36. Get out of health care

The complications of delivering health care often demand customized solutions.  But that doesn’t mean we need to depend on the ideas inside of our walls for inspiration.  We could do a lot to improve ourselves if we just looked beyond our doors.

Memorial Hospital and Health System in South Bend, Indiana has been doing just that for years.  There are plenty of examples of organizations getting out of this industry to improve what’s going on inside.  Here are a few.

Memorial has taken an innovation model from industry:

Back in 2000, [CEO Phil] Newbold and Memorial’s Vice President of Marketing, Diane Stover, searched for innovation models within health care and found none. “There was a time, a change would come from Medicare or another funding source and our leadership team would react rather than stick to a plan,” Stover stated. “We launched this initiative to spark positive changes and increase control of our destiny.” Newbold led the charge to engage all 3,800 employees in an understanding of the many challenges facing them and of a commitment to innovative thinking and solution prototyping. The first step was visiting innovators like Whirlpool, 3M, DuPont, W.L. Gore, GE, and Procter & Gamble.

Others have taken checklists from pilots:

In 2001, though, a critical-care specialist at Johns Hopkins Hospital named Peter Pronovost decided to give it a try. He didn’t attempt to make the checklist cover everything; he designed it to tackle just one problem, the one that nearly killed Anthony DeFilippo: line infections. On a sheet of plain paper, he plotted out the steps to take in order to avoid infections when putting a line in. Doctors are supposed to (1) wash their hands with soap, (2) clean the patient’s skin with chlorhexidine antiseptic, (3) put sterile drapes over the entire patient, (4) wear a sterile mask, hat, gown, and gloves, and (5) put a sterile dressing over the catheter site once the line is in. Check, check, check, check, check. These steps are no-brainers; they have been known and taught for years. So it seemed silly to make a checklist just for them. Still, Pronovost asked the nurses in his I.C.U. to observe the doctors for a month as they put lines into patients, and record how often they completed each step. In more than a third of patients, they skipped at least one.

Some have borrowed barcodes from grocery stores:

The next time you need medication at Medical Center Hosptial don’t be surprised if a nurse asks you to hold out your arm. This month, nurses started using a new bar-code technology to make sure the right medicines get to the right patients.

“All that information is right there on the computer so they don’t have to go back out to the nursing unit and gather that information from a paper chart,” Sharon Nash, the Horizon Admin-Rx project manager, said.

Memorial calls them inno-visits.  You can call them what you want.  The important lesson here is that we realize the extraordinary benefits that come with looking beyond health care, the inspiration that comes with a change of scenery.

The problems of health care are many, so numerous that one could sit in an office the entire day reading and prophesying about nothing but health care.  Time better spent would be to visit/read/listen/do/join/experience anything outside of this industry.  Your next great idea may come from an experience at a NASCAR track, in the chat of an art historian, from the pages of a great book, or on a visit to Method.  Seriously.

Principle 36: Every decision maker at our own system will be “strongly encouraged” to get out of health care, if only for moments on a daily basis.  The concept of looking beyond our walls will play a significant role in transforming our health care system, indeed it already is.