Thursday, July 31, 2008

Systemic problems in US healthcare?


If you know Tom Peters and his work, you know his focus on WOW!

This is different, though. This is my "Wow" at the intensity of his recent postings, intensity that trumps even his usual high-energy attitude.

Start with Ten Years in the Making!, his take on the state of health and healthcare in the USA today. Go read it the attachment, and then come back (that might be tomorrow; it's 288 slides long!).

I have not double-checked his references, but most of his slides provide references to other's work (and, if you're not familiar with his style, no, they aren't boring bibliographies).

Then check out The Healthcare14: U.S. Healthcare Trauma in 2008 and his tongue-in-cheek Proposed Hospital "Organization Chart."

There are other reports, among them the 1999 Institute of Medicine report To Err is Human: Building A Safer Health System, and there are and have been projects designed to make things better.

While I sense that Tom Peters isn't a big systems fan, it sounds as if a systems approach might help. The IOM and Tom Peters both described patterns of behavior. Patterns are usually stimulated by structures in the organizations we create.

To make a long-term change, we had best find the ways to change the structures appropriately. Focusing on the patterns alone (or, worse, simply the bad events) is literally treating the symptoms, not the disease. Treating the symptoms might make things better in the short term, but we shouldn't be surprised when they return if the disease remains present. That's where the systemic approaches come in: they can help us find the structures at work creating our problems, and they can help us test our theories about proposed solutions. That doesn't always mean the same approach, and it doesn't always mean simulation. It does mean deriving insights from system principles and applying them effectively to solve real-world problems.

If you're in healthcare, do these issues ring true? What do you see?

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