says use of social media improves his productivity (efficient comm. &less research time – ppl send him info)

An attendee asked Paul about how much time his social media use took. Paul claimed it's a net time saver — not only are people sending him reports from inside the hospital, people also send him articles that he'll want to read or blog about. It's like having a research team working for him, he said, basically. I benefit from much of the same with my blog (please contact me if you have articles you think I should see!).

Paul also answered the “how much time do you spend on social media?” question very directly:

I wrote: @paulflevy “You would never ask me how much time I spend on the phone.” re: social media

A good followup question, interesting to think about, is what's the lost opportunity from the time on social media? What's the right balance of going to the “gemba” to see problems and work first hand versus the important role of communicating with stakeholders including staff, physicians, and the community? That's for each executive to decide, eh?

Paul has long been a champion of transparency in the reporting of quality and patient safety data. Paul said that he started posting info on his blog before BIDMC embraced doing this on their own website.

@ClinicalCafe wrote the following:

And a final thought, also via @ClinicalCafe:

#IHI09 @Paulflevy talk: CEO's job not 2 hold employees accountable but to create environment where employees hold themselves accountable.

Sounds like, again, the idea of finding a root cause — if employees aren't accountable, we can look beyond blaming them as individuals? What about the system and the environment? Dr. Deming would be proud.

What do you think? Possible to make any sense of “tweets.” I found it interesting to see what other attendees thought was important to write about via Twitter. You?

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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 summary, Mark. I love Paul Levy’s response that “You would never ask me how much time I spend on the phone.” re: social media. I think he’s absolutely right: it’s not the tools, it’s how the tools are used.

    Of course, appropriate use requires each person to assess (and maybe even measure) how they’re using their time. Are they creating value, or gathering & disseminating information that supports value streams? If so, then tweeting/blogging/texting/emailing is worthwhile. But people really need to take a hard look at what they’re doing and what their customers need.

  2. For what it’s worth…I’m not too jazzed about attempting to decipher the tweets. Some are so cryptic that it takes extra time for me to attempt to fill in the blanks. There may be good content there but not completely sure…

  3. Thanks for the comment, Mary. I hear what you’re saying. That’s certainly a downside of Twitter is that 140 characters isn’t much. There’s immediacy, but often not enough content or context.

    I won’t do many blog posts like that, it was a bit of an experiment.


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