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Slowing down the pace.

Posted Dec 23 2008 9:14pm

Working in healthcare today especially in the acute care setting which is what most hospitals are is tantamount to being a gerbil on the treadmill wheel that never gets off. Going, going, and more going often never getting any down time to clear your head, go to the bathroom or eat a meal in less than 30 seconds. The demands are simply astronomical at times.

Paul Levy the CEO over at Beth Israel Deaconess Medical Center in Boston has gone out on a limb with a recent posting that tells of a story that we have all heard of before, wrong site surgery. A short posting with a few details to paint the scene for readers Paul clearly describes probably the biggest threat to healthcare today – the pace at which we perform our jobs.

Yes it is true that time is of the essence in some healthcare situations, when a life hangs in the balance and literally seconds count. That is what all the training is for, so healthcare providers can act quickly, confidently, and safely. In most instances they/we do. However in today’s healthcare environment the pressure to do things faster, with less cost, and keep product flow moving is tremendous. Healthcare is mired in paperwork and documentation, forms for every possible thing you can imagine must be signed, witnessed, filled out in many copies, sent here, and sent there. The time involved is enormous and it costs money, a commodity that most hospitals don’t have loads of these days. Take the events that Paul Levy briefly describes and add the endless distractions from fellow colleagues, from patients, from supervisors, from families, other healthcare personnel, and physical distractions like the pounding headache you have, the bladder that is about to give way, or the gnawing feelings your gut because you haven’t been able to eat in the past six hours. It is no wonder why healthcare providers call out sick from work as often as they do.

The solution is to all this chaos that puts providers and patients at risk for harm is as Paul mentions. Take the time to check, don’t rush, slow down the pace. In an era of increasing demands on the healthcare system healthcare leaders need to be intimately involved with the daily workload and acuity that providers of all levels face. If those resources are being taxed to the point of over capacity on a regular basis which I would argue most systems are, additional resources must be allocated to meet the demand. If that is not possible systems must work within the confines of their resources. You don’t write a check if you don’t have the money in the bank, the same is true for healthcare organizations.

Healthcare organizations must realized that even in these fiscally strained times improving services by means of adding system capabilities must be achieved to meet growing and future demand for services. Continually cutting back and trying to do more with less or the same will only end up in more costly outlays to fix problems that should have never happened. This is the case of BIDMC, the patient in question required surgery, there was an error, and the patient will likely still need to have the correct surgery a second time - More cost, more risk, faster is not always better.

I empathize with the patient and Paul; I think publicly reporting this incident as Paul did shows great leadership.

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