Creating Healthcare Success Using Lean and Redefining the Relationship Between Managers and Clinicians
Jun19

Creating Healthcare Success Using Lean and Redefining the Relationship Between Managers and Clinicians

As I look back over my experience both as a practitioner and as a medical leader, I am reminded of the joke that the life of an anesthesiologist is composed of long periods of boredom punctuated by moments of terror. Nothing describes a moment of terror for me more than knowing that the situation demands a decision, and in the moment I do not know what to do! The need to make a decision in the context of uncertainty is an apt...

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Applying Lean Thinking to the Future of the ACA
Feb21

Applying Lean Thinking to the Future of the ACA

Tom Price is now in place at his new office at HHS. One of Dr. Price’s first actions was to release a YouTube video that promises us a lot but does not say anything specific about what he plans to do. Seema Verma has been working her way toward Senate confirmation as the Administrator of CMS. Paul Ryan is throwing himself into the work of getting all his ducks in line for the repeal of the ACA. Across the country real people are...

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Good Strategy in a Fog of Uncertainty
Feb07

Good Strategy in a Fog of Uncertainty

There is no challenge like the challenge of creating a strategic plan in uncertain times. What do you do when you do not know what to do? That is a question that frequently challenges leaders. Over eight years ago, after Lehman Brothers had failed and the value of the stock market had fallen by almost fifty percent and we did not know if we were facing a deep recession or the second coming of the Great Depression, I was asking myself...

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What To Do When You Don’t Know What To Do
Jan03

What To Do When You Don’t Know What To Do

Are you wondering what you and your practice or hospital should be doing while living in the ambiguity of “repeal and replace?” Focus on getting better. That is the short answer. With or without the ACA the challenge to create  Care better than we’ve seen, health better than we’ve ever known, cost we can afford,…for every person, every time…in settings that support caregiver wellness  …does not go away. The Triple Aim long...

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Looking Forward with the Triple Aim
Feb25

Looking Forward with the Triple Aim

It is surprising that we have no good metrics to track our progress toward the Triple Aim. We have lagging numbers on what we spend as a nation and debatable public health indicators of gross population metrics. No one knows how many healthcare organizations have incorporated the Triple Aim into their strategic plans. We have very little to help us judge what organizations are accomplishing and no way of comparing their results to...

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Lean Supports Healthcare Service and Leadership
Feb02

Lean Supports Healthcare Service and Leadership

It is paradoxical that despite all of the opportunities for professional satisfaction in healthcare,  one of the issues of greatest concern that challenges the Triple Aim is the emotional health and happiness of healthcare professionals. Healthcare is populated by very competent and caring people who chose their profession because of their desire to contribute to better care. Many of those same people are becoming disillusioned, angry...

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In Defense of Lean
Jan27

In Defense of Lean

Rarely do you see a clinician, researcher, teacher, philosopher, ethicist and writer all bundled up in one person inside one white coat. Jerome Groopman has been such a person. Dr. Groopman and his wife Dr. Pamela Hartzband, an endocrinologist, are one of healthcare’s power couples. Together they are providing the world access to their insights and to their biases in popular books like How Doctors Think and Your Medical Mind: How to...

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Where Healthcare Should Focus in 2016
Jan20

Where Healthcare Should Focus in 2016

I have been looking forward to 2016 and asking myself where healthcare should focus in the year ahead. In this connection, Don Berwick’s speech at the 27th Annual IHI Forum had a profound effect on me. You can watch it on YouTube. I appreciated his insightful and historically astute descriptions of Era 1 and Era 2 of healthcare. The first era goes all the way back to Hippocrates and Galen and was dominated by clinical autonomy and...

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