The New Health Dialogue

This is the first of a two part blog series on the Pittsburgh Regional Health Initiative. Today, an overview, tomorrow how two specific hospitals tackled hospital-acquired infections.

Before I arrived at the New America Foundation in DC, I lived and interned in and around Pittsburgh, PA. Pittsburgh is well-known for its football team and its innovation in sandwiches (though as a health care policy blog, we probably can’t officially condone putting French fries on a sandwich), but Pittsburgh also deserves recognition for another area where the city has been an innovator -- health care quality and patient safety.

I spent a summer a few years back working at the Pittsburgh Regional Health Initiative (PRHI), a nonprofit organization dedicated to improving health care quality and safety in Southwestern PA. PRHI is a coalition of area medical, business, and civic leaders who believe that improving health care quality is a fiscal imperative that will help contain rising health care costs. PRHI provides resources and information to health care organizations and leaders looking to improve patient safety and quality of care.

PRHI developed an initiative, Perfecting Patient Care to encourage, support and guide providers and clinicians in improving the quality of their care delivery. Like the Virginia Mason Production System at Virginia Mason Hospital in Seattle, Perfecting Patient Care is based on the Toyota Production System (and yes, we’re talking about the car manufacturer). The basic principles of these quality improvement systems center on “eliminating errors, inefficiency and waste in complex systems through continuous improvement and standardization of work practices,” according to the PRHI website. The perfecting care philosophy is “hands on” and it empowers caregivers at all levels to think critically about how to improve their routine to promote safety and efficiency.

One activity in the perfecting care course I participated in involved building circuit boards as a part of a team. Once we made sure everyone understood their tasks and responsibilities, practiced open communication, and thought about eliminating wasteful steps, we were able to churn out much better circuit boards at a much faster rate. Each action -- handing off a circuit, or placing a wire -- should add value to the final product. Everyone on the team had a valuable perspective to offer on what was wasteful, what could be improved.

The lesson applies to health care delivery. For example, if a nurse has to walk to five different storage cabinets throughout the hospital to get the supplies to change one IV, it’s a waste of time for her, for her patient, and for the hospital that’s funding that elapsed time. That same nurse is in a good position to suggest an improvement -- like moving all those supplies to a single storage cabinet. (Here’s a real world example of how one Boston hospital did just that).