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I hope to make 2012 a year of continuing my focus on preventing problems. As many of you may know, I have been writing a book on that topic. Every day, we see reaction to problems and the resulting problem-solving cycle, both personally and professionally.
The book is titled Problem Prevention in Medical Processes and Procedures. I am working with a top surgeon here in Rochester, Dr. Louis Eichel, to tune the 8-step problem prevention process for the medical field. Dr. Eichel has allowed me to observe a major surgical procedure and has also steeped me in the process of patient flow at his medical practice. Both of these medical environments comprise complex, integrated systems of people, technology and information flows, transitions and unfortunately - problems - in no small number.
Today's physician cannot function very well without a core team working in harmony with a variety of organizations, other teams and unique individuals, all dedicated to safe and effective patient outcomes. Sounds a lot like our world of technology and product development, does it not? Having consulted for and with medical device and pharmaceutical companies, I see an opportunity to close the loop between developing new or improved medical products and the physicians and their teams who use them in their clinical environment. What I am discovering is that The Problem Machine, a term I use for the dynamics of the life cycle of a problem, is very similar in both the processes for delivering medical care and the processes for developing the products used during the delivery of medical care.
The following is a model of The Problem Machine. It is an illustration of how a problem is initiated, grows and reaches it maximum impact before it begins to recede - leaving disruptive or damaging consequences in its wake as it completes its life cycle. This illustration is adapted for doctors and healthcare providers.
It starts with the environment in which a potential
medical problem can occur...
Both human tasks and enabling medical technology contain the opportunity for a potential problem to exist ...
The flow and order of the many tasks, actions and interactions bound the initiation point for the Problem Machine to activate...
Unwanted sources of variation initiate the dynamics of a potential problem becoming real...
Next, we see the progression of the dynamics of the Problem Machine. The problem may follow a slow pattern of growth and consequences or it may act like a light switch and spring to its full impact in a few milliseconds...
There is a difference between a problem that progresses from being medically meaningful to medically significant. In general, a problem that is medically meaningful represents variation that is building to a point where it is definitely affecting measures of human health but has not yet caused damage. Medically significant variation is definitely starting to cause either repairable or irreparable damage to the patient.
The Problem Machine can be disrupted in two places: (a) prior to medically meaningful variation via outright preventive action, or (b) during the early stages of detectable, medically meaningful variation in the patient, via contingent action. Here we use innovation to enhance the medical team's judgment, experience and will to break out of the reactive, problem-solving paradigm that is all too common in current medical processes and procedures.
Finally, if a medical team gets blind-sided by an unforeseeable problem, then corrective action is their only option. Beyond the Ambulance and the Emergency Room, we would like to avoid reacting to blind-siding events in non-emergency situations, and instead anticipate preventive or contingent actions wherever possible.
Problem Prevention has much to offer in any professional or personal environment. I wish you all a great new year and may you have a very pro-active 2012!
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