INTERESTING: A six sigma discussion

ROFL! Yesterday, before Frau was given her release, yet another hospital manager came by to talk about the patient’s perception of her care. Since Frau was sleeping, the lady “nursing director” talked to me. She was taking names of did a good or bad job. Since both patients in the room were “unavailable” (i.e., sleeping), guess I was selected to be a proxy.

Boy, did she get an earful before Frau woke up. And put the kibosh on me.

I’m not good with names, but this floor was better in general than the CCU or the last floor she was on two weeks ago.

But then, she made a mistake! She mentioned that they were Six Sigma. Who, wee, here we go!

I dusted off my “consulting hat” and asked “Why six sigma?” SHe didn’t answer but asked what my Six Sigma background was. See asking “why” there times is how Six Sigma-ites get to the real reason why you’re doing something. I told her that I had some minor experience in it and challenged her about answering the question.

“Better patient care” “Why?” “Better outcomes” “Why” “To become patient centered”

Ahhh, Hah!

So we got into a discussion about how the patient was not a Customer, a Stakeholder, or even a Client in their processes. Then, I moved in for the kill describing how this morning the tech woke the patient to take blood pressure but was called away in the middle for a “safety huddle” at 8AM plus or minus a few minutes. Her response was that the “BPs were late and the huddle was on time”. And, I concluded: “So explain to me HOW that is patient focused care?” She was speechless.

We got into a discussion of how the technology, process, or people could be deployed that would have transformed that into a patient centric focus.

Like maybe, never wake a patient to do a routine test in the first place, leave an appliance there and the first person to see the patient awake take the bp. Use new bp tech that takes the patient’s bp even if they are sleeping. Or even just questioning how to organize so the patient is not disturbed.

Another example was the call bell that neither differentiates between urgency or type of need.

Another example was how there’s no call center to take the call and directly alert the right person.

Another example was there’s no feedback loop to collection and action what the patient sees.

Another example was that the staff had no technology to make their jobs more effective or efficient — there were sheets at each patient that the staff was to initial each hour that they visited the patient. An rfid badge and readers at each bedside, would collect that data without paperwork and wasting the staffer’s time. Besides at the end of each shift, they just “caught up” the log. So does leadership REALLY want to know the answer?

She gave up saying “they didn’t have …” because it was painful obvious even to her that they do NOT want “patient focused” because they have all their processes. So be honest and call it “processed focused care”.

We were discussing more examples when the BLOODDOC came and rescued the Director from the trap she had fallen into. I let him know that he was 6 minutes late. (Hey, he set the expectation. Not me. No one forced him to say what time he’d be there.)

ROFL!!!

Be careful what you ask for, you may get it.

My observation is, imho, they don’t want to change. They want the praise that comes with being Six Sigma, but they don’t want to do the heavy lifting. My experience with TQM, Six Sigma, and other quality initiatives is that the problem is ALWAYS leadership. They may “talk the talk” but they don’t “walk the walk”. You can put up all the funny inspirational signs on the wall you want, but people are smart. They see your mixed messages and adapt.

I always say I can play any game, just tell me the rules.

In this case, it is NOT “patient centric care”.

Boy, was that fun!

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