Article: "Can Hospital Chains Improve the Medical Industry?"

I was recently able to go visit my good friend who moved to New York City in June.  As we walked by one of the many newsstands on the streets I noticed a cover story featured on The New Yorker, ‘Health care’s new recipe: Chain restaurants have long delivered good, cheap, standardized service to millions. Why can’t hospitals do the same? Atul Gawande on a coming revolution in medicine.’ Undoubtedly I was drawn to purchase it, so I followed my natural instinct and did. I will brief over a couple major points I found interesting throughout the article.

In the article, Gawande studies operations at the Cheesecake Factory. He does so by working with Dave Luz, the regional manager for eight Cheesecake Factories in the Boston area. Throughout his observations he learned the Cheesecake Factory was able to work out an optimal staff-to-customer ratio and solve the problem of wasted food. They have managed to do so by producing a field of computer analytics known as “guest forecasting”.  By looking at past trends pulled from historical data they can forecast what to expect; the result is the ability to order the correct amount of food from suppliers and staff an accurate amount of employees.  We then ask the question, can this be done in Healthcare? Can we forecast what types of patients to expect? How much supplies will be needed? It is clear that the complexity of preparing food does not go hand-in-hand with diagnosing a patient, however there has to be a level to which forecasting can (and hopefully will) be achieved in health care.

Gawande also offers insight to a personal experience of his own where his mother received a knee replacement surgery. Prior to choosing a particular place where his mother would do the surgery, he did some research.  The man for the job turned out to be a surgeon named Jon Wright. A quote stated in the article by Wright was “Customization should be five percent, not ninety-five percent, of what we do.” Wright actually made this a reality by standardizing the way in which knee replacements would be done where he practiced.  Gawande’s mother had a successful surgery and better than anticipated recovery as a result. Other overall outcomes of this standardization included (as quoted by the article):

·          Distance patients could walk two days after surgery increased from fifty-three to eighty-five feet

·          Nine out of ten patients could stand, walk, and climb at least a few stairs independently before discharge

·          The amount of narcotic pain medications required fell by a third

·          Patients could leave the hospital nearly a full day earlier on average (saving some two thousand dollars per patient) 

It is evident that the standardization of this surgery was successful, however it is mentioned in the article that not all were exactly friendly about what Wright was trying to do. The role that he took on was not an easy one. It is human nature to do things in a way that one sees fit and it is also human nature to be liked by others. A major challenge being faced now and in the future will be to find the people that are willing to be advocates such as John Wright. To take on such a role one must be able to see the bigger picture and the benefits that such changes can bring as highlighted above.           

It is promising to see the visibility of such articles in major publications, public knowledge and awareness of what is currently being faced in the health care industry is definitely needed. The link to this article is provided below, I highly recommend reading it.

Gawande, A. (August 13 & 20, 2012). Annals of Health Care. Big Med. The New Yorker. Retrieved from: http://www.newyorker.com/reporting/2012/08/13/120813fa_fact_gawande?currentPage=all

Cost of Technology

My primary care physician shared this wonderful drawing with me recently.  It shows a girl visiting the doctors office, she is on an examination table surrounded by her happy family.

Aside from the wonderful colours the most striking aspect of the drawing is how the physician is depicted - he is hunched over a computer facing away from the smiling family.  Now I know that this isn't the case for all clinicians using EHRs - but it does remind us there can be unintended costs to their adoption.  

These costs can often be avoided by diligently analyzing clinical needs.  Rooms layouts should be tailored to facilitate discussion between the family and the physician often using the EHR as a discussion tool.  Similarly the task of documenting visits in the EHR should be optimized so as to be as un-intrusive as possible.

Welcome to Healthie

Howdy folks, and welcome to healthie. Healthie is a blog about industrial engineers improving the field of health care.

We plan to use this site to share what we're learned and discuss mistakes we've made as we work to improve the nations health care systems. We'll also likely discuss some industrial engineering techniques, share links that are interesting to us, and talk about pertinent literature.

To learn more about us, check out the about page.

Stay tuned.