St. Joseph’s set a time limit of 30 seconds for an emergency room patient with life- or limb-threatening symptoms to be seen by a health care professional. All others would be under active care within 30 minutes of arrival. At the time of the filming, St. Joseph’s performance record for these goals was 90 percent. They even hired a “hospitality person” who keeps patients informed as to what is happening, again contributing to patient contentment.
Lloyd Dobyns says, “You have to see the whole hospital system. You have to see how blaming people does not help. You have to see how to practice continual improvement.” At St. Joseph’s and at 40 hospitals in the Pittsburgh area, which the producers also examined, everything is focused on the patients. “It is not focused on reducing staff, reducing costs, or improving profits,” says Dobyns. “But as you focus on the patients, all the other things occur naturally. You want to help the hospital? Help the patients.” In hospitals where “systems thinking” is used, health care costs have been reduced by as much as half.
This proven system does not require more staff or expensive consultants and it certainly does not need another bureaucratic, costly and inefficient government agency, which can only make things worse. Improvements can be made, says Dobyns, starting today and in every hospital in the country. Costs will decline. “So the question now becomes, can we afford not to heal our hospitals? We can, if we want, not do anything. But if we decide not to do anything, we have to accept that every day — every day — 500 people will die in hospitals in the United States who did not have to. You and I might be among them.”
Co-producer Clare Crawford-Mason (the late former NBC News president Reuven Frank was the other co-producer) tells me systems thinking also works with schools if students become the focus and not cost, buildings or even teachers. It works anywhere and can liberate us from big government. In fact, says Crawford-Mason, some government agencies that have adopted this Toyota model are already showing dramatic improvements. If ever there was an idea whose time has come, this is the idea and this is the time.
Local PBS stations can be contacted and encouraged to run this documentary. For more, visit www.managementwisdom.com.
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