jenuesse health

Over two years ago, the folks over at the athenahealth kindly invited me to submit columns to their Health Leadership Forum, and I have done so on an occasional basis since them. As I recently reviewed the columns, I realized that my own thoughts on the topics of leadership and coaching have evolved a bit, and I thought my readers over here at Not Running A Hospital might enjoy witnessing the transition. So for several days, I will be reprinting the posts from the Forum over here. Comments are welcome at the original site and here. Today's reprint is from a post dated July 23, 2013, "Disclosure and Apology Must be taught Before they Can be Learned." If our objective as leaders is to gradually transform the health care system to make it more patient-centered, we need to ensure the rising classes of young doctors are trained to carry out this form of medicine. Unfortunately, as noted by the Lucien Leape Institute, “[M]edical schools and teaching hospitals have n...

Over two years ago, the folks over at the athenahealth kindly invited me to submit columns to their Health Leadership Forum, and I have done so on an occasional basis since them. As I recently reviewed the columns, I realized that my own thoughts on the topics of leadership and coaching have evolved a bit, and I thought my readers over here at Not Running A Hospital might enjoy witnessing the transition. So for several days, I will be reprinting the posts from the Forum over here. Comments are welcome at the original site and here. Today's reprint is from a post dated May 28, 2013, "When Good Teams Go Wrong." When things go wrong in a hospital—on either the clinical or administrative front—we are often left wondering how a dedicated and thoughtful team of people could have jointly participated in the decisions and actions that led to the failures. Recent stories in the news may give us a clue. Problems recently uncovered at the Internal Revenue Service are typ...

Over two years ago, the folks over at the athenahealth kindly invited me to submit columns to their Health Leadership Forum, and I have done so on an occasional basis since them. As I recently reviewed the columns, I realized that my own thoughts on the topics of leadership and coaching have evolved a bit, and I thought my readers over here at Not Running A Hospital might enjoy witnessing the transition. So for several days, I will be reprinting the posts from the Forum over here. Comments are welcome at the original site and here. Today's reprint is from a post dated May 3, 2013, "Learning from Mistakes." As a leader, you must do everything you can to encourage people to admit mistakes they have made and to call out problems they have found in the organization. (As Amy Edmondson of Harvard Business School similarly suggested in an earlier post ). If people think they will get in trouble for having erred, or for having brought up a systemic problem in the organizati...

For some of us, one thing that makes Friday a great day is receiving Gene Lindsey's weekly email.  It's full of observations about the health care world, living in the woods of New Hampshire, and baseball--not to mention nostalgic visits to his childhood. (You can read previous editions here .) Gene is a die-hard adherent of Lean, a process improvement and managerial philosophy that has both been used to great effect in the hospital world and has been an utter failure in the hospital world.  I am pleased that my hospital's experience fell into the former camp. In this week's edition, Gene reviews John Toussaint's latest book Management on the Mend , where he excerpts useful thoughts offered by one of the most successful employers of Lean. Why has Lean succeeded in some places and failed in others? Gene summarizes the key lesson from the book: "I think there is great evidence that John has walked the talk. Indeed the necessity that leaders be personally transf...

A Whole Systems Approach to Product Design and Development   2015 MIT SDM Conference on Systems Thinking for Contemporary Challenges October 7, 2015 at Wong Auditorium, MIT Neal Yanofsky,  Chairman, Cheddar's Scratch Kitchen; Board Member and Senior Advisor, Snap Kitchen                                                Keynote —  Can Managers Contribute to Design that Creates Competitive Advantage? Everyone loves outstanding design, but how can it be used as a business tool that provides more than fleeting benefits? And how can left-brained managers effectively support and develop the work of right-brained designers? In this keynote address, Neal Yanofsky will explore the benefits and challenges of elevating design to a strategic tool. Additional speakers include: Todd P. Coleman, PhD; Steven D. Eppinger, ScD; Pat Hale; Matt Harper; Matthew S. Kressy...

Somewhat new to the issue, the SEIU has decided that it is unfair for non-Partners hospitals to get paid less than those affiliated with Partners Healthcare System. Priyanka Dayal McKluskey reports in the Boston Globe that the union "is pushing a ballot initiative that would divert millions of dollars from Partners HealthCare to lower-paid competitors in an effort to boost community hospitals and preserve union jobs." My readers know that I am sympathetic to the cause of equalizing insurance payments to the hospitals and physicians in the state.  Now, they are set mainly on the basis of market power, something contrary to the public good. Some of us have been talking about this issue for over a decade. But why is the union more recently interested in the topic? My hypothesis is that they finally realized that the stated business strategy of Steward Health Care System to be the low-cost provider competing with Partners just doesn't hold water.  Steward has shown no abi...

Christopher Weyant in The New Yorker , June 8-15, 2015 It's well past time to talk about the elephant in the room when it comes to robotic surgery: The increased anaesthesia-related risks from these procedures.  The question I ask today is whether, as part of the informed consent process, patients are given information about such risks.  Under principles of shared decision-making between the doctor and the patient, such risks should be carefully explained well before the short stay at the pre-op area. I've found little in the recent literature about this topic, although--based on my small sample of anaesthesiologists--it is a significant concern among their profession.  The concern most often expressed has to do with the extended length of procedures conducted robotically compared to traditional laparoscopic procedures or open procedures.  While anaesthesiologists are very good at handling long cases--and even unexpectedly long cases--they will generally tell you th...