by Lee Fried, on 30 Nov 2006 11:15 am
The Journey
A Cultural Challange
Last night I had dinner with a family member who is in town for cancer treatment. For hours we talked about the challenges of the current healthcare system. Although he is a stock broker by trade he has more experience and knowledge about the healthcare system then most people I know. Why, because he has been an active patient for a long-time, having fought off cancer many times. He has become an expert in cancer treatment and councils patients from around the world. It was fascinating to hear his observations and point of view.
One part of the conversation stuck with me in particular. A couple of weeks ago he spent a week in the ICU of a large east coast hospital. While there he became very close with two traveling nurses that were working on staff and he spent much of the week talking with them about the Quality of healthcare. These two nurses have been travelers for more then fifteen years and have worked in more then fifty different hospitals. One would assume that they would be an incredibly valuable resource for any hospital. They could come in and provide a fresh set of eyes, share best practices and transfer knowledge to the permanent staff. This was not the case. After observing the nurse work for a while my family member noticed inefficiencies in the process and began to ask why. Very simple challenges like why were the most commonly used supplies not stocked in the nursing stations.
The travelers agreed with the efficiencies, but said they were unwilling to pursue improvement. When asked why, they replied that to do so would mean that they would be blacklisted by the staff and end up in undesirable shifts doing undesirable work. They told several stories about how they had attempted in the past to bring best practices from high performing hospital to lower performing hospital without success and lots of hardship. I wonder why this is the case? I wonder why change is so hard in healthcare? This is a cultural challenge that will need to be overcome.
on 02 Dec 2006 at 2:56 pm 1.Ted Eytan said …
Sad story, Lee.
As you and I know well from our work here, customer focus (patient-centered) means that the hardship that we worry about are the ones we prevent our members from experiencing.
It’s possible that there are still hospitals out there that still operate like the cockpit crew of KLM Flight 4805. That crew killed 583 people in 1977 when a request for safety was disrespected by the hierarchy in place in the cockpit.
There are hospitals who do not operate like that. How does one find out which one is which? The only way is to ask the question, and ask it from the patient perspective rather than from the doctor, nurse, or administrator perspective.
Sometimes, it’s useful to end requests with, “because there is someone that all of us care deeply about that might need to be hospitalized here and they will want us to make sure they receive the safest care possible; as a matter of fact, those are the people who are here right now.”