SHS Notes: Hospital Improvement, Deming Lessons from Mike Stoecklein, Shocking Doctors
I'm still reflecting on what a great conference the Society for Health Systems put on again this year. Here are some highlights from other talks… (see also my previous two posts)… if you're curious about “Shocking Doctors” in the post headline, be sure to read to the end of the post.
Airica Steed, now with the University of Illinois, gave a presentation about improvement work in a previous role at Advocate Health. They used Lean, as part of their Baldrige journey, to improve key measures over just a few years, including:
- Outpatient patient satisfaction increased from the 40th percentile to 93rd percentile
- Workforce engagement scores went from the 25th percentile to the 99th percentile
- They went from a $50 million deficit and losing money for 10 years to making a $10 million profit
Those are amazing results.. and it was done through patient-centered operational excellence methods.
Mike shared a lot of lessons from Dr. Deming, including the idea that “People go to other companies and other countries and try to copy, but they don't know what to copy.” As Doris Quinn discussed, you can't copy what you've seen when you have a weak foundation – hampered by the “prevailing style of management,” which includes:
- Short-term focus
- Results by any method
- Dividing the organization into parts and then managing the parts, instead of the system
- Managing from the office and the conference rooms
- Competition, win-lose, focus on individual
He talked about Deming's red bead experiment, the need to better understand variation (including mentions of the great Wheeler book Understanding Variation: The Key to Managing Chaos), and other topics.
He did a nice exercise for the audience that illustrated “special cause” versus “common cause” variation.
When I wrote five consecutive a's with my dominant hand (my right), the variation is “common cause.” I could reduce variation by having a better pen, a smoother writing surface, slowing down, etc.
Switching to my left hand… that's a “special cause” and you can see the increase in the variation. I could fix that variation by removing the special cause – by going back to my right hand.
Leaders and managers waste a lot of time looking for special causes when none exist – we over-react to special cause variation (the theme of my webinar on Statistical Process Control or SPC).
Oh, and you HAVE to read his blog post from yesterday about a lunch table discussion he was a part of at the conference: B.F. Skinner Would Be Proud.
Why did an attendee SERIOUSLY think that giving doctors electric shocks might be a good way to trigger the right behaviors?? Read Mike's post. Read it!! It's a real shame how some people are so quick to blame the individual instead of the system.