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  • In celebration of National Nurses Week: Two ways to end nursing’s 55-second cycle

    National Nurses Week (May 6–12) is a time for everyone—not just nurses but other health care professionals, individuals, employers, and community leaders—to recognize the vast contributions and positive impact of America’s 4 million registered nurses. It’s also a time for us, as lean practitioners, to look at emerging research about the complexity of nursing work…work that requires critical thinking, knowledge application, and constant vigilance. On average, a nurse switches between tasks every 55 seconds. Think about the nurse who cares for you or your loved one moving through 88 separate...
  • Lean at home, after my husband’s surgery

    Before becoming a lean healthcare consultant, I worked for many years as licensed physical therapist in the inpatient setting, specializing in post-operative recovery for patients following orthopedic surgeries and those who had suffered strokes and spinal cord injuries. Specifically, for my patients who had orthopedic surgeries, I assumed they were just fine to do their exercise program as prescribed. I advised them to stay ahead of their pain by keeping on a consistent pain medication regimen, to ice frequently, and to do their exercises two to three times a day. I never thought deeply...
  • Rules of the road

    Recently, caught in a winter snowstorm, I had to drive extremely slowly down the middle of the road in the tracks made by previous cars. I realized that driving rules were significantly suspended in this situation. This reminded me of when a sensei told me about the concept of “rules of the road.” Every company has “rules of the road.” They are the unwritten values, norms, and social pressure of a group. Think of them as the part of the iceberg we don’t see of social standards. For example, a new employee is told in orientation that it’s okay to speak-up in a meeting, but everyone knows...
  • Tar Pit: Adaptive mutation for EMR evolution and medical system survival

    Let’s say you’d like to compare two doctors to find a new primary care provider (PCP). You are a Boeing engineer. You practice lean production methods, kaizen, on the Boeing 737 line.  Dr. Craft has a nice assistant who weighs you in the hallway but doesn’t say your weight out loud. You remark that their scale seems to add five pounds to your weight or maybe it’s those wet clothes. The assistant invites you to the exam table and chats amiably while measuring your blood pressure. Hmmm … 135/88, substantially higher than you remember. You get...
  • Inspired by our patients

    Since shifting from my physical therapy career two years ago, I am frequently asked if I miss patient care. My response is always the same: Nothing will ever be as rewarding -- or emotional – as first meeting a patient lying in an ICU bed after a stroke or spinal cord injury and having the incredible honor to partner with them in their rehabilitation journey so that they can return home. Oftenthey don't go home the way they hoped or envisioned, but the honor of working with them through their difficulties, helping educate them so they are...
  • Go and see, ask and listen: In service to patient safety, every moment, every day

    As we celebrate patient safety awareness week, we encourage you to think about what more you can do to ensure safe, appropriate, timely patient care each and every day. With potential risks to patient safety at any level within an organization, every single team member can make a difference in preventing harm.  We offer some practices for you to consider as you move forward: Regularly go and see the work in the place where it happens. Engage and empower all team members to serve as safety inspectors to find and fix defects, surface workarounds, and interruptions that get in the...
  • Honoring diversity and innovation during Black History Month

    “The National Museum of African American History and Culture celebrates the contributions African Americans have made to our country’s history by showcasing the talent, ingenuity, creativity, and resiliency of our people. I laughed, I cried, and I left with an even stronger sense of pride. I think it’s important for all Americans to learn more about African American culture and history, as it is American history.” - Shaunte KinchDirector, Rona Consulting Group This photo was taken on a trip I made to Washington, DC, to visit the National Museum of African American History...
  • The Murmuring of Our Medical Multitude

    “The art world has changed out of all recognition in the last twenty years.”  These are the opening words of a book I stumbled upon at the makeshift bookstore in a low-budget art gallery in Amsterdam not long ago. The Murmuring of the Artistic Multitude: Global Art, Politics and Post-Fordism, by cultural sociologist Pascal Gielen, attracted my gaze because of the term Fordism, but also because we have all heard the same assertion about the transformation of medical care in the last 20 years. Might this tome address some relationship between art and production science? Indeed, post...
  • “I’ve Been to the Mountaintop” – Remember MLK on his 90th birthday

    Martin Luther King Jr. would have been 90 years old on the 15th of January and on the 21st, we remember his life and legacy. This year, I chose to read Dr. King’s speech, “I’ve Been to the Mountaintop.”  It’s an eerily prescient and inspiring speech delivered the night before he was assassinated on April 4, 1968 at the age of 39.  As you read the words you can almost feel that this great person knew his time was drawing near while at the same time throwing his whole being into the struggle for equality with a sense of gratitude for the fight. He writes, “And another reason...
  • Outside eyes

    A cardiovascular clinic recently held a second improvement event, a kaizen workshop. The clinic is part of a nonprofit regional health system with 34 unique medical specialties at several locations and more than 300 physicians. Planning for the event began eight weeks prior, including defining the target metrics and goals for the workshop. The plan was to reduce a number of wastes, including the time required to prepare charts for patients. As we were planning, the process owner and kaizen promotion office representative each had ideas about how this might be accomplished. The kaizen...

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