Engineering Systems Solutions to Real World Challenges in Healthcare

moderator: Irving Wladawsky-Berger, Engineering Systems Division, Massachusetts Institute of Technology, MIT
author: Daniel Z. Aronzon
author: Nicholas Christiano Jr.
author: Stephen A. Katz
published: Sept. 3, 2013,   recorded: December 2006,   views: 67
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Description

The Rx for an ailing healthcare industry lies only partly with new technology, say these panelists, who report on their attempts to realize a streamlined vision of healthcare at their Hudson Valley regional hospital.

Pediatrician and CEO Daniel Aronzon describes a set of organizational challenges his institution faces, including accountability, transparency, safety, capacity, efficiency and cost. Myriad small problems can add up to millions in losses, and an occasional but catastrophic error may drain hospital resources. Aronzon notes that in the U.S., 97 thousand people die in hospitals every year because of such mistakes as giving a chemotherapy drug the wrong way. To get a handle on the safety problem, Aronzon has tried to create “a non-punitive just culture,” where employees who hurt patients by making “an honest mistake” are not punished. The hospital also invested in systems enhancements and prescription bar-coding technology to eliminate or mitigate such errors.

To cut expenses, Aronzon tagged computerized IV pumps with RFID, which prevented hoarding by staff and unnecessary replacement of the pricey machines. He frets about the coming demand on healthcare as boomers age: “Can’t you see it coming,” asks Aronzon, imagining this scene: “What do you mean there’s not enough nurses? I’ll sit on the call bell till they all come!”

After examining his hospital’s business model, Nicholas Christiano says his team decided that the most robust area for change lay with nurses. “They’re continually in motion,” running back and forth dealing with non-clinical issues. The model is “crazy and doesn’t work,” says Christiano.

The closest analogy to hospitals is the airline industry, where “if you make a mistake you have a catastrophic event,” says Christiano. To avoid errors, the airline industry has an infrastructure “that can support and track everything in a real-time environment.” Christiano proposed a wireless communication network for nurses, which he promoted through an internal marketing campaign as a way of easing nurses’ workload and enhancing their interactions with patients.

Despite all the technological advances, Stephen Katz believes healthcare is still informed by a 1950s culture. Medicine “hasn’t had to deal with efficiencies other businesses have had to establish in the same years.” But more so than other industries, “we’re a people business -- people at their very worst and stressed out.” The question, says Katz, is how to improve the lives of staff, with new systems and technology, “to bring them along with us for the betterment of the patients.”

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