A few years ago, when my father became ill, I discovered two uncomfortable truths. First, I was unprepared to make the necessary life/death decisions. Second, the physicians I spoke with were in a similar situation.

Read more: Low Hanging Fruit

Six Sigma, lean—the latest labels on the fad diet table. Good for you, or just another program of the month? For most hospitals, the answer is that it’s bad because the implementation will fail, and it could be the kiss of death for your at-risk career. Yeah, I’m for quality—apple pie and the flag, too. But being in favor of quality improvement doesn’t mean leaving your management brains parked at the door.

Read more: Six Sigma Stop Sign

When state inspectors appeared on the doorstep of University of Iowa Hospitals & Clinics in August, administrators must have greeted them with open arms. After all, the Iowa City hospital is consistently ranked as one of the nation’s best by US News & World Report. Imagine their chagrin when the inspectors, sent on behalf of CMS, wrote up a 132-page report listing 41 health and safety violations, including those deemed serious enough that they placed patients in “immediate jeopardy.”

Read more: Dimmer Switch Removed

Chicken. It’s what we used to say to our buddies on the playground when they wouldn’t jump from the jungle gym. One of the things you learned back then was that it wasn’t cool to hang too far back, that risk and achievement would forever be part of life’s equation.

Read more: Whose Standards? Mom's or The Joint Commission's?

Administrators, docs, and nurses at 225-bed Bon Secours Richmond Health System watched their performance metrics like a stockbroker eyeballing a ticker. After a yearlong Six Sigma initiative in the emergency department in 2005, they were anxious to see the results of their investment. Wide eyes and smiles turned to furrowed brows and frowns. Expecting a breakthrough, improvement was marginal at best.

Read more: Hitting Pay Dirt

You enter the hospital as a patient. You hope to get good care, but somehow things go awry, and you end up receiving the wrong procedure. Shouldn’t someone have realized a mistake was being made? Turns out, someone probably did know —but he or she was too scared to speak up.

Read more: Eliminating the Dysfunction

Healthcare still has some catching up to do in the technology area, but with significant progress now being made, it’s time to tackle the next problem: coordinated care. Let’s face it, as the baby boomers age and the healthcare system struggles to take care of these more demanding patients (who are also living longer), our current system is not going to cut it.

Read more: Long Live Coordination

Dizzy Dean, the great Detroit Tigers player and broadcaster, once described a runner thrown out at second base this way: “That feller spent too much time running in one place!” If that sounds like your typical day, read on. You and your management team are feeling tired, overworked, and underpaid because you’re spending way too much time and effort on the things that don’t really matter. You’re working on the wrong stuff. 

Read more: Sludge Removal

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