Three reports released last week by the Institute of Medicine confirm that. As The Washington Post summarized it, “Emergency medical care in the United States is on the verge of collapse.” Dangerous overcrowding and an inability to provide necessary expertise to treat patients in a safe, timely and efficient manner are the main reasons.
The report recommends that Congress should create a new federal agency and spend billions of dollars to fix the problem.
That is the worst possible recommendation, because it is not a solution. Another federal agency is precisely what is not needed. What we need is “Systems thinking.”
What is “systems thinking”? As described by veteran reporter Lloyd Dobyns in a new documentary for Public Television that has received some airings, but needs to be viewed more widely, “systems thinking” is “basically how you see things. Instead of seeing a huge mess with one problem piled on top of another, you see differently. You see with what people call ‘new eyes.’ You see how you and your work fit into the system, and how you and your work connect to the other people in the system.”
This is not theory. It is being tried at several hospitals throughout the country, reducing patient waiting time, dramatically cutting costs and delivering quality care to patients, making them happier and healthier. It has also resulted in doctors, nurses and other hospital workers enjoying their jobs more instead of worrying about other things. With systems thinking, the patient comes first and when that happens, other concerns take care of themselves.
This is what is known as the “Toyota model.” When one focuses on the person or customer and his or her satisfaction, profits and efficiency result.
The PBS documentary, titled “Good News: How Hospitals Heal Themselves,” shows how St. Joseph’s hospital in St. Charles, Mo., adopted “systems thinking,” dramatically improving its emergency care. Simple things like moving the X-ray room closer to the emergency room, allowing doctors to get their X-rays faster; or coordinating with housekeeping so that a room is clean when a patient needs it, thus reducing waiting time, has substantially reduced costs, increased efficiency and contributed to patient satisfaction.