Category: Front Line Management

On Healthcare as a Complex System: Ensuring Context and The Capacity to Adapt

There is a minor brouhaha in the world of healthcare quality and process improvement.  It started with a perspective piece written by Pamela Hartzband and Jerome Groopman published in a January issue of the New England Journal.  In the essay, (and I’m paraphrasing) Groopman and Hartzband argue that process improvement tools like LEAN are “medical Taylorism” that lead to ...

To Reduce Physician Burnout Eliminate Garbage Time

Here’s a new chart from the AMA (reprinted from work done by Dr. Shanafelt and colleagues in Mayo proceedings) that reports the percentage of burnt out physicians sorted by specialty.  It’s a pretty horrifying report.   I’m not at all surprised to see emergency medicine at the top of the list. There are a bunch of theories on the ...

The “Religion of Big Data” in Medicine: Will Getting More Granular Help Doctors Make Better Decisions?

I’ve been thinking a lot about “big data” and how it is going to affect the practice of medicine.  It’s not really my area of expertise– but here are  a few thoughts on the tricky intersection of data mining and medicine. First, some background: these days it’s rare to find companies that don’t use data-mining and predictive ...

Will We Improve Healthcare Delivery By Building Hierarchies or Loose Networks? Considering Lunch Delivered in Mumbai

When you talk to patients about improving the “patient experience”, the conversation usually steers to how patients move between episodes of care; how information is shared; how scheduling works or doesn’t; how test results are lost and wait times are long. It’s rarely the science of medicine that antagonizes patients, but rather the lack of functional systems. I was ...

Learning from Adjacent Industries: What Apple Computer Can Teach Healthcare

Last week Apple introduced its newest product, the Apple Watch. According to BusinessWeek, Apple spent years researching watches before deciding to build one. The company flew watch historians to California and they worked to understand how wristwatches have traditionally been used, and how a new “wrist computer” might work. They have hired leaders from diverse ...