10 Healthcare Innovations

The Harvard Business Review’s Health Care Innovations Insight Center has listed ten innovations it thinks could eventually improve healthcare (“Health Care of the Future,” Gardiner Morse, March 8, 2010).

Checklists. A checklist at Johns Hopkins Hospital required doctors to confirm, among other things, that they had washed their hands before inserting a central line. The 10-day line-infection rate went from 11% to zero. But getting people to use checklists can be a struggle.

Behavioral Economics. Nudge patients to comply with doctors’ orders, and nudge doctors to improve care.

Patient Portals. Patients could log onto their own secure portal to access and share their medical records, check lab results, renew prescriptions, deal with insurers, and communicate with doctors and nurses.

Payment Innovations. “Any hope of affordable, quality care lies partly in payment reform.”

Evidence-Based Decision Making. Electronic medical records should help doctors make better decisions based on the best evidence.

Accountable Care Organizations. The health reform bill includes plans for a pilot ACO whose job is to keep people healthy and out of the hospital and reward doctors and hospitals when they do.

Virtual Visits. Televisiting, a la Ellen Page talking to her doctor, who is in Denmark, in the Cisco ad.

Regenerative Medicine. “Stem cells…can potentially cure an array of devastating, once intractable conditions.”

Surgical Robots. The jury is still…

The Real Heroes

Toyota’s front-page fall-from-grace has rivaled that of Tiger Woods, a business world parallel to the sporting world’s latest scandal. No wonder. Our business publications, from BusinessWeek to Fortune to Fast Company to the Wall Street Journal, weave their stories around the companies and executives who have risen to the top today. It is a cult of personality, no different than the teams and stars in the athletic world or the TV shows and actors in the entertainment world. We read about a company’s breakthrough performance or an executive’s startling turnaround and we place them on a pedestal and feel betrayed when they fall off.

They always do, of course. No company or leader can sustain performance excellence indefinitely. There are Baldrige Award winners that have failed after they received the Award, but so what? The Baldrige Award doesn’t guarantee unending success. It simply recognizes that, in the year it was received, that organization was one of the best-run organizations in the country. Next year, who knows? It’s like winning the Super Bowl one year (not that I’d know what that’s like, living in Minnesota) and expecting to win it next year and the year after, ad infinitum.

We’re focusing on the wrong thing. Baldrige Award winners have a lot to teach us about designing, managing,…

How Can You Stay on Top?

For years, if you wanted the highest quality car, you bought a Toyota. Ford, General Motors, and Chrysler floundered. Toyota’s reputation grew. The Toyota Production System was the poster child for Lean, for eliminating waste and shortening cycle times while improving quality in the process.

And then its goal changed from being first in quality to being first in global sales. A culture built on slow-and-steady, where teams were given months to find solutions and leaders spent years developing their capabilities, gave way to quicker product launches, faster plant openings, and rapidly expanding supplier networks. Customer started to grumble. Flaws appeared. Recalls tarnished a reputation that seemed indestructible.

The Baldrige Criteria ask how you create a sustainable organization. That’s not the same question as how you sustain a great organization, and based on results, you can’t, at least not indefinitely. Companies rise and fall. Some reach the top and dominate the landscape for years, even decades, but they, too, eventually lose the lead.

Why is that inevitable? The Baldrige model can help your organization achieve performance excellence and it can help you sustain it, but for how long? New owners and chief executives enforce new agendas, hungry competitors draw away customers, and markets, economies, and industries change.

So how can you stay on top?…

99% Above Average

Call it the Lake Wobegon effect after Minnesota’s very own Garrison Keillor, that fictional place where “all the women are strong, all the men are good looking, and all the children are above average.”

Only in this case, they’re not children: They are the chairmen of 722 nonprofit hospitals, and 99% of them think their hospitals fare at least as well as a typical hospital on standard quality measures, according to a survey published in Health Affairs. Even worse, 100% of the chairmen of hospitals that perform the worst think they are at least as good as a typical hospital. (“Only 1% of Hospitals Are Below Average,” Jacob Goldstein, WSJ Blogs, November 9, 2009)

It’s hard to know what’s most appalling about this ignorance:

• The chairmen don’t know how their hospitals perform on standard quality measures, information that is available to anyone on the Internet.

• The chairmen don’t know what “typical” performance is—also available on the Internet.

• No one has bothered to share this information with the people who bear some responsibility for their hospitals’ performance or, worse yet—

• The chairmen don’t care.

The Baldrige Criteria ask how you evaluate the performance of your board members. I would add questions about how the board reviews the hospital’s quality performance to that evaluation. The Criteria also ask how you…