Business Systems Lessons From the ICU

admin — Fri, 20 Nov 2009 12:02:21 +0000

Early in my business career I worked at the world-renowned UCLA Medical Center, running the non-medical patient care activities in several regular and intensive care units. I frequently heard comments that ‘healthcare just isn’t the same as business.’ It was said in ignorance about the true complexity and need for accurate coordination needed to provide excellent customer service: patient care.

As a Unit Service Coordinator, I was in charge of arranging all the movements of the patients and the services, treatments, food, pharmaceuticals, and so on for each patient. I was also in charge of making sure the information that came from one source, such as a physician, was distributed to every other resource that needed to know it.

I later implemented improvements of the operations of several out-patient clinics: front office, reception and billing functions to serve the patients themselves.

So you might say I’ve got an experienced eye when it comes to assessing the ‘business systems’ of healthcare. I’ve had the opportunity to spend time in UCLA’s new facility this past week and was reminded about the common challenges in business, no matter the industry.

Lesson 1: Take The Human Element Into Account

Clients often ask me “Is this the best solution?” If business were entirely run by machines perhaps the answer could be “Yes!” Fortunately I learned a deeper appreciation for what it really takes to accomplish results in medical care.

Medicine is an ‘art’ not a science. Each patient is a complex system that will interact with medicines and surgical procedures differently than the patient in the next room. The best hope is for ‘optimal’ results, called healing and health. So standardized care steps are used. I took that wisdom with me into the rest of the business world.

Depending on the complexity of your customers’ challenges, there may be no ‘best’ solution you can guarantee, either. From the employees running your company, to the customer on the phone, the results you’ll get depend on their actual experience, training, tools, systems, personality and mood.

Start by creating standardized process to approximate ‘science’ in the results you want to deliver.

Lesson 2: Build Your Systems By Asking The Users

Information flow, manufacturing steps, people movement inside the business… each poses it’s own challenges. The designer of the system believes they know what’s needed. Yet very often they haven’t spoken with the true users.

A district headquarters I worked with had 60 percent of the personnel relocated to new locations by an industrial planner who ‘knew’ where they should sit. Of course that worked when data was correct. But when there were problems, with 17% of the data, problem solving was best done face-to-face. Yet folks suffered through having been relocated 2 floors away from each other.

The brand new cardiac intensive care unit at UCLA is a visual marvel. A ‘U’-shaped hallway, private rooms for each patient, high definition TVs to entertain them. But the loss in nursing productivity is enormous. The unit’s curving layout was designed by a famous office architect and a physician who strolls through for a total of one hour daily. The result? None of the nursing staff have line of sight beyond 3 rooms.

Nurses are no longer able to do quick visual checks about patient status or colleagues needing an extra hand. Their walking has increased 400% every day. They have to carry phones to call each other from 30 feet away.

Always include the ‘users’ in the design stage for your systems.

Lesson 3: Find Out Where The True Knowledge Is

In the metal finishing manufacturer I’m working with, the detailed expertise is often with the blue-collar worker standing at the machine, and not the ‘planner’ sitting in a meeting, or the CEO.

In a teaching hospital the ‘doctors’ walking in and out of the patient rooms are often training in one- or two-month rotations. It’s not uncommon for a patient to be admitted, and then handed off a few days later to newcomers who are trying to familiarize themselves with 20 different patients’ cases. Then off they go to ‘learn’ about another area of medicine.

So when a patient care system is being designed, the critical source may be the nurse who has worked continuously with thousands of patients for years. I know that comes as a shock to many folks who assume ‘the doctor’ can give them the best information.

The person with the biggest title may not be the one with the most thorough expertise.

Take a look at your business today and see which people you need to have at the table to design the inner workings of your company, the solutions for your customers and the systems to deliver those results.

Copyright (c) 2008 Linda Feinholz

By: Linda Feinholz

Business Continuity Audit » Patient Care Activities

Business Systems Lessons From the ICU