Posts Tagged ‘hypertension’

Medical Errors Cost Two Arms and Two Legs

Thursday, June 11th, 2009

Woman who lost arms, legs gets 2nd chance to sue doctors | www.azstarnet.com ®.

Lisa Strong had a history of kidney stones and suspected that the sharp pains she was experiencing was caused by yet another kidney stone. She told the ER Nurse this. But instead of treating the kidney stone the healthcare professionals responsible for Lisa’s care proceeded on a course of treatment that was to ultimately cost her both legs below the knees and both arms below the elbows.

Lawyers involved think so many mistakes were made the jury had a hard time fixing blame.

As an industry, healthcare has been remarkably reluctant to utilize the process improvement tools provided by Lean, Six Sigma, and other quality and process improvement methodologies. These technologies have proven to be extremely useful in defining and improving processes in a diverse range of industries. Indeed, I am personally aware of several successful applications of Six Sigma in healthcare. Results include:

  • A reduction in central line bacteremia infections from over 17% to under 1%.
  • A reduction in unnecessary Cesarean Sections resulting in reducing the over all C-section rate from 30% to 18%.
  • 98% of hypertension patients achieving control of their condition for a group of 50 PCPs. (The national average hovers around 30%.)
  • A DMAIC project that dramatically decreased time from arrival to initiation of Percutaneous Coronary Catheterization and Intervention. The new process meets recommended guidelines for nearly all patients.
  • Dramatic reduction in the number of Medicare patient hospital readmissions.
  • And many, many more.

True story: My wife observed her sister’s physician come into her room, shake hands with family members, then begin to change the surgical dressing on her sister’s wound. When she asked the doctor if he shouldn’t wash first he replied that it wasn’t necessary. (News flash for physician: it is necessary.)

Given the outstanding success of Six Sigma and other methods in improving the quality and cost-effectiveness of healthcare, it is a disgrace that the healthcare field continues to embrace outmoded approaches to healthcare delivery based on the “physician as magician” model. The costs in terms of dollars and human suffering is staggering. Let’s all hope that the profession sees the light soon and begins to take the  oath”First, Do no harm” seriously. Until they do, it is patient beware.

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The physician as magician

Wednesday, May 20th, 2009

At the recent ASQ WCQI conference speaker Robert E Matthews stated that doctors are opposed to process in their hearts. Physicians are taught in medical school that it is the individual doctor that makes all of the difference in healthcare. Of course, the physician is a critical component of success. However, the physician is a member of a team. He or she works within a system that includes (we hope) a defined process, laboratories, pharmacists, nurses, physician assistants, patients, families, other care providers, payers, and a host of others.

Process excellence is, of course, the focus of this author. While it is but one of many factors, it is the one most often overlooked in healthcare. Robert Matthew’s presentation presented a case in point. While the national average for hypertension control hovers around 31%, Matthew’s case study showed that a group of 50 physicians were able to achieve levels of over 98%. The accomplishment had to overcome the perception that physicians were magicians capable of  achieving spectacular results without the need for a defined process. Once the group of physicians agreed to link their compensation to compliance with the mutually agreed to process, improvement to the unprecedented breakthrough levels was achieved.

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