If Google ran healthcare..................

A couple of days ago Mark Brittin, CEO, Google UK was speaking to a couple of hundred of healthcare people on improvement Google style. The first 7 on the list below are from his slides as principles that drive Google; the last 6 are what he said in his talk that I thought may have relevance to healthcare. 

Here are my early thoughts on what the Google CEO said and my understanding of how it might work in healthcare? I need to think more about it and am likely to post an update or change what I have written in the coming months. In the meanwhile....

What Mark Brittin said....	How I think it might work in healthcare.....
Focus on the user	Patient defined personalised pathways. Experience based design. (Current designs/pathways are built around  facilities and staff)
Open will win	Facilities as platforms for anyone to provide clinical care as long as care standards are met.
Ideas will come from everywhere	Other industry models. Customer service from hotels, safety from aviation, etc. To improve patient care 'copy shamelessly' principles
Think big, start small	More PDSA and roll up (rather than the current roll down)
Never fail to fail	I suppose we already do that more often than other walks of life but learning not to repeat the failures. Learning to fail safely.
Launch early and iterate	Continuous Improvement principles. Model for improvement. Evolution by stepwise changes.
Make it matter	Best quality, best cost at right time, every time to every patient
If you can’t spell it is our problem	If the patient will not take medication as prescribed it is our problem. If a patient comes in with MRSA/DVT from a nursing home, secondary care takes responsibility for this as well
You should get the answer even before you complete the question	Pro-active, extensive, repeated information in many formats
Internal ‘open’ is very important	All research, improvement can be presented/published after and only if it was rolled in and out within the organisation
Very small team to deal with big problems	Smaller MDTs, smaller numbers in meetings, smaller/shorter meetings. Enablers only
Speed is the forgotten killer app	Its not 4 hours, 2WW, 31/62, 18 weeks; it happens when the patient wants it to happen. In the quality puzzle we often forget time.
Aim to delight the user and figure out how to make money later	No need to reframe this one, I suppose

Here is a template for your use. Why don't you print this off and do your own list on how it might work in healthcare? Oh, if you did that, please share it by posting some of your thoughts as comments on the basis that 'open will win' and 'ideas will come from everywhere'.

What Mark Brittin said....	How I think it might work in healthcare.....
Focus on the user
Open will win
Ideas will come from everywhere
Think big, start small
Never fail to fail
Launch early and iterate
Make it matter
If you can’t spell it is our problem
You should get the answer even before you complete the question
Internal ‘open’ is very important
Very small team to deal with big problems
Speed is the forgotten killer app
Aim to delight the user and figure out how to make money later
©M HEMADRI

Will this work in healthcare? I think it will. What do you think?

©M HEMADRI

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Likeability and Interviews

Guest Blog from SAMI (Success At Medical Interactions)

One of the main factors in being successful in an interview is likeability.

Some may say that is unfair, some might be surprised. Let us explore this.

Once you are shortlisted and invited for an interview it means you have met the essential criteria which means you are appointable. On that basis you have an equal chance of actually getting the job as anyone else. If you are invited for an interview it may also mean that you have met many of the 'desirable' criteria. The chances are that the content of any answers you may give is also going to be more or less the same as the other candidates at an inteview, i.e. the knowledge is likely to be equal amongst the shortlisted candidates.

Well, if you have the essential criteria and your knowledge level is also the same then how can an interviewer make a decision?

The decision is therefore likely to be based on whether the interviewer likes you.

Jobs for the boys, known candidates, mentors on interview panels, old school ties, social networks and many other link-ups all mean just one thing in an interview context. It means that the interviewer likes the interviewee.

Likeability is very important. It will be pretty difficult, if not just impossible to work with someone that you do not like. We at SAMI, argue that the likeablility should be based on contextual performance based 'professional likeability' rather than personal links history based 'social likeability' (which is important and relevant in general/social life). This means that the interviewer makes a decision on whether the candidate is likeable purely on the interview performance of the day rather than any prior knowledge of the candidates that the interviewer might be aware of.

That will be the basis of Success of people in healthcare.

That is part of what we try to train you in when you attend the SAMI interview courses - on how to be likeable within an interview context thus potentially outshining anyone who may have social or personal links with the interview panel. Its not easy, there are no guarantees but no harm in trying!

Reposted from SAMI blog

http://successatmedicalinteractions.blogspot.co.uk/2012/05/likeability-and-interviews.html

Toyota for you doc

Toyota for you doc, what will it be for your patients?

In a recent Medscape survey it was found that doctors’ choice of cars were as follows: Toyota (16.73%), Honda (14.8%), Lexus (8.3%), BMW (7.5%), and Mercedes-Benz (5.32%). Ford came in a very close sixth at 5.24%, and Chevrolet came in eighth at 4.13%.

It is apparent that 25% of doctors chose Toyota directly (since Lexus is manufactured by Toyota) and 31.53% come from the the lean methodology (since Honda also follows similar methods) constituting the top two car choices of American doctors. If other Japanese manufacturers were included it would be much more. It is a 2012 survey that means the doctors were probably aware of Toyota’s problems from 2010.

Why would doctor’s chose cars manufactured with lean methodology despite Toyota's recent problems? It is possible that the doctors feel those cars are still highly reliable despite the odd headline problems. The doctors are perhaps really impressed with the degree of honesty with which Toyota has recalled to rectify problems and the degree of humility shown in offering a public world wide apology. It may be the case that Toyota, Honda and those who share their lean philosophy still offer great value for money – doctors also do look for value for money.

What is fascinating is that the majority of doctors, the same doctors who like Toyota lean methodology despite its problems, do not follow the healthcare adaptations of lean methodology despite undeniably proven examples within America. Virginia Mason is a small scale system and Intermountain is a large scale system that has excellent versions of clinical lean (there are others too). There is huge resistance to even begin to look at the methodology.

Human beings and healthcare, are not cars and car manufacturing, so I do understand if we did not want industry people directly applying their methods to healthcare. Clinical lean and healthcare delivery lean is specific and different (as practised at a few places in the world), the translation and adaptation has already been done and fine tuned for nearly a quarter of a century. Clinicians need to show the relevant leadership to make it work in their patch where ever they are in the world.

It is not too much to ask is it, to deliver value to your patient; the same or more value that you expect from your car? I know patients are not cars and healthcare is godzillion times more complex that the automotive industry. That is why I talk about value creation and the application of healthcare specific lean (not other industry lean) from proven systems. Clinicians only have to learn and apply clinical lean in healthcare – if you can learn and practice medicine with all its complexity, applying clinical lean where possible, with its eventual elegant simplicity is a piece of cake. Or is it?

©M HEMADRI

Taste the sampler menu of clinical lean by attending the Clinical Quality Improvement Course

Find some of the high level the outlining principles HERE