These meetings go on forever…

Health care needs this, pronto.  PSFK:

London based Industrial design studio ico created this table that helps office workers keep an eye on the length of their meetings. A twist of a dial sets the length of the meeting at the start and then ten illuminated panels appear on the surface of the table, each panel representing a tenth of the meeting time. As the time passes, panels are switched off and a sound is played.


Insurance company, clinic play nice

Look! Over yonder!

“Minnesota nice” has brought an insurance company and a provider together to work on reducing, yes reducing, costs:

So Eustis and Tilford struck a deal. The insurance company agreed to provide an undisclosed amount of money to help Fairview — Minnesota’s second-largest health care provider — move from fee-for-service billing to a system based on fixed payments. Tilford says it was by no means a gift to Fairview.

“I was very clear that we would make investments, and that those investments should produce changes in the way care was delivered,” Tilford says.

Eustis, for his part, says Medica took a carrot-and-stick approach with Fairview: “If we don’t perform, we’re going to get less. If you perform at a higher level, you’ll be able to get additional payment.”

The idea, says Eustis, was to keep patients well — by spending more on them when they’re healthy, with the aim of reducing costly illness.


Does health care need to follow this path?

What kind of company declares itself uninterested in maximizing profit? “Companies looking to maximize revenue need to throw as many revenue-generating opportunities at users as they will tolerate,” Buckmaster says. “We have absolutely no interest in doing that, which I think has been instrumental to the success of craigslist.” (Wired)

Just asking.  It could actually turn into a really interesting discussion.

Health Care Should Be designed with you

A new project for your participation!

Health Care Should Be:

This is a collaborative effort in discovering ideas to improve the parts that make up health care delivery (the whole).

American medicine is good, very good. But it’s only a part of the health care experience.

Talk to almost anyone who has encountered the health care system and you’re likely to find a past disappointing experience. It might have been a lack of parking. Or getting lost navigating the hallway. Or a poor interaction with a nurse or doctor. Or an incredibly long wait. Or trouble getting your PHR to interact with the hospital’s EMR… (okay, so predicting future problems is a part of this project too).

Every day a lot of people go to work to improve health care. But there’s something lacking in the approach: the opinion of the patient.

This project in reimagination is a collaborative one. An effort, if you will, to describe a health care utopia. Share your personal opinions. Or a link to an article describing an improved registration process. Or a superior customer service story from a retailer. Or an image of a product that should be used. Or embed video of technology that could be implemented. Or a quote to provide perspective.

The information here provides only a frame for your suggestions. Don’t hold back. Share anything you feel is important, relevant, or worth pursuing. Share as much as you want, can, and/or need.
The end goal of this project, at some point in the possible future, is to implement these ideas.

Go! Now! Share!

Transferring culture

Noah links to this Nike article.  A nice tidbit on culture and organizational values:

It’s an inevitability that most companies the size of Nike will eventually lose touch with the core values instilled by their founders. It has arguably already happened to Google in a much shorter space of time. However, Nike’s philosophy of ‘innovation and inspiration’ is still present in absolutely everything it does.

Nike employs over 30,000 people.  Maybe it’s because of the traditionally siloed, hierarchical structure of health care organizations, but it doesn’t take size like Nike’s to lose touch with cultural values.  The inevitability of progress combined with the struggles of change make staying true to original intentions difficult.  Here’s how Nike does it:

Ekins are official company storytellers employed to evangelise about the Nike brand and its sports technology. Before being unleashed on the world, Ekins are required to undergo an almost military-like training regime comprising a nine-day rookie camp at Nike’s headquarters in Oregon and a full day’s running at the Hayward field track where Bill Bowerman worked as a track coach. Almost unbelievably, as a further sign of their devotion to the brand, each Ekin is then invited to have the Nike ‘swoosh’ tattooed on their ankle ahead of their ‘graduation’.

Hmmm, tattoos…

Stop your screaming, the expert’s lesson

Seth’s sensemaking is brilliance.  But we all know that.

If you want to challenge the conventional wisdom of health care reform, please do! It’ll make the final outcome better. But if you choose to do that, it’s essential that you know more about it than everyone else, not less. Certainly not zero. Be skeptical, but be informed (about everything important, not just this issue, of course). Screaming ignorance gets attention, but it distracts us from the work at hand.

It’s easy to get started assessing the patient experience

It’s easy to assess (and improve!) the patient experience in existing inpatient and outpatient facilities. Here’s how, with inspiration from Matthew May, to improve an organization’s focus on empathy.  First things first, drop the data (just for now and only for a moment…)

  1. Observe a patient(s). Ask a patient if they’re open to being followed during their entire visit/stay.  An easy way to start would be with a planned admission.  Proceed cautiously with a patient who first presented to the emergency room. Outpatient facilities should provide several opportunities in a single day.
  2. Become a patient. One way is to actually become ill and require health care services.  Sometimes that’s realistic, sometimes not.  The other is to become a patient just for the day.  Pluses and minuses for both, but an actual immersion into a patient’s shoes is the best way to experience health care.
  3. Include the patient(s). This is easy, too.  Plenty of people are willing to talk to just about anyone about their health care experiences.  Ask a patient or a group of patients to participate in a focus group.  Structure the conversation—but not too much; this is about listening to the patient’s observations, thoughts, wants, and desires.

There it is.  Three easy ways to start assessing the patient’s experience.  Start changing what can be changed tomorrow.

Swapping supplies.

Paul Levy with a simple (read: great!) idea:

We plan to have a general office supply swap for the hospital soon, but I thought I’d run an experiment in the meantime. It is based on my community experience running a soccer cleat exchange. I created the “Presidential swap shop” in the corridor near my office, which is within eyesight of a highly trafficked thoroughfare. The sign says, “Take what you need, leave what you don’t.” Already, within a couple of days, there has been a dramatic amount of trading activity.

Here comes Peter…

Just saying (Laurence Peter, Peter Principle):

Peter pointed out that in large organizations where these practices are used, it is inevitable that individuals will be promoted until they reach their level of maximum incompetence. The unavoidable result is the runaway spread of incompetence throughout an organization.

Now Pluchino and co have simulated this practice with an agent-based model for the first time. Sure enough, they find that it leads to a significant reduction in the efficiency of an organization, as incompetency spreads through it. That must have an uncomfortable ring of truth for some CEOs.

Solution?  Two show promise:

The first is to alternately promote first the most competent and then the least competent individuals. And the second is to promote individuals at random. Both of these methods improve, or at least do not diminish, the efficiency of an organization.

Or a third, luck?

Strategic Guessing

Serendipitously, the planning quotations keep showing up.  It’s great!  From 37 SignalsSignal vs. Noise blog:

Why don’t we just call plans what they really are: guesses. Unless you’re a fortune teller, long-term business planning is a fantasy. There are just too many factors that are out of your hands: market conditions, competitors, customers, the economy, etc. Writing a plan makes you feel in control of things you can’t actually control.

In fact, you might as well change the name of your business plans to business guesses, your financial plans to financial guesses, and your strategic planning to strategic guesses. Do that and you’ll probably start putting a lot less weight into those things.

That thought inspired by a pair of academics, Ian MacMillen and Rita Gunther McGrath, who amongst other things say, “It’s not failure that companies need to avoid, but rather failing expensively.”  Failure is good.  It’s learning.  More importantly it’s not planning, it’s doing.