I spent some time today debated if I would write this posting, because I have lot of energy right now around the subject matter due to an experience my family is going through as I write to you today. I started this posting a couple of times and then walked away from the computer for a while. So I will start with a story to provide some context. A family member of mine recently had surgery at a very well respected hospital on the East Coast. A couple of weeks after the surgery he developed some complications and was rushed back the hospital. He appeared in the emergency room on a very busy, and chaotic Friday night and after waiting for quite some time was finally admitted and treatment began. After his initial treatment there was some additional complications and in the chaos of the situation there were several missed communications between clinicians. Additionally, the proper treatment path was not followed even though it would be considered “evidence based.” Luckily, the mistakes were realized when one of my other relatives that happens to be a physician intervened from afar and things seem to have stabilized. Afterwards it was very clear that if the processes were standardized and the standards were followed it would have been simple to have avoided the mistakes. But caught up in the chaotic environment with no clear processes to follow it was easy to make very preventable mistakes. Throughout this experience my family was taken care of by incredible nurses, physicians and other care takers. Great people that were trying to work in a broken system.
I often find myself debating with people within my industry whether standard work can be applied to patient care. I often hear back that it does not apply because ”no two patients are the same” or “healthcare is far too complex for standard work” to work. This argument is frustrating and we need to find ways to put to rest. I am sure that every industry has heard the same exact argument about why standard processes can not be applied in their field. I was telling my neighbor about what happened and he confirmed that in his industry (aerospace) twenty years ago it was the same story. “Airplanes are far to complex to be built by standard processes.”
The healthcare industry needs to start to pay attention to what other industries have already figured out. That the same reasons that we give as excuses on why processes cannot be standardized is the exact reason why we need to make them standard. The more complex a process the more important it is to standardize in order to bring it under control and then understand where it can be simplified. This also applies to the variation argument. If there a high degree of variation in inputs it is essential that you standardize to understand how much variation really exists and then have a strategy to respond to it. This is the only way to effectivly minimize the variation of outputs.
Like in Aerospace we work with a product (patients) where the stakes are very high and mistakes can be very painful. This is why I work in healthcare.
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