OK, it’s Tuesday… “Throwback Tuesday.” I’ll make that a thing.
Somebody I really appreciated getting to know, before her retirement from healthcare improvement work, was Naida Grunden. She wrote or co-authored two fantastic Lean healthcare books:
Ah, whiskey. I like whiskey. I’m not afraid to say that. I’ve blogged about whiskey (or whisky) once before: Why Kaizen is an Important Differentiator for Japanese Whisky. I also have a personal Kaizen story that I need to write about...
Episode #246 is my second episode in recognition of Patient Safety Awareness Week.
My guest is Steve Montague, who talked about Lean and Crew Resource Management with me in episode #195 in 2014. He’s a retired Navy fighter pilot, a commercial pilot, and a consultant for hospitals and health systems… and a fellow Texan and a near-neighbor of mine. See his full bio here.
In healthcare, it’s a well-known problem that people often don’t speak up to point out risks or to report near misses. It’s an organizational culture problem… people are afraid of being blamed, punished, or retaliated against for speaking up.
My wife and I are getting ready to leave tomorrow night for a two week vacation, so it jogged my memory about this story I saw back in December in the WSJ: Airlines Try to Make Coach Classier. Anything that makes long flights more bearable is good news to me.
Continuing the “Throwback Thursday” theme for the 10th anniversary of my blog, today’s post looks back at and builds upon one of my favorites from 2007. The post is a “GM War Story” from 1995 when I was just starting my career:
In healthcare patient safety circles, there’s always a lot of discussion about lessons learned from aviation safety. Aviation has gotten much safer over the past few decades, while each new study done in healthcare indicates the patient safety problem is not getting better (or is getting worse… or is being measured better).
I realize that some people in healthcare get just as annoyed hearing about planes and cockpits as they do hearing about Lean manufacturing and factories. We take it for granted now that aviation is safe. There are many annoying things about flying and baggage might get lost… but you’re very unlikely to die in a plane accident, even flying 120,000 miles a year, like I do.
To close out the year 2013, I once again need to close some browser tabs that are full of things that I was maybe going to write about, but don’t merit a full post. So, the latest in my occasional “What I’m Reading” series:
New York State Hospital Data Exposes Big Markups, and Odd Bargains (NY Times): The state of New York has made data available that shows the gap between what it “costs” a hospital to provide care and the price that’s actually charged to the payer (and the inconsistencies across the state). I’m not so certain most hospitals have cost accounting methods that really create an accurate view of what the cost (direct cost and overhead) of a certain procedure is for a particular patient. This is hard to do (allocating overhead). I think transparency can only help, but hospitals lamely argue that releasing such data only “confuses” people.
In the Lean methodology, building upon the teachings of Dr. W. Edwards Deming, we work hard to shift away from “naming, blaming, and shaming.” Dr. John Toussaint is one of many who provide alternatives to the “blame and shame” approach that’s, sadly, so common in healthcare.
When I teach about focusing more on fixing systems and processes (instead of blaming individuals), I talk about workplace scenarios where things go wrong. As Deming taught (and I believe strongly, from my own experience), roughly 94% of problems are caused by the system.
I often say that it’s human nature to try to blame others. It’s easier to lecture and say “don’t blame” than it is to practice this in our daily lives. I’m not perfect, but I try.
My wife is a leader in a business (not GE) that does aircraft engine “MRO” work – maintenance, repair, and overhaul. I’ve been able to visit her shop floor (her “gemba”) and we noticed similar parallels between their work (bring engines back to prime “health”) and what’s done in healthcare. This parallel was also explored in this recent article from GE Healthcare that was published by The Guardian in England: “What lessons can healthcare learn from industry?”
There are interesting and sometimes humorous parallels between engine MRO and human healthcare:
As we move into the Labor Day weekend, I need to close some browser tabs that are full of things that I was maybe going to write about, but don’t merit a full post. So, the latest in my “What I’m Reading” series:
“How to Disarm a Nasty Co-Worker: Use a Smile“ (WSJ): I think when we have “nasty” or “venting” co-workers or employees, we should work hard to understand the system. We should ask “why are nurses frustrated?” rather than just telling the nurses to not complain about doctors or problems. Staff engagement is really important and I think we should create a workplace that people can enjoy being a part of. But, I agree with a quote in the story, “It is your job as a manager to get at truth and excellence, not to make people happy.” We can’t force people to be nice, but maybe we can create conditions where they are less stressed and more likely to be nice. Look at the system issues.
This is proudly displayed (as it should be) near the register. Click on the image for a larger view.
Why don’t we see similar summaries and information posted in hospital lobbies? What were the most recent deficiencies from the latest accreditation visit from the Joint Commission or another body? The more I think about it, why don’t airlines post similar information about maintenance and other public safety issues?
I flew back safely from Finland on Saturday – or I should say British Airways and American Airlines flew me safety, including in the 747 pictured at left. 15 hours across three flights. It was a long day. But, I wasn’t really worried about my safety because of the great track record that the aviation industry has demonstrated (and taught to industries like healthcare).
That said, mistakes still happen. We’re all human. But, what does an industry do and how do they react when a mistake is made? Recent events with a British Airways flight are telling.
I’ve added to a new post to my LinkedIn Influencers series: “The Ability to Iterate is Not an Excuse to Do It Badly the First Time.”
It’s about the new American Airlines digital airport signage that’s being rolled out across airports — signage that I think is a big step backward in readability…. but they look pretty.