A matter of life and death

April 17, 2012 - | Filed under: Lean thinking


Call it human nature, but there are few feelings in the world better than the relief of exoneration, in matters big (a courtroom comes to mind) or small (a fender-bender comes to mind). We all hope for it and that connecting of the dots, that sudden calming of a fast-beating heart is hard to beat.

Lean thinking, then, comes as a bit of a buzz-kill as it teaches us to avoid directing blame and take responsibility as a group instead. This concept came to mind in a recent Q&A I conducted with a pair of professors in the Fisher College of Business’ Management Sciences department. Drs. Aravind Chandrasekaran, pictured left, and Kenneth Boyer worked with graduate student Claire Senot to examine the relationship between the quality of hospital care and patient satisfaction as organizations work to reduce medical errors and keep in step with government regulations. What they found: Those efforts to “chase zero” might work, but that comes with a trade-off in the patient experience.

This is touchy ground. On the one hand, who cares if you’re not smiling and satisfied as long as you leave the hospital in one piece? On the other, as an insurance-toting “customer,” aren’t you entitled to top-notch, error-free care in and out of the operating room?

Boyer (pictured left) in the Q&A offered a fascinating take on how the overall patient experience has become a metric along with clinical quality, one that will be directly linked to federal reimbursements starting next year. In the culture of medicine, a natural defense mechanism is to – yep – seek exoneration in seeing a patient death as an unambiguous result of illness. Over the years, however, it’s been more recognized that while some patients will die even if they do get “perfect” treatment, preventable errors also exist. With this realization, health-care providers can’t just pretend clinical quality is near-perfect, so it’s harder to brush off other problems that lead to less-than-thrilled patients.

“Revealing that there are excellent opportunities for improving one dimension leads to a realization that the other can be too,” Boyer wrote.

Process improvement, when done right, is infectious – pun intended.



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