Theory of Constraints Handbook - James Cox Iii [621]
While many of the support services utilized within healthcare have benefitted from, and will continue to benefit from, advancing technology, the interaction between a patient and a physician is one area of healthcare where it will not be possible to replace with automated services.
Telemedicine and remote consultations have their place, but these are compromise solutions to provide patients and their caregivers access to a wider community of clinicians. These technological advances are not a substitute for face-to-face consultations that can provide the clinician with a much greater depth of understanding of the patient’s condition and therefore their subsequent diagnosis and treatment needs.
Many attempts have been made to standardize the processes that form the interaction between a patient and clinician and while the outcomes of these interactions can share a commonality, the route through different levels of understanding and modes of communication are rarely the same from patient to patient.
The need for effective clinician/patient communication is gaining recognition with medical and nursing schools to the extent that many, if not all, now provide training in patient/clinician communication. In some schools, these programs carry a required pass mark for progression to qualification.
These programs offer evidence of healthcare systems’ reliance on the people working within it to provide the people working with patients, and each other, effective means of communication and the ability to adapt the required communication to a form that will contribute to the most effective clinical outcomes.
In short, successful outcomes associated with healthcare improvement initiatives are much more likely to occur when the “process units” (people responsible for delivering the service) are able to recognize, understand, and resolve relatively simple local problems through the use of standardized critical thinking processes, communication skills, and working practices.
By teaching the staff how to resolve problems effectively and by providing them with commonly understood management taxonomy and subsequent language that can be used on larger, systemic problems, it is possible to achieve greater success than the application of systemic solutions to standardize or improve operational process alone.
The Constantly Evolving Workforce
Being so people-dependent, healthcare has the never-ending task of providing service with a constantly evolving and changing workforce. It is a profession with clearly defined career paths and it has a culture of life-long learning. As additional patient needs are recognized, the necessary scope and depth of learning keeps growing. It is the ability to keep learning that underlies the adaptive nature of healthcare givers and provides the service with its greatest strength.
No matter what the configuration of a hospital, the people working within it can very quickly change the services conducted within its physical confines to meet the needs of their patients. Although this happens unnoticed each day in each facility, this adaptive behavior is most evident in times of large-scale disasters; a facility designed to treat patients with long-term chronic conditions can be transformed into a triage center for victims; a unit designated to treat children can provide care for adults; a dental hospital can house wounded military personnel. The function of a facility is more dependent on the skills of the people working within it than the physical plant in which they work.
In addition, the ability of staff to adapt to meet the challenges of prevailing circumstances provides the biggest managerial challenge in healthcare today.
As large-scale healthcare systems prepare to treat more patients, better, sooner, now and in the future, they face the task of aligning a workforce that possesses a very wide range of evolving clinical and interpersonal skills to move their organizations forward.
The Reality of Healthcare
In management terms, healthcare is a blend of two types of project management; that