Posted by steven_spear | Under Innovation, health care, high velocity organizations, organizational learning, process excellence
Tuesday Dec 29, 2009
Bravo to Bob Herbert (”A Less Than Honest Policy,” NY Times, December 29, 2009) for outing this crazy Senate health care proposal. It is exactly as he describes, an elaborate way to tax and spend–to transfer wealth and dependent on setting wage and price controls, both on health care professionals and also on those who need their services.
It will not advance quality, affordability, and access, despite its promises.
The are two real problems in healthcare right now. One is the obvious one for which government is somewhat well suited to tackle. Some people have too few means to meet their own needs. Providing them with assistance is the charitable thing to do. We do that with essentials already: Food, housing, eduction, and some medical. No reason not to get that better.
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Posted by steven_spear | Under Economy recovery, Innovation, health care, high velocity organizations, process excellence
Wednesday Dec 23, 2009
Synopsis: Health care reform is ostensibly aimed at improving quality, affordability, and access. But why is healthcare such an outlier, when most other products and services are characterized by high and ever improving quality, low and ever decreasing per unit cost, and ever expanding volume-the stark opposite of the healthcare experience? The problem is that the delivery of care is typically managed in fashions inadequate for achieving excellence, and markets for health care services are too primitive to encourage and reward improvement and innovation necessary to achieve excellence care delivery.
If Washington really wants to help, it should stop creating Rube Goldberg schemes that largely are about wealth redistribution. Instead, it should focus on repairing health care markets, so health care markets can repair the delivery of care.
In the meantime, health care leaders can focus on improving the delivery of care. Then they can advertise to patients and payers when they’ve made breakthroughs in complication-elimination, wait-time reductions, outcome-improvements, and the like, drawing more work to the best providers and denying it to the least capable.
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Posted by steven_spear | Under Economy recovery, Innovation, health care, high velocity organizations, process excellence
Tuesday Dec 22, 2009
David Brooks is right (”The Hardest Call,” Dec. 17, NYTimes) and Paul Krugman is wrong (”Pass the Bill,” Dec. 17, NYTimes).
Health care reform is ostensibly aimed at improving quality, affordability, and access. But why is healthcare such an outlier, when most other products and services are characterized by high and ever improving quality, low and ever decreasing per unit cost, and ever expanding volume—the stark opposite of the healthcare experience?
The problem is that the delivery of care is typically managed in fashions inadequate for achieving excellence, and markets for health care services are too primitive to encourage and reward the improvement and innovation necessary to achieve excellence. This penalizes the providers most innovative in achieving excellence and rewards the laggards who don’t.
If Washington really wants to help, it should stop creating Rube Goldberg schemes that largely are about wealth redistribution. Instead, it should focus on repairing health care markets to allow informed choice by patients and reward innovation in delivery by providers, so health care markets can repair the delivery of care.
Posted by steven_spear | Under Innovation, health care, high velocity organizations, leadership and innovation, organizational learning, process excellence
Monday Dec 7, 2009
Dear Friends and Colleagues,
Many are pressured to do the impossible: Increase quality, variety, and sales volume — all while controlling costs.
Some overcome these ‘tradeoffs’ superbly by improving and innovating relentlessly. They see problems, solve them, and incorporate what they discover in ever better approaches.
Others try to do the same, but inadvertently sabotage themselves. They overload in gathering data telling them where to look, but they terribly under equip themselves with information needed to make things better.
For avoiding this mistake and getting the information balance right, please see my new piece, “How to Get the Right Information to Improve Performance,” at HarvardBusiness.Org.
Best wishes,
Steve Spear
Author of Chasing the Rabbit: How Market Leaders
Outdistance the Competition (McGraw-Hill: October 2008)
• http://chasingtherabbitbook.com for preface, forward, and blog.
Other recent writing:
• “Innovation and Workforce Engagement in a High-Velocity World,”
in Quality Magazine.
• “Leadership and Innovation in a Commoditized World,”
e- piece on HarvardBusiness.Org
Posted by steven_spear | Under Innovation, health care, high velocity organizations, leadership and innovation, organizational learning, process excellence
Wednesday Dec 2, 2009
Dear Friends and Colleagues,
Do bad people hurt patients or do bad systems sabotage even good people into hurting others? Fred Southwick take up this question in our new article in December’s
Academic Medicine.
Cascading complications from mismanaged care nearly killed patient “Mary” 15 years ago. In response, her physician husband, Fred Southwick, lashed out at his colleagues in a scathing article in Annals of Internal Medicine for abject lack of professionalism, commitment, and concern for patients.
15 years later, Dr. Southwick and I re examine the events that nearly caused Mary’s demise in “
Who Was Caring for Mary, Revisited,” and reach considerably different conclusions about cause and remediation.
Yes. The physicians behavior and performance appeared awful.
But at nearly every instance, their efforts were compromised by a completely ineffective system. Responsibilities were assigned ambiguously at best, handoffs of information and role were rudimentary and improvisational at most, and work was repeatedly done without clarity as tow what ‘best practice’ would prescribe. No one, no matter how heroic, could hope to succeed consistently.
That leads to wholly different recommendations to improve performance–not to fix people, but to teach them to fix the systems of which they are part.
You can find the article at the link, above. To post comments, do so below. Dr. Southwich and I look forward to hearing from you.
All the best,
Steve Spear