Comments for Chasing the Rabbit by Steven Spear

Comment on Measuring Therapeutic Effectiveness and Cost–One Part of Better Care for All by Joel

Joel — Sun, 08 Nov 2009 21:54:26 +0000

For measuring and rating health care the biggest obstacle might be the fact that no one reports honestly in medicine, and almost no one in health care is aware of that. For instance, surgeons write their own post operative reports and routinely declare them to be perfect with no complications even when permanent disabilities were the result. The way around that is to get the information from patients - epidemiology through crowd-sourcing. If you have a 12-year-old with diabetes, you could learn where other families with the same problem got help at what cost. If we get that information from experts reviewing medical records, we will never learn the most important information. For instance, no physician writes in the record that he/she was inebriated at work. Nurses almost never note that either. That can be learned only from the parents of the children who smelled his breath, listened to his slurred speech and watched him stumble.

Comment on WSJ: The Informed Patient: Hospitals Admitting Errors is a small step towards better quality, cost, and access… by Joel

Joel — Fri, 16 Oct 2009 03:37:51 +0000

If you think that some hospitals have achieved near perfection in eliminating patient harm as an occurrence, I have a few studies to show you. Adverse events in medicine are reported only 1.5% of the time. Looking at the record created by the health care professionals who don’t report makes them look perfect. But they are not. See: http://patient-safety.com/Medical.Reporting.htm
Requiring public transparency from people who won’t report the problems in the first place isn’t likely to result in anything substantive.

Comment on Rage at Government for Doing Too Much and Not Enough by Retail Sales Drop on Fall in Autos and the Role of Government in Economic Policy…. | Chasing the Rabbit by Steven Spear

Thu, 15 Oct 2009 22:57:42 +0000

[...] a previous post, I suggested public sentiment that government does too much but not enough is not contradictory. [...]

Comment on Bio by Get Lean and Prosper » Blog Archive » Silver Bullets and Easy Answers — Always Appealing

Thu, 08 Oct 2009 13:40:54 +0000

[...] focus of a few class sessions, including guest lectures from MIT’s Deborah Nightingale and Steve Spear. It’s great that Lean is being given such [...]

Comment on 20 Years After “The Machine That Changed the World,” Why No 2nd Toyota by Jim Drennen

Jim Drennen — Sun, 04 Oct 2009 21:27:58 +0000

Tha Japanese, and Toyota especially, get this: “Managers need to quit treating common cause variation as if it was special cause variation.” Say that to a mid-to-top level Japanese manager at a decent-sized company, and you would receive affirmation. Say that to most U.S. managers, and they would go looking for a Greek dictionary. Two major culprits to the current mess: 1.) our management education system or lack thereof; 2.) how we measure and reward managers. Re-read Deming; he had it figured out.