We haven’t written anything on applying OM principles to healthcare recently so here are two quick stories. The first is from Colorado. Denver Health is an integrated healthcare system that serves many uninsured patients. It also has the lowest mortality rate of any academic medical center in the country and was the first healthcare provider to win the Shingo Prize. How did they do it? They embraced lean operations. Here is a report from PBS’s Newshour.Vodpod videos no longer available.
You can find more on what they did to win the Shingo Prize here.
The second story comes from a profile of cardiologist in the Yale Alumni Magazine (The Heart of the Matter, Jul/Aug). Dr. Harlan Krumholz leads the Center for Outcomes Research and Evaluation which tries to identify ways changes in medical practice that can have a meaningful impact on patient care. Here is an example:
The American College of Cardiology and American Heart Association recommend that hospitals perform angioplasty, a procedure that clears blocked arteries using a catheter and a balloon, within 90 minutes of a patient’s arrival. Yet in the mid-’90s, the average “door-to-balloon” time was about two hours. By 2005, hospitals still missed the 90-minute target half the time. “Everyone thought it was impossible to consistently get below 90 minutes,” Krumholz recalls.
But on closer inspection, he and his colleagues found “a small number of hospitals treating people with extraordinary speed.” Teaming with Elizabeth Bradley ’96PhD, a Yale professor of public health and director of Yale’s Global Health Leadership Institute, Krumholz contacted the top performers to plumb their secrets. “None of them were surprised when we called them,” he says. “They all said, ‘Oh, yeah, we’re good at this.’ It wasn’t by accident.”
The researchers interviewed key players and distilled their speed strategies. (One key move, according to Bradley: let the ER docs diagnose a heart attack instead of waiting for a cardiologist.)
This subsequently led to a national program in 2006 to get hospitals to focus on their D2B — i.e., there door to balloon time. Here is what the results look like:
An interesting part of this is the opportunities that are available for experimentation and information sharing in hospitals. While it is hard to imagine competing manufacturer’s sharing their secrets to better performance, hospitals are pretty much obliged to. That means there are many opportunities to learn from top performers.