Sunday, March 16, 2008

A Lesson from BIDMC SPIRIT

Paul Levy, in my mind one of the bright lights in health care management, is CEO of Beth Israel Deaconess Medical Center in Boston. He has his own blog (www.runningahospital.blogspot.com) and one of the things he talks about is an initiative at his institution that he calls BIDMC SPIRIT. BIDMC SPIRIT tries to get everyone in the hospital involved in trying to do things better and more efficiently.

In a recent posting about it, he had this to say:

“The underlying premise is that a democratic approach to problem identification and problem solving is what makes it possible for a complex organization to discover ways to improve. As Steven Spear notes, the alternative method -- trying to design the perfect complex system in advance using the traditional business hierarchical approach -- is unlikely to produce a sustainable and efficacious solution, especially in an environment characterized by structural change.”

All of the people trying to force computer and other management tools and techniques onto health care providers would do well to take note. The result in too many cases is that the provider (usually a hospital) continues to do what it always did in the inefficient way it always did it and just adds what is being urged upon it (together with its cost ).

What should be required of providers is that they show what they are doing to improve safety, enhance quality and reduce cost. How it is done should be for the providers to figure out, using methods like BIMDC SPIRIT.

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