Wednesday, February 9, 2011

Speaking and Listening

If you were granted five minutes with any individual or group to improve healthcare in the U.S., where would you go and what would you say?  With so little time, you’d want to find the fulcrum--the leverage point to amplify your message.  Perhaps a physician group, for they order the tests and procedures that make our healthcare the most expensive in the world.  Perhaps hospital administrators.  Those tests and procedures are done in their facilities.  Would you “raise your voice” and implore them to inject “quality” into their healthcare practices?  What does “quality” look like?  How much does it weigh? 

Used to be that quality meant statistical analysis of assembly line output.  Then Deming pointed his finger at management.  Today, we hear about process improvement, LEAN, and TPS.  Then, there are dashboards and Six Sigma and myriad other tools.  So which is the magic bullet?  The key to success.

Rene Dubois, the shepherd of the French anti-smoking efforts talked about the variety of initiatives his group had done over many years to achieve a notable and unlikely success.  Someone asked what was the most important factor--the key to success, and he replied, “You have to do it all.”  There is no shortcut.  Managers must be nimble and skillful in selecting the right tool at the right moment.   This requires knowledge.  It’s not possible to pull a book off the shelf when you need to do a Root Cause Analysis or produce a Pareto chart to decide where to start.  The knowledge must be available in the minds of well trained employees.

Above all, however, there must be a goal.  We must know what improvement would look like.  Where are we going?  Then, we can employ the tools to get us there.

For this, my five minutes would distill into one minute and no slides:
“Take this as your goal:  Make everything you do cost less next year than it did last year.  Every service, every procedure, every product must cost less than before.  Go forth and do good work."