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Fearless Thinking Will Drive Health Care Transformation

By Gary Kaplan | Monday, March 12, 2018

Fearless Thinking Will Drive Health Care Transformation

We in health care have much work to do to improve the care experience for patients and their providers. If we are to succeed, we must be fearless in trying new things, embracing innovation, and helping new ideas come to life.

We have more information and evidence than ever before about how to reduce waste, control costs, improve quality and safety, and ultimately elevate the patient experience. Yet inconsistent performance across the nation’s health care system continues to impede progress in these areas.

Here are three improvement opportunities, each of which requires overcoming the inherent fear of change:

  • Really listen to what patients say when we ask what truly matters to them. This means being unafraid to invite criticism of ourselves and our organizations. Creating a remarkable experience is about being in the moment with patients and their families.

    The IHI/NPSF Lucian Leape Institute concluded in its report, Safety Is Personal: Partnering with Patients and Families for the Safest Care that engagement leads to safer care by improving the outcomes of care, improving the experience of care for individual patients, and improving the work experience for caregivers.

    At Virginia Mason Medical Center, for example, we use experience-based design to ensure we are focused on the perspectives and emotions of our patients as we strive to continually improve. We view patients and their families as our equal partners as we co-design processes together. Our teams have moved from the mindset of “We’re the experts – it’s all about us” to “It’s all about you.”
  • Encourage broader information sharing and interdisciplinary collaboration between providers from the spectrum of specialties. Silos are barriers to achieving everything we want health care delivery and the patient experience to be about.

    A 2015 report,  Shining a Light: Safer Health Care through Transparency, supports the premise that greater transparency (including information sharing) is not only ethically correct, but leads to improved outcomes, fewer errors, more satisfied patients, and lower costs.

    While transparency can be a powerful catalyst for change, IHI President and CEO Derek Feeley observed in a Line of Sight blog that “full and open transparency is still hampered by fear, from both individual and organizational perspectives.”

    The ongoing work of improving quality and safety, as well as provider and patient satisfaction, requires that purposely sharing data and relevant information for the benefit of all become the standard.
  • Apply a systems-engineering approach to standardize health care processes.

    Bringing a Systems Approach to Health, a discussion paper published by the Institute of Medicine and the National Academy of Engineering, for which I had the honor of serving as a co-author, points out that systems approaches have improved efficiency, quality, and safety in the aviation and automotive industries and “could be similarly transformative for health and health care.”

    I know firsthand that a systems approach to care delivery can be transformative, based on our experience at Virginia Mason. More than 15 years ago, we adopted Toyota Production System principles as the foundation for our management methodology, the Virginia Mason Production System. That was a fearsome step for some team members at the time. Not only did we have to overcome the apprehension of looking outside health care for the best path forward, we had to accept that the ways we had always done things were no longer good enough.

Regular doses of fearless thinking can drive transformation. It is our responsibility as health care leaders to look forward with courage and commit with confidence to identifying new ways of doing things better.

Gary S. Kaplan, MD, a practicing internal medicine physician, is chairman and CEO of Virginia Mason Health System in Seattle. He is the immediate past chair of the Institute for Healthcare Improvement Board of Directors and chair of the IHI/NPSF Lucian Leape Institute.

You may also be interested in:

IHI/NPSF Patient Safety Congress (May 23-25, 2018 in Boston, MA)

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