Lean Improvements for Patient Safety

Making preventable harm a priority for continuous improvement

Do all employees in healthcare understand how their jobs link to patients in some way? If they do, then they are more likely to know the importance of service excellence.

Does every leader, physician, and employee know the statistic that preventable medical errors are the third leading cause of death in the United States? If they don’t, then they aren’t aware of the severe disconnect between service excellence and preventable harm. Organizations that are truly focused on service excellence realize the necessary connection to system-wide process improvement.

To make sustainable improvements, individuals must first be made aware there is a significant problem and that it needs attention every single day with every patient. This heightened awareness helps them see the link to co-workers and other team members and be more willing to speak up in honor of a shared vision to reduce preventable harm.

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Comments

Do they work to improve safety or argue about the data?

"Does every leader, physician, and employee know the statistic that preventable medical errors are the third leading cause of death in the United States?"

They might know that study, but they also might put more effort into debating the accuracy of the studies and extrapolation by Makary and others that led to the 440,000 Americans per year number.

Even if the number is 44,000 Americans dying each year due to preventable medical error (the lower range of earlier estimates), that's a huge problem.

I agree that hospitals need to focus on their most important problems first. Too many hospitals focus on traditional cost-cutting and efficiency as a goal (or they mislabel their layoffs and cost cutting as "Lean").

Patient safety, employee safety, and quality need to be the TOP priorities.

In manufacturing, the Lean dogma says "overproduction is the worst form of waste." That might bankrupt a company, but it probably doesn't kill anyone.

In healthcare, the waste of defects, harm, and errors isn't just a business issue - it's a moral issue and a public health issue.

Quality starts in the boardroom?

Thanks again for your piece.

One other thought:

"What could possibly be more important than keeping patients safe? It is not just the role of physicians and nurses; it is everyone’s job."

Everyone has a role to play, but would you agree with Dr. Deming's assessment that quality (and safety) start in the boardroom?

We can't just tell nurses, pharmacists, and other front line caregivers that they are responsible if leaders don't (as you said) lead by example AND create a system that allows people to be successful.