Large amounts of money had been poured into healthcare. Nothing much has come about as result. It is not hard to understand why. A visit to any hospital is sufficient to comprehend why 'process' continues to be the biggest problem in healthcare. Non-standardization is everywhere- from the care delivery process to stabilizing the machines which are essential to any modern hospital. Errors occur due to the lack of reproducibility. A process can only be improved after it is stabilized and standardized. A better result cannot be expected simply by pushing a modern system like the Electronic Health Record (EHR). Costs will not be decreased.
Technology is easiest to change. The majority of American health systems either already have or will implement EHR. The vendor process for this implementation is excellent. The problem lies in getting the doctors, administrators, and nurses to agree on what constitutes the best care delivery. The medical team follows the lead provided by doctors as the latter makes the decisions. Mess happens when the doctor turns out to be wrong. Compounding the problem is the churn of personnel. New technicians or nurses take time to master the system.
Two kinds of improvement systems are required to make a better-designed care process. One improvement system consists of an approach which brings all members of the existing clinical team together. The aim of such an effort is to improve the existing care process. Proven improvement techniques like Toyota Production System or TPS, as it is popularly known, are used. The second improvement system is an innovation process directed at the radical redesign of care. It uses design thinking and linked with TPS. In both the cases, rapid experimentation occurs in the initial effort. This usually happens in an ER or in any ambulatory clinics.
Start small and move up
The ambulatory clinic becomes a place for the organization to learn. The zone becomes a veritable sandbox for change in practices. New processes will be incorporated not only for delivery of care but also for its management. The result will be that the necessary systems will fall in place over time. There will be a sustained improvement. After this model line achieves about 80 percent improvement (50 percent will also suffice) over the baseline performance, then this learning must be spread to the organization's other parts. The new method becomes the standard technique to deliver care.