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It takes a village to bring healthcare from good to great

December 9th, 2013

by Lynn McVey

"Congress is an evidence-free zone," Hillary Clinton joked at the recent Press Ganey conference. "We need more data and less suffering," she added on a serious note. I had arrived an hour early to get on line to listen to her speak. The next day, I did the same for Atul Gawande, M.D. Regarding healthcare reform, these two were on my own personal Mount Rushmore.

My life passion is disrupting healthcare using evidence-based practices to uncover expensive operational variations. I have been totally disgusted by some of the variations I've discovered over the years. The most repulsive waste was the hospital who had built three (three!) medical imaging departments. They built capacity for 900,000 exams a year. They were performing 100,000. It was no surprise the CEO's background was construction.

You can imagine my thrill to hear Hillary tell an audience of 2,500 healthcare leaders that "without good data, decisions are made based on emotion and experience." She was saying what I've been screaming for years!

[More:]

Although Lord Kelvin, a physicist from Belfast, Northern Ireland, died in 1917, he said "without a numerical understanding, we have no understanding." So here we are, 100 years later.

Finally ... data, metrics and evidence are being introduced to healthcare for the first time. Data is the heart of change, improvement and reform. Hillary optimistically anticipated a future where the healthcare system would be "data driven, evidence based and compassion driven," which filled me with hope.

If you haven't heard of Atul Gawande, M.D., do yourself a favor and read "The Cost Conundrum," which he wrote for The New Yorker magazine in June 2009. He's had me hooked since then. In fact, during the question-and-answer period, with shaking legs, I publicly admitted to him he was "my Bruce Springsteen" of healthcare.

What I'm not ashamed to add is the may be one phone call away from putting a restraining order on me as an online stalker. I love what he says. I love how he writes. I love his passion. And most of all, I love his goodness. Atul Gawande is a good man trying to bring "good" to healthcare. I appreciate anyone whose heart is in the right place when it comes to our beloved healthcare system.

"Criticizing a caregiver in front of a patient shakes the patient's confidence in the caregiver AND the doctor." Gawande began his presentation with this statement. (He had me at hello.) He told us mistakes will continue to be made. That is the nature of our beast. But what we do when mistakes are made is what separates us.

He told us the story of a patient who had a horrible post-surgical complication, which was discovered by the nurse and the resident because the surgeon "listened" to their concern. The patient was immediately scanned and was back on the operating room table in 90 minutes. Her life was saved. She is back at work.

Gawande's message is the failure to rescue when things go wrong is the difference between good and great. Every hospital has a complication rate. This is uncontrollable. However, how we rescue those patients is controllable. Not running away from a problem and having group capability (teamwork is crucial) is what makes a hospital great.

Before I met him, I thought Atul Gawande was larger than life. But meeting him changed my mind. He said humility is critical for physicians. He says without humility, patients die instead of getting rescued. He said physicians and caregivers must accept that we don't know it all. Me making him larger than life was a mistake. No physician should be held any higher that the rest of the caregivers. His message was loud and clear. Atul Gawande and Hillary Clinton send the same message. It takes a village.

Lynn McVey serves as CEO and president of Meadowlands Hospital Medical Center, an acute care, 230-bed hospital in New Jersey

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