tag:blogger.com,1999:blog-32053362.post2980564025283294799..comments2024-03-29T06:37:18.029-04:00Comments on Not Running a Hospital: Where are the pumps? Part 1.Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-32053362.post-87481135570863393442008-06-24T09:02:00.000-04:002008-06-24T09:02:00.000-04:00Thanks, Steven. Stay tuned. More to come!Thanks, Steven. Stay tuned. More to come!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-32975420266532553672008-06-24T08:26:00.000-04:002008-06-24T08:26:00.000-04:00While I don't know if you consider this a major is...While I don't know if you consider this a major issue of public policy, I just thought I would throw out that this particular post and its much anticipated follow up is by far the most interesting to me. <BR/><BR/>I am curious to see how successful you are with this set of employees, who sound very dedicated (in contrast to what little first hand observation I had at a NYC hospital). Also wonder if you're looking into any shortfalls that could result in some serious bumping of heads with some Dr. egos.Geewhizhttps://www.blogger.com/profile/07267823098094566514noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-76089487997348539322008-06-22T18:39:00.000-04:002008-06-22T18:39:00.000-04:00iv pumps are definitely hoarded (in out-of-the-way...iv pumps are definitely hoarded (in out-of-the-way-not-easily-observable-spots) on floors - pretty understandable given the frustration of waiting, waiting, waiting for them (sometimes for critical meds) but of course that's no reasonable solution... think par number for each floor/unit would be good start. <BR/>west campus rnAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-741226575768476662008-06-19T20:07:00.000-04:002008-06-19T20:07:00.000-04:00OOPS - here is the correct link to my previous pos...OOPS - here is the correct link to my previous post:<BR/><BR/>http://www.innovate.gatech.edu/Default.aspx?tabid=32&NewsID=171Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-62320565129346409922008-06-19T17:04:00.000-04:002008-06-19T17:04:00.000-04:00Paul – thank you for sharing! One of my colleague...Paul – thank you for sharing! One of my colleagues, an MD, had this comment “this blog is written by the hospital CEO...there lays the difference between a lean transformation and using lean tools to solve some of our issues”. We applaud your leadership!<BR/><BR/>We have also tackled the wayward IV pump issue. Here is a link to a write-up on that project: <BR/><BR/>http://runningahospital.blogspot.com/2008/06/where-are-pumps-part-1.html <BR/><BR/>It will be interesting to see if your team comes up with a similar process.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-79592918944450819542008-06-18T10:23:00.000-04:002008-06-18T10:23:00.000-04:00Working closely with hospital emergency department...Working closely with hospital emergency departments, I can say the same issue exists with the typical "Stretcher Hunt". Things are fine in the AM but come afternoon, staff must do a search and recovery mission when they are needed most in the unit which detracts from patient care and safety.<BR/><BR/>Wondering if you have looked at this...EBhttps://www.blogger.com/profile/10031048458428647087noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-46615166041247978662008-06-18T08:08:00.000-04:002008-06-18T08:08:00.000-04:00Paul, just wanted you and the BIDMC team kow how f...Paul, just wanted you and the BIDMC team kow how far you have reached...I gave a talk on leadership this morning in Africa, and the leaders in the room asked for an example of what a CEO could really do (I have included specific leaderhsip behaviors, such as rounds, etc.) and so I opened your blog and walked them through this entry. They were amazed, impressed and will all be tuning in to watch the progress on the pump team! Thanks!<BR/>Maureen BisognanoAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-23311325169779202942008-06-18T04:56:00.000-04:002008-06-18T04:56:00.000-04:00Dear Anon 2:09,Actually, it is applicable to resea...Dear Anon 2:09,<BR/>Actually, it is applicable to research, as well as clincial activities. Trying calling out a problem . . .<BR/><BR/>And, your characterization about their not caring is not at all true. If you have a suggestion, make it, please.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-62989632256442443062008-06-18T02:09:00.000-04:002008-06-18T02:09:00.000-04:00Dear Paul, - SPIRIT is usually applicable on the C...Dear Paul, - SPIRIT is usually applicable on the Clinical Side. What are we doing to improve the Research Side (administration/bench work)?<BR/><BR/>BIDMC has been always very active in the clinical side. I would like to see BIDMC more offen involved in research side. I thinks moving to CLS should be a new start point where evaluating the necesities of research are considereted seriusly and it is not just moving from one building to another.<BR/><BR/>Research administration is soo inefficient that sometimes I need to guide them in how to run their business. They do not care about our science and we are just a number.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-2525469703623865692008-06-17T17:31:00.000-04:002008-06-17T17:31:00.000-04:00And I thought I had something to be annoyed about ...And I thought I had something to be annoyed about when I simply couldn't find a wheelchair at checkout time!<BR/><BR/>Re "simply go and see" - I guess that explains why so many good managers I've known have practiced MBWA, which (I just discovered this moment) is now enshrined in the Toyota method as <A HREF="http://en.wikipedia.org/wiki/Genchi_Genbutsu" REL="nofollow">Genchi Genbutsu</A>, aka Getcha BootsOn. And the Japanese literally means "go and see for yourself." Huh!<BR/><BR/>Along similar lines, I hope everyone involved in the next generation of healthcare IT will spend a few months actually having a critical disease. Genchi Genbutsu stage IV cancer! :)e-Patient Davehttps://www.blogger.com/profile/11608258246509102466noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-3427007693969931422008-06-17T12:03:00.000-04:002008-06-17T12:03:00.000-04:00I loved a lot of things about this post, but ESPEC...I loved a lot of things about this post, but ESPECIALLY "key learning" point #1. There is absolutely no substitute for "going and seeing", as so aptly put. <BR/>It's utterly amazing to me that management people (this is not confined to health care) don't do this more often. It also pays immeasurable benefits in staff morale. I look forward to part II!<BR/><BR/>nonlocalAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-75970998939610964392008-06-17T10:36:00.000-04:002008-06-17T10:36:00.000-04:00Anon 8:49,While I agree that is one possible solut...Anon 8:49,<BR/><BR/>While I agree that is one possible solution, I would submit that it does not get to the root of the problem and fix it which is the goal of the SPIRIT program as I understand it from this blog (I'm not a BIDMC employee). It is possible that the team finds the supply of pumps is too low, but I would venture that the problems turn out to be more along the lines of getting an accurate number of pumps needed by PACU at various times throughout the day, how the pumps are returned to the distribution area once the patients no longer need them, the process for preventive maintenance and how long that takes, having a few extra to replace those that are being serviced, lack of a reliable tracking system so you can determine where a pump is, and hoarding by departments because this has been a problem for such an extended time period (as it is pretty much everywhere else, my own hospital included). I think it's great that the SPIRIT team is tackling this problem and will follow it with great interest in hopes of shamelessly "stealing" good ideas. Congratulations, BTW, Paul on your hospital being a 2008 Premier Award for Quality winner!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-46063143627451536662008-06-17T10:04:00.000-04:002008-06-17T10:04:00.000-04:00I seem to get the same pump with each visit over a...I seem to get the same pump with each visit over a two year period. I recognize it because the bottom ring that holds other stuff like the cath bag doesn't stay up. I take a rubber glove and twist it around the pole, pushing the ring down on it. This works very well. Cheesy, but good.<BR/><BR/>Curious about a few things -- How much do these pumps cost? Does anybody lease them and therefore replace broken ones? Is there a routine maintenance schedule?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-26946414659763219672008-06-17T09:23:00.000-04:002008-06-17T09:23:00.000-04:00That's certainly one possible solution. We'll see...That's certainly one possible solution. We'll see where this leads.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-11291013969371185222008-06-17T08:49:00.000-04:002008-06-17T08:49:00.000-04:00Why don't we just stock a "par level" of extra pum...Why don't we just stock a "par level" of extra pumps on every unit, avoiding a separate "hunt and fetch" every time we need one? Then distribution could easily see where the pumps need to go just by "rounding" the units once or twice a day. (Yes, I know the pumps are expensive, but how much are we spending in nurses' time, etc. when one isn't readily available? and in "delayed discharge from PACU" time which often has the effect of backing up the ORs.) Pretty much EVERY patient in the hospital has an iv on a pump, so we should have at least one for every bed (more in the ICUs.)Anonymousnoreply@blogger.com