IWantGreatCare advances the Lean agenda

I don't think Neil Bacon (of IWantGreatCare* fame) meant to reinforce one of the main tenets of Lean process improvement in a recent blog post, but he did do so. I also don't think Neil meant to enhance the Lean philosophy by adding a new key dimension, but he did that, too.  Let's start with his story from University Hospitals Morecambe Bay Trust:

The senior nurse from the surgical unit recounted to her colleagues how last week an elderly patient had used his iPad, from his hospital bed, to provide feedback on his care, highlighting a problem and concern he had using the iWantGreatCare pages for the hospital.

The nurses on the wards are able to receive instant alerts if there are concerns that need addressing for their ward – and thus the nurses were instantly made aware of a problem. Interestingly, in his comment the patient said something along the lines of “this needs sorting at some point, but I don’t want to interrupt anyone now”. Whilst the comments on iWantGreatCare are anonymous there were not many elderly patients sitting in bed with iPads! Thus the nurse was able to go directly to the patient and say “Let’s solve that problem now”.

I am told that the patient (who is still in the hospital) was completely amazed, not really expecting anybody to do anything ever, let alone seconds after he had given his feedback – this was not what he had come to expect from the NHS! Not only was the problem fixed, but the patient has been telling all his visitors and family about the incredible hospital and how the staff really listen, really care and get things fixed. His confidence is high, as is the morale of the staff who see people talking about the great care they deliver.

Lean is about front-line driven process improvement.  We encourage staff to call out problems they see in their work environment, and then managers "swarm" on those call-outs--in real time--and invent experiments that might improve the situation.

Here, though, we've gone a step further.  Here, the patient has been added to the front-line team by being given a simple technological approach that permits him/her to be empowered to make the call-out.

Whether Neil knows it or not, he just advanced the science of process improvement in the health care environment by one great leap forward. Well done!

--
* Think TripAdvisor for health care to get the concept.

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Terry Wise shares

Terry Wise is an extraordinary person--wise, empathetic, warm, thoughtful, and vulnerable.  She shares all these attributes with us in her book Waking Up, but she shares the benefit of her work with others through The Missing Peace Foundation:

The Foundation provides financial assistance, public speaking and other resources to entities that lack funding to advance their efforts to help those confronted with mental and physical health issues. Qualifying recipients include organizations, communities, schools, and other associations who aspire to raise awareness and educate others on topics related to long-term caregiving, grief, depression, mental health, suicide prevention, and the process of recovery.

Please check out the website to see if the foundation might be able to help your organization, or whether you might feel moved to contribute money to help the work of the foundation.

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"Wounded" comes to America

Emily Mayhew's book Wounded, about which I wrote in early October, is now available in the United States through Amazon.  This is simply the best book I have read about World War I, the 100th anniversary of which occurs this coming year.  It tells the intimate stories of doctors, nurses, and other medical personnel assigned to the front during this terrible war.

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How the British Empire lives on

From The Times of London, a new type of Advent calendar!

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Leadership Skills on WIHI

Madge Kaplan writes:

The next WIHI broadcast — New Leadership Skills for Better Health and Health Care — will take place on Thursday, November 21, from 2 to 3 PM ET, and I hope you'll tune in.

Our guests will include:

• Gary R. Yates, MD, President, Sentara Quality Care Network; former Senior Vice President and Chief Medical Officer, Sentara Healthcare
• Lee Sacks, MD, Executive Vice President & Chief Medical Officer, Advocate Health Care; Chief Executive Officer, Advocate Physician Partners
• Derek Feeley, Executive Vice President, Institute for Healthcare Improvement
• Andrea Kabcenell, RN, MPH, Vice President, Institute for Healthcare Improvement

IHI has been doing a lot of thinking of late about leaders and leadership… in particular the skills, behaviors, and outlook necessary to steer today's health care organizations toward a very different future. A new IHI white paper (working title: High-Impact Leadership) will be out before the end of the year that captures this complex transition. Among other things, it offers a new framework for leaders who are not just responsible for making change manageable, but enthusiastically supported by all staff. You can get an early look at the new leadership framework on the Nov. 21 WIHI: New Leadership Skills for Better Health and Health Care. One of the goals of this WIHI is to describe the interdependence between the growing focus on population health, the shift from volume to value, and the corresponding leadership skills required to address these challenges. 

At Advocate Health Care, Dr. Lee Sacks has been hard at work learning by doing, with the help of other physician leaders. He’ll explain in concrete terms what his team’s leadership practices look like day to day, including those needed to lead an Accountable Care Organization (ACO). Sentara’s Dr. Gary Yates will spend his time on WIHI outlining key leadership behaviors that signal to staff how change is going to come about and what’s expected of everyone. If leaders want to alter the perception that they alone have all the answers, hashed out in some corner office, they must become a regular, approachable, and authentic presence throughout the organization. Discussions in the hallways talking with staff, and learning from patients and patient stories, need to become the norm.

Fresh from his leadership perch at NHS Scotland, IHI’s Derek Feeley has been thinking hard about what’s applicable and relevant to the US context and in many other countries seeking better health and health care for their citizens. He, along with Andrea Kabcenell, will discuss how leaders can better manage and prioritize all the tasks necessary to succeed. WIHI host Madge Kaplan invites you to put on your leadership cap wherever you reside in your organization, and take part in this next discussion on Nov 21. Tell us what you’re doing to lead differently, with a different future in mind, and what impact this is already having.

I hope you'll join us!  You can enroll for the broadcast here.

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I have no way of knowing whom I may have hurt

A colleague writes with a thought-provoking story:

As is often the case, learning the meaning of something can happen well after the actual events that precipitate our own maturation.  So it was for me when my mother developed a growth on her esophagus just before her stomach, in the fall of 2009.

My mother was scared and my father was trying not to appear scared.  Together, they were preparing themselves to be lead by the healthcare system in the discovery of exactly what my mother was afflicted with and how it would be treated.  Having started my life in healthcare 29 years ago, working then as an X-ray Technologist, it took no time for me to launch into an effort to assist my mother and father in navigating through this event.  The reflexive urge I felt to help is well known by all those who work in healthcare.  As healthcare professionals of all disciplines, we know, that despite the best intentions and the best training in the world, there is no predicting how a health episode will go.  Nor is there an outcome that can be reliably delivered.  

After some phone calls by me, my mother was seen, biopsied and got her results well ahead of the typical time frame for these millstones of care.  She also had the benign growth removed well ahead of what would have been normally scheduled.

When I recount my efforts to help my family, with my friends and acquaintances, who also work in healthcare, every person affirms they would do the same for their spouse, children, family members and friends.  Normally, this affirmation is heartily expressed like those who are part of an exclusive club.  It was not until earlier this year that I was struck with a profound sense of guilt as I reflected on my actions.  I most certainly delayed the care that would have otherwise been given to someone with a malignant growth.  Someone who my mother and father, knowing her growth was benign, would have gladly had go ahead of them.  I have no way of knowing whom I may have hurt or if my actions had no consequence at all.

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Aim for muscle fitness

My friend, colleague, and neurologist Seward Rutkove has invented several new fascinating medical devices.  One of these--Aim--is designed for the general marketplace (as opposed to medical clinics.)  He and his partner have started an Indiegogo campaign through which you can support the introduction of this device, plus get one for yourself.  What does it do?

Press Aim against any major muscle to measure the fat percentage and muscle quality (MQ) for that muscle.

• Each measurement takes less than a second and results are immediately displayed
• By measuring four muscles (biceps, triceps, abs, and thigh), you get an accurate estimate of your total body fat percentage and MQ
• Aim sends your results to an online dashboard via Low Energy Bluetooth
• You can review your results on the online dashboard to track progress and get tailored fitness advice

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