I'm attending and participating again, as I do most every year. It's a great event that's focused on process improvement. Let me know if you're attending and please say hello. Follow on Twitter via the hashtag #SHS2017.
Since SHS is part of the Institute of Industrial and Systems Engineers, many of the attendees, like me, have worked in both manufacturing and healthcare.
We're able to see parallels and differences between the settings and understand how process improvement and leadership principles are transferrable across industries. We're working to make hospitals better hospitals. That doesn't mean “turning them into a factory” as people might fear in healthcare.
I understand when healthcare people have trouble seeing what would be transferrable, especially when many of them have never set foot in a factory. They don't know “what good looks like” in manufacturing. They wouldn't necessarily know the difference between a modern Lean factory that you would want to learn from and a bad, traditionally-run factory (like my GM plant was in 1995).
I get frustrated, though, when people make broad generalizations about factories being backward or crappy workplaces, as I blogged about here:
I read with interest when this Seattle Times article invoked the term “factory” when writing about a hospital and a surgeon (and a management team?) who are accused of putting quantity before quality.
My GM factory, sadly, did that in 1995. I've seen that outdated mindset in other factories that were still early in their Lean transformation.
But, we need to distinguish between “factory” as a general term and “bad factory.”
See this investigative piece from the Seattle Times that is interesting on many levels… it refers to the “O.R. Factory” as if all factories are sweatshops that crank out poor quality products. Again, that's as unfair as saying all bankers are crooks or that all restaurants would give you food poisoning.
In the article, the word “factory” doesn't get used. The word “Lean” thankfully doesn't enter the discussion. People sometimes incorrectly think Lean means pressuring people to work faster. No, Lean is actually the opposite of that old mindset and approach. Lean puts quality first and truly empowers people to do improve quality.
I suggest you read the article.
I shared some quotes from the article via Twitter, as I was reading it, including:
“toxic, repressive environment has negatively impacted the ability of the SNI community to provide [quality]” https://t.co/jXsWQnA2q7
— Mark Graban (@MarkGraban) February 23, 2017
In a nutshell, the accusations (and counter claims are):
- A surgeon, Dr. Johnny Delashaw, is accused of prioritizing money, quantity, and volume over clinical best practice and quality (he denies that)
- Many staff members and other surgeons have quit or complained about his practice and behavior (the surgeon claims they are jealous or resistant to culture change)
- The surgeon payment model has been changed from pooling some revenue to encourage teamwork to a strictly individual RVU payment scheme
- It's alleged that a state law meant to encourage patient safety is being used (through a loophole) to force nurses to work 20 hours in a 24 hour period
- Some claim they are afraid to speak up in M&M reviews (but the surgeon claims he is not a bully)
- Poor outcomes are blamed on the surgeon having concurrent cases or being in clinic while “his” patients are in the O.R. being worked on by residents or other surgeons
- Delashaw was promoted into a leadership role, despite concerns that were raised by colleagues
- Hospital leadership seemed to diminish or ignore the allegations
There are a lot of concerns and problems here that you'd hope hospital leaders would take seriously.
Calling a bad hospital a “factory” doesn't shed any light or help the discussion. The problem is putting quantity over quality, as the article accuses them of. I'd criticize a factory or a hospital (or any organization) for doing that.
In a follow up to the investigation, we have this news:
“Swedish Health Services CEO Tony Armada has resigned, days after a Seattle Times investigation examined turmoil and troubles inside Swedish's premier neurosurgery institute.”
That article also has a shorter synopsis of the investigation.
“The Times reported that doctors have expressed concerns to Armada and other administrators about patient-safety issues at the neurosurgery institute, particularly when it came to Delashaw. Ten surgeons and staff members met with Armada in October, with some making desperate pleas to remove Delashaw, to detail their concerns about the shifting culture at Swedish, according to minutes from that meeting obtained by The Times.”
The meeting minutes include:
The investigation and the meeting minutes seem to suggest those “Bests” or values aren't always being lived up to.
The CEO, Armada, stated:
“…patient safety and quality are our first priority.”
Yup, they alway SAY that, as I've blogged about before:
The key is translating that goal into daily practice, as I also wrote about here:
What do you think about any of this? In the grand scheme of things, using the word “factory” is probably the least important issue.