Knowing when it's time to leave

Please check out this autobiographical new post over at the athenahealth Leadership Forum.  Comments welcome there or he...

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How is it different?

Rosemary Gibson--author of The Treatment Trap--offered a trenchant comment on a ProPublica story by Charles Ornstein about how the University of Illinois violated its own policies by endorsing the product of a medical device company:Okay, so in Europe, when device maker J&J paid doctors who are government employees to use J&J products, the DOJ and SEC called it bribery...

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No coaches for doctors?

I was re-reading a portion of Atul Gawnde's book Better: A Surgeon's Notes on Performance and was struck by a couple of sentences in the afterword:Ours is a team sport, but with two key differences from the kinds with lighted scoreboards: the stakes are people's lives and we have no coaches.  The latter is no minor matter.  Doctors are expected to caoch themselves. We have no one but ourselves to lift us through the struggles.I imagine...

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They found a replacement!

My post of March 20 made note of a Seattle doctor who permitted her name and reputation--and that of her hospital--to be used in support of a medical equipment company.  Well, I'm guessing that--for whatever reason--either she or her employer told the company to stop doing that.Luckily for the sake of American commerce, the company was quickly able to find a replacement. ...

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With insurance available, ED visits rise

My friend and colleague Peter Smulowitz and co-authors have documented what many of us noticed anecdotally at the time.  Looking at Massachusetts following the introduction of universal health insurance coverage, they found:Compared with the 2-year period before reforms started to go into effect, emergency department visits increased by up to 1.2% during the 1-year implementation and by up to 2.2% during the 2-year period after reforms were...

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Sherman Award deadline is this week

Reminder: Friday, March 28 is the deadline for submissions to the Sherman Award for Excellence in Patient Engagement.  Details he...

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Patients with complex needs on WIHI

Madge Kaplan writes:The next WIHI broadcast — ​Bright Spots for Patients with Complex Needs — will take place on Thursday, March 27, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:John W. Whittington, MD, Lead Faculty, Triple Aim Initiative, Institute for Healthcare ImprovementCrispin Kontz, Manager, Support and Clinical Systems, Alberta Health...

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Lean comes in small doses

The concept of Kaizen--small, incremental improvements--is at the heart of the Lean philosophy.  But small does not mean meaningless.  Each such change offers the chance to deliver better service to the customer and/or provide better working conditions for the staff.Thus, when I see examples of Kaizen in action, I smile.  The changes are the result of concerted...

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The spread of Lean in Den Bosch

We're back in Den Bosch at Jeroen Bosch Ziekenhuis for the next phase of Lean training workshops for senior adminstrative and clinical leaders.  Our first session always includes the Toast Kaizen video, featuring GBMP's Bruce Hamilton.  It never fails to generate laughs from the crowd as Bruce fumbles his way through a series of process errors making toast for his...

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It could have happened to anybody

My rule of thumb is that when an error is made and you can say, "It could have happened to anybody," there is a systems problem behind the error.  Here's a story that demonstrates this so clearly, courtesy of our friends at MedStar Health.As you watch the video, imagine the more common scenario in hospitals, where the clinician is blamed and where the underlying problem goes unsolved.Thanks to Annie for sharing her sto...

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Congestive Heart Disease Information

Congestive heart disease is a physical disorder in which the heart no longer pumps hard enough. Since the heart pumps weakly, blood can back up into the lungs, liver, gastrointestinal tract, and extremities. Congestive heart disease is also called congestive heart failure (CHF), cardiac failure, or heart failure. These names can be misleading, since they seem to indicate that the heart has totally failed and that death is imminent. This...

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Leadership doesn't have to be rocket science

My friend and colleague Leah Flynn Gallant has started a website called Engineering Leadership Development, with the subtitle "Because leadership doesn't have to be rocket science."Leah helps run a number of leadership training programs for MIT students and has a lot of interesting observations on the subject.  Please take a look and give her some feedba...

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Health communications at Tufts this summer

I'm pleased to pass along this note from Professor Lisa Gualtieri, Tufts University School of Medicine, Department of Public Health and Community Medicine:The Tufts University School of Medicine’s 2014 Summer Institute offers three courses critical to staying current with the field of health communication:  ·         Mobile...

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Help Alex go back to the craftsmanship of printing

Our buddy, Alex Green, the owner of a great independent book store in Waltham, MA, is asking for help with an Indiegogo project.  Please take a look!He writes:Helping an indie-bookshop owner step into the future by taking a step into the past...Hello, my name is Alex Green.  I own a small, independent bookstore just outside of Boston.  For over five years, I've published authors the oldest way it can be done, using letterpress machines...

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Spear Webinar: Competing at Speed in a Fast-Moving World

Webinar–'Gap-Filling Organizations': Competing at Speed in a Fast-Moving World MIT SDM Systems Thinking Webinar SeriesSteven J. Spear, D.B.A., M.S., M.S., Senior Lecturer, Engineering Systems Division and Sloan School of Management, MITDate: March 24, 2014Time: Noon – 1 p.m. EDTFree and open to allRegister About the Presentation Determining, documenting, and...

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Next case: Just one doctor this time.

We've spent a lot of time recently focusing on how high-ranking people decided to let a private medical device company use the name and reputation of the University of Illinois in support of its product.But there are smaller versions of this happening all the time.  These cases raise the same set of issues:  How can the public have trust that a doctor who has publicly...

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Business, as usual

A story in HealthLeaders Media by Marianne Aiello asks "Can University of Illinois Hospital Save Its Brand?"A decision by hospital leaders to participate in an advertising effort with an equipment vendor was intended to promote institutional expertise with robotic surgery. Instead it sparked an outcry among critics.Despite the countless blog posts, tweets, and articles published about the University of Illinois Hospital & Health Sciences...

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Leaders have a responsibility to set an example for others in their institution

I'm going to take advantage of the delay of the promised report containing "a methodical assessment of policies, guidelines, procedures and practices" concerning the University of Illinois ethics matters to send the University folks a helpful reference document.Entitled "Conflict of Interest Policies for Academic Health System Leaders Who Work With Outside Corporations" this article in the Journal of the American Medical Association states:New “Sunshine...

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T + 3 and counting

The report to the President of the University of Illinois from the Vice President for Research was due on March 15.  That's three days ago.  Many are waiting.The report is to supposed to evaluate the circumstances surrounding the use of the University's name and reputation in support of a private medical equipment supplier.  Recall that the VP was charged...

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The Courage Muscle. Free again.

These balloons always garnished Monique's house on St. Patrick's Day, when she and her family would invite friends and neighbors to celebrate the holiday.In honor of the day, here's a repeat of a post from last year.  Michael and I just found a few dozen more copies of the book.  If you'd like one, free, just leave a comment with your full name and snail mail address.When...

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A new way to get spammed

Just what we needed, getting advertisements as text messages on our cell phones.  It's one thing for the cell company to try to sell you an enhanced service plan or something like that.  It's another to try to sell you a music album.At least they don't charge you extra to be bother...

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A fraud, but not a villain. What about us?

Bruce Ramshaw, a surgeon from Daytona, FL, has spent a lot of his career exploring the ramifications of complexity science.  In this article in General Surgery News, he offers some observations worthy of attention.He starts with a story:In September 2010, a 44-year-old academic superstar was named dean of the Tilburg School of Social and Behavioral Sciences faculty at Tilburg University in Tilburg, the Netherlands. Just one year earlier,...

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Saskatchewan leaders take sides on Lean

I want to make clear that I am not taking sides in the internal political debates of another country, but I think it is instructive for all to watch a current scuffle in Saskatchewan.Several years ago, the provincial government began an effort to adopt the Lean process improvement philosophy in the health care facilities across the province.  This was to require a large...

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Seeing America, the old way

Lee Crites has recently begun a nine month journey walking across America.  When his three daughters asked why, he gave ten reasons:10. I want to go back to San Francisco and I'm tired of driving.9. I need to lose 20 pounds.8. There are millions of great people out there and I want to meet some of them where they live. 7. "A virtue to cover a multitude of sins" - Horace...

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A plane crash every day

Every day that has passed as they search for the wreckage of the Malaysia Airline plane, another plane has crashed in America.  Well, better put, the equivalent number of people have died every day from preventable harm in America's hospitals.Which story gets our attention?  Which is the greater public health hazard?Remember Captain Sullenberger's words as he remarked on the scattered application of systemic approaches to safety in the...

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Inspiring

I missed this story a couple of years ago about a boy from Sierra Leone, although it was just recently reposted.  If you haven't seen it, I think you'll be inspired when you watch the vid...

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Hypertension guidelines on WIHI

Madge Kaplan writes:The next WIHI broadcast — How High? How Low? Shared Decision Making Amidst Shifting (Hypertension) Guidelines — will take place on Thursday, March 13, from 2 to 3 PM ET, and I hope you'll tune in. This is a special collaboration with the Journal of the American Medical Association that we're calling JAMA on WIHI: An Online Audio Forum on...

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