“I’m confident, Jaded Julie, that you know this old saying, ‘There are only two things in this life that you have to do. You have to die and you have to…”
“…pay taxes.’ Everybody knows that one, Curmudge. So why wreck a nice day by talking about taxes?”
“Because, Ms. Know-It-All, the old saw is wrong. Some people exist out in the boonies, live off the land, and don’t pay taxes. The correct saying is, ‘You have to die, and you have to make choices’ (1).”
“That makes sense, Well-Read Relic, but what does it have to do with the patient experience and building an addition onto the hospital?”
“Pretty simple, Julie. In our last discussion, the teams began with 860 patient ideas and made judicious choices of common themes and big ideas. Next was deciding where to apply these learnings, and the logical choice was the construction project at the top of the list, the Heart, Lung, and Vascular Center.”
“If this blog is about Lean in health care—and it is—you’ll soon tell me about the advanced Lean techniques used in designing the new construction.”
“I sure will, but first we need to define ‘the team.’ Because we were planning Heart/Lung Center construction, the team represented H/L staff, the architectural firm, and a facilitator from the Kaizen Promotion Office. The facilitator’s tasks were critical because he had to teach the advanced Lean techniques to the staff and guide them in their use.”
“I understand, Curmudge, that the team used matrices as the advanced Lean methods to aid their choices (2). Back on September 25, 2007 you described a matrix using a calendar as a simple example.”
“This time, Julie, our discussion will be even less technical. First the team used the customer needs—most of which are the criteria of our Personalized Care—to create a matrix of critical-to-quality factors (CTQs). CTQs are measureable characteristics of service that are, in the eyes of the patients, critical to the quality of care that they receive. So up to this point, the team had identified what the patients want and the relative importance of things that can be measured to determine if the patients’ needs are being met.”
“That’s pretty cool, Curmudge. The team’s judgments were based on quantifiable measures rather than on seat-of-the-pants choices.”
“Next the team used another technique (a Pugh matrix, but you can forget the name, Julie) to select projects and measurements that should have the greatest impact on meeting patient needs. The results pointed the team toward educated decisions regarding projects needed to guide the architect’s final design. In-room scheduling, clinic communication, and exam room layout were among the potential projects that received the highest rankings. We’ll talk about those projects next time.”
“It’s certainly reassuring to learn that there can be science behind making decisions. Do you suppose, Curmudge, that using a Pugh matrix might have helped me in choosing a husband? If I had, I might not have selected a couch potato.”
Affinity’s Kaizen Curmudgeon
(1) Hunter, James C. The Servant (Crown Business, 1998)
(2) Hess, M. Quick, quality decision-making using Six Sigma tools. http://www.isixsigma.com/library/content/c041108a.asp
Check out the latest posting in Curmudge and Jaded Julie’s personal blog, Curmudgeon’s Wastebasket.
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