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Article Revised: April 26, 2019
Lisa Strong had a history of kidney stones and suspected that the sharp pains she was experiencing was caused by yet another kidney stone. She told the ER Nurse this. But instead of treating the kidney stone the healthcare professionals responsible for Lisa’s care proceeded on a course of treatment that was to ultimately cost her both legs below the knees and both arms below the elbows.
Lawyers involved think so many mistakes were made the jury had a hard time fixing blame.
As an industry, healthcare has been remarkably reluctant to utilize the process improvement tools provided by Lean, Six Sigma, and other quality and process improvement methodologies. These technologies have proven to be extremely useful in defining and improving processes in a diverse range of industries. Indeed, I am personally aware of several successful applications of Six Sigma in healthcare. Results include:
- A reduction in central line bacteremia infections from over 17% to under 1%.
- A reduction in unnecessary Cesarean Sections resulting in reducing the over all C-section rate from 30% to 18%.
- 98% of hypertension patients achieving control of their condition for a group of 50 PCPs. (The national average hovers around 30%.)
- A DMAIC project that dramatically decreased time from arrival to initiation of Percutaneous Coronary Catheterization and Intervention. The new process meets recommended guidelines for nearly all patients.
- Dramatic reduction in the number of Medicare patient hospital readmissions.
- And many, many more.
True story: My wife observed her sister’s physician come into her room, shake hands with family members, then begin to change the surgical dressing on her sister’s wound. When she asked the doctor if he shouldn’t wash first he replied that it wasn’t necessary. (News flash for physician: it is necessary.)
Given the outstanding success of Six Sigma and other methods in improving the quality and cost-effectiveness of healthcare, it is a disgrace that the healthcare field continues to embrace outmoded approaches to healthcare delivery based on the “physician as magician” model. The costs in terms of dollars and human suffering is staggering. Let’s all hope that the profession sees the light soon and begins to take the oath”First, Do no harm” seriously. Until they do, it is patient beware.
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