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Ralph Bernstein 3 days ago
p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in;margin-bottom:.0001pt;font-size:12.0pt;font-family:Arial;} @page Section1 {size:8.5in 11.0in;margin:1.0in 1.25in 1.0in 1.25in;} div.Section1 {page:Section1;} A thoughtful segment on 60 Minutes recently explored the thorny issues surrounding the costs of caring for people at the end of their lives. It struck me that some of those issues relate to lean principles. The story, reported by Steve Kroft, noted that last year, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients' lives – and it has been estimated that 20 to 30 percent of those medical expenditures may have had no meaningful impact. I was particularly struck by comments from Dr. Ira Byock of Dartmouth-Hitchcock Medical Center in Lebanon, N.H., who leads a team that treats and counsels patients with advanced illnesses. By law, Medicare cannot reject any treatment ...
Ralph Bernstein 5 days ago
p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in;margin-bottom:.0001pt;font-size:12.0pt;font-family:Arial;} @page Section1 {size:8.5in 11.0in;margin:1.0in 1.25in 1.0in 1.25in;} div.Section1 {page:Section1;} Can lean strategies help doctors make fewer diagnostic errors? Most healthcare process improvement efforts focus on preventing treatment errors – making sure patients are given the correct course of treatment after a diagnosis has been made. But diagnostic errors also occur, an issue I wrote about nearly a year and a half ago. I’m revisiting that issue now because a new survey has shed some light on diagnostic errors. A group of researchers led by Gordon Schiff, MD, associate director at the Center for Patient Safety Research and Practice at Brigham and Women's Hospital in Boston, asked doctors to describe – anonymously – diagnostic errors they had made or witnessed. Their findings, published in the Archives ...
Ralph Bernstein 8 days ago
p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in;margin-bottom:.0001pt;font-size:12.0pt;font-family:Arial;} a:link, span.MsoHyperlink {color:blue;text-decoration:underline;text-underline:single;} a:visited, span.MsoHyperlinkFollowed {color:purple;text-decoration:underline;text-underline:single;} @page Section1 {size:8.5in 11.0in;margin:1.0in 1.25in 1.0in 1.25in;} div.Section1 {page:Section1;} I’ve often heard people argue that the lean tool of 5S – whose five words are most commonly listed as sort, set in order, shine, standardize and sustain – really ought to be 6S, and that the sixth “S” should be safety. Regardless of where you stand on that debate, if you believe safety is important in the workplace – and everyone should – then you may be interested in Lean Safety: Transforming your Safety Culture with Lean Management by Robert Hafey, a new book we are publishing next month. Hafey, who has 40 years ...Ralph Bernstein 9 days ago
p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in;margin-bottom:.0001pt;font-size:12.0pt;font-family:Arial;} a:link, span.MsoHyperlink {color:blue;text-decoration:underline;text-underline:single;} a:visited, span.MsoHyperlinkFollowed {color:purple;text-decoration:underline;text-underline:single;} span.td {;} @page Section1 {size:8.5in 11.0in;margin:1.0in 1.25in 1.0in 1.25in;} div.Section1 {page:Section1;} Like IBM and HP, Xerox is a technology company that transformed itself from just being a hardware provider into a services company as well. (You may not think of Xerox as a technology company, since it doesn’t make computers, but what else would you call printers, copiers and fax machines?) What is interesting about Xerox is that they promote Lean Six Sigma as an essential part of their expertise. There are plenty of lean consulting firms, but not many (if any) that are focused on document and information management. Xerox ...
Ralph Bernstein 10 days ago
p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in;margin-bottom:.0001pt;font-size:12.0pt;font-family:Arial;} @page Section1 {size:8.5in 11.0in;margin:1.0in 1.25in 1.0in 1.25in;} div.Section1 {page:Section1;} ol {margin-bottom:0in;} ul {margin-bottom:0in;} Hiding mistakes is a bad idea, and definitely contrary to any type of lean or other improvement strategy. You can only improve if you know what you are trying to improve, which means having complete and accurate information about the current process and the problems that are occurring. Not long ago I wrote about a positive trend among some hospitals to admit mistakes – to patients, amazingly enough – and try to learn from them. But on the heels of that information comes a disturbing report from the Hartford Courant that information about “adverse events” in Connecticut hospitals is now rarely available, thanks to revisions lobbyists obtained in state law. ...
