Optimization has become a defining characteristic of modern healthcare.
We optimize, review, tweak and measure our systems and ourselves against an ultra-optimized standard. Better, faster, safer, more productive, effective and efficient.
We are always looking to improve. And for good reason. 21st century healthcare has prioritized improving safety and quality, and the results have been remarkable. Small changes in equipment sterilization or preoperative exhalation processes, for example, can have a significant impact on patient safety.
But not every corner of the hospital should be subject to six sigma scrutiny. And what do we do when the movement of patients in the preoperative or convalescent phase approaches perfection? How will health systems remain competitive? Or even be defined?
The greatest opportunities can be found in things that are rare. The winning variable could be what industrialism seeks to retain: connection, touch, presence and the unfolding of experiences.
Real money may be under selective sub-optimization. In other words, thinking intentionally about what we want to leave without measure and without perfection. And benefit can be found in the parts of the patient care journey left to the chance of human engagement: the conversations, connections, and experiences that unfold between people in real time during their stay in our facilities.
Let's not analyze the speed or effectiveness of our end-of-life discussions. Skin-to-skin contact time between a mother and her newborn may not belong on a chart. Seth Godin in The song of meaning was right : “Part of the challenge of leading a large organization is clearly identifying the right officers.»
You have to know what to measure. Or what not to measure.
Think of selective sub-optimization as the “wiggle room” found during the period under our responsibility. These elements of intentionally slow medicine are integrated into a sworn system of performance and effectiveness.
Real human engagement cannot be operationalized. The presence and depth of the connection escape measurement. This generation's experience of human caregivers measured with stopwatches has left us with unions and epidemic levels of burnout.
In an industry focused on incrementalism, it may be the rare, unmeasured part of the patient journey that sets a healthcare organization apart and gives it a competitive advantage.
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