Monday, October 22, 2007

Wanna help write my speech?

I have been invited to give the Brunel Lecture at MIT tomorrow (Tuesday) afternoon. This is a nice honor, but I am not so impressed with myself to miss this chance to ask you for help. I told them I would address the issue of process improvement in academic medical centers. If you have any stories about successes or failures in that environment, please post them, and I will try to wend them into my story. It would be even better if they could be somewhat humorous. But be forewarned: I will have a computer with projector tied into the Internet during my talk, so you might find your comment displayed for all to see.

14 comments:

Bob Wachter said...

I have the perfect story for you, Paul: humorous and telling. I posted it last week on my new blog:

http://the-hospitalist.org/blogs/wachters_world/archive/2007/10/10/can-computerized-decision-support-get-docs-to-toe-the-line-on-quality.aspx

Just shows that fancy computers and decision support are nice, but they'll only take us so far without buy in from the docs.

Keep up the great work.

Paul Levy said...

Perfect! Thanks, Bob.

To others, keep 'em coming.

Anonymous said...

we are pretty impressed with you...you are naturally humourous...just look at your personal process improvement since you left MWRA. Maybe you could open with.....
"I went from cleaning up the dirty water" to hearing it played down the street at night in Fenway
"Love that dirty water"

Paul Levy said...

Would be nice to do that and talk about something I really understand for change . . .

John Droney said...

I don't generally recommend bathroom humor for these austere occasions but...

Go with the automated paper towel dispenser experiments and waste baskets near the bathroom door riff. Great "Plan, Do, Check, Act" example and certainly not limited to academic medical centers - benchmarking at its best. (Probably best to go light on the MRSA angle, although it's close to Halloween so a good scare might be in order).

Anonymous said...

http://www.washingtonpost.com/wp-dyn/content/article/2007/10/19/AR2007101902620_pf.html

The above was interesting today... Said few hosps and docs had adopted.

David Mayer said...

Paul,
Was referred by Rosemary Gibson who said we should post a paragraph on our program to your blog.

The University of Illinois at Chicago’s medical school trains medical students on medical errors, patient safety and risk reduction strategies. The school has also incorporated communication skills training on full disclosure of medical errors to patients and their families when they occur as well as the value of rapid apology, “benevolent gestures” and the promise to learn from the mistake by implementing the necessary changes so the error hopefully never happens again to another patient. A number of patients help with the education and training programs (see attachment).

Quotes from the recent Chicago Tribune Sunday front page article on the University of Illinois at Chicago College of Medicine’s approach to patient safety education and full disclosure of medical error training incorporated into the medical student curriculum:

“UIC’s medical school last fall became the first in the U.S. to incorporate patient safety instruction in all four years of training. The curriculum culminates in a two-week course on patient safety.”

UIC is now nationally known for its comprehensive error disclosure program, and the university's medical school has created a curriculum to train future doctors how to recognize and deal with mistakes.”

Best regards,

David Mayer, MD
Associate Dean for Education
University of Illinois at Chicago College of Medicine

rjh said...

Two things I want more insight on are:

a) The cultural thought processes for introduction of new ideas and processes into academic care. My experience is that the academic is an odd pairing of extremes: fascination with trying new ideas (from the right sources) with abhorrence of any change (especially if it is not their idea). Part of the abhorrence may be the regular experience of discovery that the new idea does not work in practice.

b) The methods that work for improving insider vs outsider communication. Pre HIPAA I would insist that all engineering and design employees spend several days interning in appropriate departments and repeat this every year or two. The imagined healthcare environment of all these "experienced experts" (aka patients) bears little resemblance to the real work environment. It was always an eye opener. It also provided the needed context so that a phrase like "make sure you involve bio-med" carried all the associated cultural issues.

There seems to be little of the reverse. It is extraordinarily hard for doctors to conceptualize how concepts from other disciplines might apply (with suitable modifications) to healthcare.

Do you have techniques that help? (I'll bring my laptop :-)

Anonymous said...

Okay, how was the speech?

Paul Levy said...

OK, I think. Maybe those in attendance will choose to comment.

Dan Whitney, MIT said...

I thought your talk was great.

On the chance that you are not familiar with the system accident literature, I suggest that you look at papers by folks like Reason, Rasmussen, and Weick. The medical world has only recently discovered this literature, with the exception of the BMJ which published articles about it around 2000.

sgouris@MIT said...

Excellent talk by the way. Well prepared and interesting with the interspersion of anecdotes and real life experiences. It proves once again that improving operations is not rocket science but common sense applied persistently.

Your achievements seem to be making a difference to the lives of employees and patients alike and this is what counts. Will be checking back to learn more on your efforts :-)

Anonymous said...

From MIT - thanks for your talk yesterday. Just a quick note on the incentive process re: hand-washing. I heard a story that a local hospital created an interesting graphics display as the log-in backdrop to its computer system. It showed a rendering of typical levels of bacteria superimposed on physician hands. Apparently, the image worked as an alert that encouraged hand-washing.

Joe said...

Your Brunel lecture was just terrific! It was substantive and entertaining--- I earned a lot both about health care and system thinking from what you had to say.