Thursday, August 12, 2010

Toussaint and Gerard tell us how to get on the mend

John Toussaint and Roger Gerard have published a book entitled On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry. Ordinarily, you would be well advised to be skeptical of anyone promising revolution and transformation, but not here.

Here's an excerpt from the introduction:

With few exceptions, [government policy] debaters assume that healthcare costs are fixed, that America's proud history of medical care and innovation comes with a staggering bill.

We know different.

Governments can tweak payment systems and probably get some temporary fiscal relief. But until we focus reform efforts on where most of the money goes, which is healthcare delivery, we will remain stuck in a revolving door of near disaster and narrow escapes. To get to the point where all people have access to high-quality healthcare, affordably, we must focus our attention on how the healthcare delivery system determines costs and quality. Then we need to change that delivery model entirely.

In fact, hospitals, physicians, and nurses -- all of healthcare -- must change. First, we must emphasize the science of medicine over the art. This means turning to evidence-based medicine, which is already underway in some sectors. But we are also talking about evidence-based delivery, work that has barely begun.

And then, they go on and explain how to do this.

You can get a sense of the message in this video produced by the Lean Enterprise Institute, which also published the book. If you can't see the video, click here.


Richard Wittrup said...

In pursuing these various routes to improving clinical care you are headed in the right direction but be careful, it leads to places a lot of people don't want to go.

e-Patient Dave said...

Just watched this video ... I'm moved by the honesty and openness of the people in the case.

I wonder if the story of the "removed" manager will cause some managers to resist this sort of initiative, lest they get fingered as a problem. I hope not!

I hope everyone involved will be inspired, not scared, by the possibility of having more patients "walk out of here alive," as your chief of medicine Mark Zeidel put it (on a very old post here that I can't find).

Tom said...

Just got through reading it, thanks for the suggestion. It was an eye-opener. One thing the book made very clear; without full support and sustained effort at the top, changes like those made at ThedaCare will never happen. Tom