How to make systems work in healthcare

Posted: Monday, July 6, 2015 at 12:00:00 am

In today’s world, knowledge is abundant in every field, and we have vast amounts of information to make our lives easier that was unavailable just a few decades ago. This amount of knowledge has also complicated processes and systems, and healthcare is no exception. Atul Gawande, surgeon and health journalist, presented a TEDTalk in March of 2012 titled “How do we heal medicine?” where he discussed the complexity of healthcare and how to improve systems in healthcare.

The healthcare field has compartmentalized as it has progressed. Physicians are now highly specialized and skill sets are grouped into smaller components. However, to make healthcare work, having isolated specialties and health components is not good enough. So how do we make systems work in healthcare, particularly in infection prevention? The components must come together and function as a system. To do that, Gawande recognizes that a good system capitalizes on three skills.

First, a good system has the ability to recognize successes and failures. This can only be done by paying attention to data and measuring outcomes, because you can’t know what you don’t measure. In infection prevention, measuring outcomes will help infection preventionists recognize which interventions work and which are less effective, helping them target the most effective interventions.

Second, a good system has the ability to devise solutions to address failures. Gawande specifically discusses checklists and their ability to be implemented in healthcare to improve processes. These are the same types of checklists that are used in the aviation and high-rise industries to handle the complexity of tasks and to ensure that high-risk activities follow the necessary processes for the best outcomes. Gawande’s work with checklists among surgical teams has shown that they have the ability to drastically reduce mistakes and improve outcomes. Infection prevention teams can benefit from these same checklists by identifying key steps in a process that must not be skipped when caring for a patient.

Third, a good system has the ability to implement the solutions that they have discovered. We are taught that in order to be successful we should value independence, self-sufficiency and autonomy.  These values directly conflict with the idea of working with others as a group. Gawande feels that this is why checklists are currently underutilized in healthcare, despite his proof that they work. He points out that values like humility, discipline and teamwork help contribute to group success and can help teams work toward a common goal.

To watch Gawande’s TEDTalk, visit: http://www.ted.com/playlists/70/what_doctors_worry_about.html

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