p.1 The old way no longer works. Like a lumbering dreadnought,
once the envy of all those at sea, health care delivery in America became outmoded not for a single reason but for many reasons.
A modification here and there was no longer sufficient; a completely new kind of ship was needed - radically redesigned.
Breakthroughs are required. Old thinking
must be vigorously shaken off like water on a dog.
p.4 Patients are not boxes. They are complex
systems.
Although the basic concept is intuitive and
well accepted, the principles and application of systems thinking are too rarely applied in health care.
In an industry with hundreds of self-designated "systems," this lack of a true system orientation stands as a great irony.
The dynamic nature of systems
requires structural fluidity. Integrated organizations will need to flex and evolve if they are to withstand the buffeting
of the marketplace.
p.6 Most computer-based information systems operating in hospitals
remain creatures of finance. Such information systems themselves are not value-added. Only information that allows
the organization to respond more effectively and profitably to customer needs is "value-added."
p.7 According to Harvard professor Kim B.
Clark, "Every product reflects the organization and the development process that created it. Companies
that consistently develop successful products - products with integrity - are themselves coherent and integrated.
Moreover, this coherence is distinguishable, not just at the level of structure and strategy, but more importantly, at the
level of day-to-day work and individual understanding."
p.7 When it comes to redesigning the work
of the organization, there are really only three questions to be asked and answered, "What does the customer want?",
"How can we best organize to meet the customer's needs?" and "How do we need to change the work we do every day?"
Everybody should get a piece of the question and a piece of the answer.
