Lean works, but execs balk

Re: "Goodbye Best Practice, Hello Lean" by Haydn Bush in H&HN Daily, Aug. 9

I have used Lean before in health care and was told it would not translate from other industries. Well, it did and it will only get better as more facilities use it. In the facility I was in, we improved patient care by giving nurses more time with their patients, freeing up a pharmacist to round with physicians, and reducing potential medication errors.

We lowered cost by eliminating waste in work processes, moving tasks from higher-salaried employees to lower-salaried employees and reducing the number of medications about to expire. We also identified areas where the facility was not charging for items or work they should have been. The use of Lean was to improve patient safety, which it did; all the other items were normal outcomes from Lean. My biggest issue was lack of buy-in from senior management.

Jim Hampton

3 keys to patient-customer service

Re: "Bad Attitudes, Bad Service Just Won't Cut It" by Bill Santamour in H&HN Daily, Aug. 7

Upgrading patient satisfaction scores and delivering customer-focused care require three things: an organizational commitment (consistently and visibly demonstrated); an easy, inexpensive, interactive and "customizable" way to deliver the skills to every function and employee; and accountability (clear service performance standards established, taught in orientation, and applied in performance appraisals).

Susan Berk

Nurses get big degrees. Then what?

Re: "Trends in Nursing: Blame the Boomers (Again)" by Bill Santamour in H&HN Daily, July 24

Lots of questions come to mind. Is the higher education going to be commensurate with a higher wage as it is in other professions and business? Will the nurses obtaining the higher education want to move from the bedside to less stressful or more manageable working hours? Or will other fields become more inviting due to the nature of nursing? Will the hospitals increase the staffing to accommodate the higher-educated nurse questioning the status quo and safety of patients and staff?

Kathy

Compassionate care thwarted

Re: "Understanding the Need for Empathy in Health Care" by Marty Stempniak in H&HN Daily, Aug. 13

I truly believe that a great majority of providers are very empathetic individuals — it is why they went into health care in the first place. A lack of time to spend with patients and a task-oriented focus interferes with the ability to provide compassionate care. Inadequate staffing and training, lack of time to provide comprehensive care, and no mechanism for team building are barriers to empathetic care.

Julia Hallisy, D.D.S.
The Empowered Patient Coalition

Primary care forecast is dismal...

Re: "A Coming Physician Shortage for Medicare and Medicaid Patients" by Nathan Kaufman in H&HN Daily, July 25

My area of expertise is in health care data visualization and analysis. Having examined data from Massachusetts, the trend lines for primary care physicians who are older than 55 and those who are newly minted is very telling. In short, the 55-plus group is selling out to a hospital or like organization, or simply retiring early. Concurrently, only 20 percent of new doctors are going into primary care. Net-net, the top of the funnel has 18 million new patients coming on line and the theory of constraints tells a very dismal story for those who will need care and how long they can wait.

Larry Keller

...so wake up to what NPs can do

I find it so interesting that use of nurse practitioners to effectively fill this gap, including freeing state practice acts from physician "supervision" mandates, is not mentioned. Wake up, America. The data are in: NPs are effective and efficient in maintaining patients at home while they indeed get better.

Chandice Covington