May 18, 2009
A Network of Teams, Not an Integrated System
We were in and out of the hospital a lot back in March/April for the last few weeks with one of our kids (she’s ok now). One of us was with her 24 hours a day for the 10-11 days she was hospitalized, with lots of down time, which gave me lots of time to observe health care in action. While she ultimately got very good care at a very good hospital, it was incredibly clear to me that the hospital functioned as a network of teams, not as an integrated system.
The nurses were great. Followed their routine practices and responded to doctors’ orders on cue. Same with the nursing assistants. Same with the docs. Same with the phlebotomists and labs. Same with the hospital support staff. But the hand-offs from one team to the next, and from one shift to the next within a team, were seriously lacking.
What was wrong with this? Nothing was optimized around the patient. I mentioned this to my father-in-law, who is an HMO executive, and he noted that the concept of “patient-centric care” was a hot topic in managed care right now — but that it had also been a hot topic 10-15 years ago, to no apparent end (and not just in this one hospital that we were at). Seems like customer relationship management became a persistent priority in the rest of the business world years ago. Why hasn’t this stuck in health care?
This was a great exercise for me in thinking about the customer-centric view of a business. We talk here at Return Path about “stapling yourself to a customer” to see what they see. Every business should go through that exercise at some level regularly to make sure they’re functioning as an integrated system as far as the outside world is concerned.