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Tom Peters’
Re-Imagine!Business Excellence in
a Disruptive AgeCHIME Fall CIO Forum
Dynamic Times Demand Dynamic StrategiesHilton La Jolla Torrey Pines/10.27.2004
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Slides at …
tompeters.com
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V.A. Moment …
1Y/2N: Commerce Bank2 Pizzas: JB
Plastic Bulldozer: MD
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XYZ Corp: Complete Vision & Values
Any Service or Product of ours is yours
for absolutely NO CHARGE if any employee says—or implies—to you
at any point …
“It’s Not My Fault.”
V. Big Cheese, Founder, CEO & Dictator
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Employee Manual
Item 1.0. I.N.M.F. =
F.O.
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Part I:
A Brand New Ballgame!
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Re-imagine!
Summer 2004: Not Your
Father’s World.
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26
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“We’re now entering a new phase of business where the group will be a
franchising and management company where brand management is central.” —David
Webster, Chairman, InterContinental Hotels Group
“InterContinental will now have far more to do with brand ownership than hotel
ownership.” —James Dawson of Charles Stanley (brokerage)
Source: International Herald Tribune, 09.16, on the sacking of CEO Richard North, whose entire background is in finance
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1. Re-imagine Everything: All Bets Are Off.
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Jobs New Technology
GlobalizationSecurity
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2. Re-imagine Permanence:
The Emperor Has No Clothes!
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Forbes100 from 1917 to 1987: 39 members of the Class of ’17 were alive
in ’87; 18 in ’87 F100; 18 F100 “survivors” underperformed the market
by 20%; just 2 (2%), GE & Kodak, outperformed the market 1917 to 1987.
S&P 500 from 1957 to 1997: 74 members of the Class of ’57 were
alive in ’97; 12 (2.4%) of 500 outperformed the market from 1957 to 1997.
Source: Dick Foster & Sarah Kaplan, Creative Destruction: Why Companies That Are Built to Last Underperform the Market
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3. Re-imagine Organizing I:
IS/IT Leads the (Virtual) Way!
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Productivity!
McKesson 2002-2003: Revenue … +$7B
Employees … +500
Source: USA Today/06.14.04
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100 square feet
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E.g. …
Jeff Immelt: 75% of “admin, back room, finance” “digitalized” in
3 years.
Source: BW (01.28.02)
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“Dawn Meyerreicks, CTO of the Defense Information Systems Agency, made one of the most fateful military calls of the 21st century. After 9/11 … her office
quickly leased all the available transponders covering Central Asia. The implications should change everything about U.S. military thinking in the
years ahead.
“The U.S. Air Force had kicked off its fight against the Taliban with an ineffective bombing campaign, and Washington was anguishing over whether to send in a few Army divisions. Donald Rumsfeld told Gen. Tommy Franks to
give the initiative to 250 Special Forces already on the ground. They used satellite phones, Predator surveillance drones, and GPS- and laser-based
targeting systems to make the air strikes brutally effective.
“In effect, they ‘Napsterized’ the battlefield by cutting out the middlemen (much of the military’s command and control) and working directly with the
real players. … The data came in so fast that HQ revised operating procedures to allow intelligence analysts and attack planners to work directly
together. Their favorite tool, incidentally, was instant messaging over a secure network.”—Ned Desmond/“Broadband’s New Killer App”/Business
2.0/ OCT2002
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“MIT Everyware: EVERY LECTURE, EVERY QUIZ, ALL ONLINE, FOR
FREE. MEET THE GLOBAL GEEKS GETTING AN MIT EDUCATION,
OPEN SOURCE-STYLE.” —Headline/Wired/09.03
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“Our entire facility is digital. No paper, no film, no medical records. Nothing. And it’s all integrated—from the lab to X-ray to records to physician order entry. Patients don’t have to wait for anything. The information from the physician’s office is
in registration and vice versa. The referring physician is immediately sent an email telling him his patient has shown up. … It’s wireless in-house. We have 800 notebook computers that are wireless. Physicians can walk around with a computer that’s
pre-programmed. If the physician wants, we’ll go out and wire their house so they can sit on the couch and connect to the
network. They can review a chart from 100 miles away.” —David Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)
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“Some grocery stores have better
technology than our hospitals and
clinics.” —Tommy Thompson, HHS
Secretary
Source: Special Report on technology in healthcare, U.S. News & World Report (07.04)
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“Ebusiness is about rebuilding the organization from the
ground up. Most companies today are not built to exploit the Internet.
Their business processes, their approvals, their hierarchies, the
number of people they employ … all of that is wrong for running an
ebusiness.”Ray Lane, Kleiner Perkins
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Words to Live By …
“Hierarchy is an organization with its face
toward the CEO and it’s a__ toward the customer.”
Jack Welch
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07.04/TP In Nagano …
Revenue: $10B
FTE: 1*
*Maybe
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Not “out sourcing”Not “off shoring”
Not “near shoring”Not “in sourcing”
but …
“Best Sourcing”
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IS/IT is strategy!
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5% F500 have CIO on Board: “While some of the world’s
most admired companies—Tesco, Wal*Mart—are transforming the business
landscape by including technology experts on their boards, the vast majority are
missing out on ways to boost productivity, competitiveness and shareholder value.”
Source: Burson-Marsteller
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4. Re-imagine the Organizing II: The
Professional Service Firm (“PSF”) Imperative.
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Sarah: “ Papa, what do you do?”
Papa: “I’m ‘overhead.’ ”
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Sarah: “ Daddy, what do you do?”
Papa: “I manage a ‘cost center.’ ”
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Sarah: “ Daddy, what do you do?”
Papa: “I’m a ‘bureaucrat.’ ”
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Answer: PSF![Professional Service Firm]
Department Head
to …
Managing Partner, Finance [IS, etc.] Inc.
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“Typically in a mortgage company or financial services company, ‘risk
management’ is an overhead, not a revenue center. We’ve become more
than that. We pay for ourselves, and we
actually make money for the company.” —Frank
Eichorn, Director of Credit Risk Data Management Group, Wells Fargo Home Mortgage (Source: sas.com)
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Eichorning
Mantra: “Eichorn it!”
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5. Re-imagine Business’
Basic Value Proposition: PSFs Unbound/ The
“Solutions Imperative.”
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And the “M” Stands for … ?
Gerstner’s IBM: “Systems Integrator of choice.” (BW)
IBM Global Services: $35B
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“Big Brown’s New Bag: UPS Aims to Be the Traffic Manager
for Corporate America” —Headline/BW/07.19.2004
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New York-Presbyterian: 7-year, $500M consulting (systemic) and equipment contract with
GE Medical Systems
Source: NYT/07.18.2004
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Eichorning
Mantra: Eichorn it!”
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9. Re-imagine the Fundamental Selling
Proposition: “It” all adds up to …
THE BRAND (THE STORY).
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“WHO ARE WE?”
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“WHAT’S OUR
STORY?”
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Story > Brand
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10. Re-imagine the Roots of Innovation: THINK WEIRD … the
High Value Added Bedrock.
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FLASH:
Innovation is
easy!
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Saviors-in-Waiting
Disgruntled CustomersOff-the-Scope Competitors
Rogue EmployeesFringe Suppliers
Wayne Burkan, Wide Angle Vision: Beat the Competition by Focusing on Fringe Competitors, Lost Customers, and Rogue Employees
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“To grow, companies need to break out of a
vicious cycle of competitive
benchmarking and imitation.” —W. Chan Kim & Renée
Mauborgne, “Think for Yourself —Stop Copying a Rival,” Financial Times/08.11.03
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“This is an essay about what it takes to create and sell something remarkable. It is a plea for originality, passion, guts and daring. You can’t be remarkable by following someone else who’s remarkable. One way to figure
out a theory is to look at what’s working in the real world and determine what the successes have in common. But what could the Four Seasons and
Motel 6 possibly have in common? Or Neiman-Marcus and Wal*Mart? Or Nokia (bringing out new hardware every 30 days or so) and Nintendo
(marketing the same Game Boy 14 years in a row)? It’s like trying to drive
looking in the rearview mirror. The thing that all these companies have in common is that they have nothing in common. They are outliers. They’re on the fringes.
Superfast or superslow. Very exclusive or very cheap. Extremely big or extremely small. The reason it’s so hard to follow the leader is this: The
leader is the leader precisely because he did something remarkable. And that remarkable thing is now taken—so it’s no longer remarkable when you
decide to do it.” —Seth Godin, Fast Company/02.2003
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Innovation!
NOT
Imitation
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13. Re-imagine
Excellence I: The Talent
Obsession.
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Brand = Talent.
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From “1, 2 or you’re out” [JW] to …
“Best Talent in each industry segment to build
best proprietary intangibles” [EM]
Source: Ed Michaels, War for Talent
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Did We Say “Talent Matters”?
“The top software developers are more productive than
average software developers not by a factor of 10X or 100X, or
even 1,000X,
but 10,000X.” —Nathan Myhrvold,
former Chief Scientist, Microsoft
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14. Re-imagine Excellence II: Meet the
New Boss … Women Rule!
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“AS LEADERS, WOMEN RULE: New Studies find that female managers
outshine their male counterparts in almost
every measure”Title, Special Report/BusinessWeek
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Women’s Strengths Match New Economy Imperatives: Link [rather than rank] workers;
favor interactive-collaborative leadership style [empowerment beats top-down decision making]; sustain fruitful collaborations; comfortable with sharing information; see redistribution of power
as victory, not surrender; favor multi-dimensional feedback; value technical & interpersonal skills, individual & group contributions equally; readily accept ambiguity; honor intuition as well as pure
“rationality”; inherently flexible; appreciate cultural diversity.
Source: Judy B. Rosener, America’s Competitive Secret: Women Managers
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16. Re-imagine Leadership for Totally Screwed-Up
Times:
The Passion Imperative.
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Start a Crusade!
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G.H.: “Create a ‘cause,’ not a ‘business.’
”
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“Beware of the tyranny of making Small
Changes to Small
Things. Rather, make
Big Changes to Big Things.” —Roger Enrico, former Chairman, PepsiCo
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Make It a Grand
Adventure!
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“Ninety percent of what we call ‘management’ consists of making it difficult for people to
get things done.” – Peter Drucker
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“I don’t know.”
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Quests!
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Organizing Genius / Warren Bennis and Patricia Ward Biederman
“Groups become great only when everyone in them, leaders and
members alike, is free to do his or her absolute best.”
“The best thing a leader can do for a
Great Group is to allow its members to discover their
greatness.”
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Yes!!!!!!!!!!!!!!!!!
“free to do his or her absolute best” …
“allow its members to discover their
greatness.”
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“Reward excellent
failures. Punish mediocre
successes.”Phil Daniels, Sydney exec (and, de facto, Jack)
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Dispense Enthusiasm!
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“You can’t behave in a calm, rational
manner. You’ve got to be out there on
the lunatic fringe.” —
Jack Welch
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Part II: Healthcare
Horrors & Hope
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1. Premise.
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“If one didn’t know better, one might think that hospitals set
out to design systems that provide the most sophisticated technical care but deliver the worst possible experience to sick people.” —Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
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Golden American Age of Patient-centric, Genetics-driven Healthcare Looms!
Current status: $1.3T+. 30M-70M uninsured. 100K killed and 2M injured p.a. in hospitals. 85% treatments
unproven. Cure prescribed depends on locale in which treated. 50% prescriptions do not work. 2X hospitals.
IS primitive. Accountability & measurement nil.
And … EVERYBODY’S MAD-AS-HELL AND FEELS POWERLESS: DOCS, PATIENTS, NURSES, INSURERS,
EMPLOYERS, PHARMA & DEVICE COS, HOSPITAL ADMINISTRATORS AND STAFF.
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2. Consumerism (Patient-centric Healthcare Arrives)
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“We expect consumers to move into a position of dominance in the early
years of the new century.”
Dean Coddington, Elizabeth Fischer, Keith Moore & Richard Clarke, Beyond Managed Care
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Today’s Healthcare “Consumer”:
“skeptical and demanding”
Source: Ian Morrison, Health Care in the New Millennium
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“Savior for the Sick”
vs.
“Partner for Good Health”
Source: NPR
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CAM (Complementary & Alternative Medicine):
83M in US (42%)CAM visits 243M greater than to PCP (Primary Care
Physician) (With min insurance coverage)W-F-Educated-Hi incDon’t tell PCP (40%)
(<30% procedures used in conventional medicine have undergone RCTs/randomized clinical trials)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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Consumer Imperatives
ChoiceControl (Self-care, Self-management)
Shared Medical Decision-makingCustomer Service
InformationBranding
Source: Institute for the Future
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3. Demographics: The BOOMERS Reach 60 in ’05!
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“NOT ACTING THEIR AGE: As Baby Boomers
Zoom into Retirement, Will America Ever Be the
Same?”USN&WR Cover
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Boomer World
“From jogging to plastic surgery, from vegetarian diets
to Viagra, they are fighting to preserve their youth and
defy the effects of gravity.”M.W.C. Howgill, “Healthcare Consumerism, the Information
Revolution and Branding”
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“Pick up any copy of Glamour or Men’s Health, and you’ll see pages of advertisements encouraging readers
to enlarge their breasts, retard baldness, correct their vision,
improve their smile, or relieve stress through herbs, massage therapy,
acupuncture—you name it.”Coddington, Fischer, Moore & Clarke, Beyond Managed Care
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“Sixty Is the New Thirty”
—Cover/AARP/11.03
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4. “Quality”: COULD IT TRULY BE
THIS AWFUL?
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“Quality of care is the problem, not
managed care.”Institute of Medicine
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“A healthcare delivery system characterized by idiosyncratic
and often ill-informed judgments must be restructured
according to evidence-based medical practice.”Demanding Medical Excellence: Doctors and Accountability in
the Information Age, Michael Millenson
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“As unsettling as the prevalence of inappropriate care is the enormous amount of what can only be called
ignorant care. A surprising 85% of everyday medical treatments have never been scientifically
validated. … For instance, when family practitioners in Washington State were queried about treating a simple urinary tract infection, 82 physicians
came up with an extraordinary 137 strategies.”
Demanding Medical Excellence: Doctors and Accountability in the Information Age, Michael Millenson
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CDC 1998: 90,000 killed
and 2,000,000 injured from nosocomial
[hospital-caused] drug errors & infections
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1,000,000 “serious
medication errors per year” … “illegible handwriting, misplaced decimal points, and missed drug
interactions and allergies.”
Source: Wall Street Journal / Institute of Medicine
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HealthGrades/Denver: 195,000 hospital deaths per year in the U.S., 2000-2002 =
390 full jumbos/747s in the drink per year. Comments: “This should give you pause when you go to the hospital.” —Dr. Kenneth Kizer, National Quality
Forum. “There is little evidence that patient safety has improved in the
last five years.” —Dr. Samantha Collier
Source: Boston Globe/07.27.04
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“This should give you pause when you go to the
hospital.”
“There is little evidence that patient safety
has improved in the last five years.”
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RAND (1998): 50%, appropriate preventive care. 60%,
recommended treatment, per medical studies, for chronic
conditions. 20% chronic care treatment that is wrong.
30% acute care treatment that is wrong.
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“In a disturbing 1991 study, 110 nurses of varying experience levels took a written test of their ability to
calculate medication doses. Eight out of 10 made calculation mistakes at
least 10% of the time … while four out of 10 made mistakes 30 %
of the time.”Demanding Medical Excellence: Doctors and Accountability
in the Information Age, Michael Millenson
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YE GADS! New England Journal of Medicine/ Harvard Medical Practice Study: 4% error rate (1 of 4 negligence). “Subsequent investigations around the
country have confirmed the ubiquity of error.” “In one small study of how clinicians perform when patients
have a sudden cardiac arrest, 27 of 30 clinicians made an error in using the defibrillator.” Mistakes in
administering drugs (1995 study) “average once every hospital admission.” “Lucian Leape, medicine’s
leading expert on error, points out that many other industries—whether the task is manufacturing
semiconductors or serving customers at the Ritz Carlton—simply wouldn’t countenance error rates like
those in hospitals.”—Complications, Atul Gawande
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“In health care,
geography is destiny.”
Source: Dartmouth Medical School 1996 report
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Geography Is Destiny
“Often all one must do to acquire a disease is to enter a country where a disease is recognized—leaving the
country will either cure the malady or turn it into something else. … Blood pressure
considered treatably high in the United States might be considered normal in England; and the low blood
pressure treated with 85 drugs as well as hydrotherapy and spa treatments in Germany would entitle its sufferer to lower life insurance rates in the
United States.” – Lynn Payer, Medicine & Culture
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Geography Is Destiny
E.g.: Ft. Myers 4X Manhattan—back surgery. Newark 2X New Haven—
prostatectomy. Rapid City SD 34X Elyria OH—breast-conserving surgery. VT, ME, IA: 3X differences in hysterectomy
by age 70; 8X tonsillectomy; 4X prostatectomy Breast cancer screening: 4X NE, FL, MI vs. SE, SW. (Source: various)
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PARADOX: Many, many formal case reviews …
failure to systematically/ systemically/ statistically
look at and act on evidence.C.f., Complications, Atul Gawande
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“Most physicians believe that diagnosis can’t be reduced to a set of generalizations—to a ‘cookbook.’ … How often does my intuition lead me astray? The radical implication of
the Swedish study is that the individualized, intuitive approach that lies at the center of modern medicine is flawed—it causes more mistakes
than it prevents.” —Atul Gawande, Complications
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Deep Blue Redux*: 2,240 EKGs … 1,120 heart attacks.
Hans Ohlin (50 yr old chief of coronary care, Univ of
Lund/SW) : 620. Lars Edenbrandt’s
software: 738.
*Only this time it matters!
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“Practice variation is not caused by ‘bad’ or ‘ignorant’ doctors. Rather, it is a natural
consequence of a system that systematically tracks neither its processes nor its outcomes,
preferring to presume that good facilities, good intentions and good training lead automatically
to good results. Providers remain more comfortable with the habits of a guild, where
each craftsman trusts his fellows, than with the demands of the information age.”
Michael Millenson, Demanding Medical Excellence
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Genius Required?
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Leapfrog Group:
CPOE/Computerized Physician Order Entry*ICU staffing by trained intensivists**EHR/Evidence-based Hospital Referral***
*Duh I: Welcome to the computer age.**Duh II: How about using experts?***Duh III: If you do stuff a lotta times, you tend to get/be better. Source: HealthLeaders
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The Benefits of … FOCUSED EXCELLENCE
Shouldice/Hernia Repair: 30-45 min, 1% recurrence.
Avg: 90 min, 10%-15% recurrence.
Source: Complications, Atul Gawande
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5. The IS/Web REVOLUTION
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“Some grocery stores have better
technology than our hospitals and
clinics.” —Tommy Thompson, HHS
Secretary
Source: Special Report on technology in healthcare, U.S. News & World Report (07.04)
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“We’re in the Internet age, and the average
patient can’t email their doctor.”
Donald Berwick, Harvard Med School
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Computerized Physician Order
Entry/CPOE: 5% of U.S.
hospitals
source: HealthLeaders/06.02
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“Our entire facility is digital. No paper, no film, no medical records. Nothing. And it’s all integrated—from the lab to X-ray to records to physician order entry. Patients don’t have to wait for anything. The information from the physician’s office is
in registration and vice versa. The referring physician is immediately sent an email telling him his patient has shown up. … It’s wireless in-house. We have 800 notebook computers that are wireless. Physicians can walk around with a computer that’s
pre-programmed. If the physician wants, we’ll go out and wire their house so they can sit on the couch and connect to the
network. They can review a chart from 100 miles away.” —David Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)
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“Patient by patient, problem by problem—drug reactions, hospital
caused infections—Salt Lake City’s LDS Hospital has attacked treatment-
caused injuries and deaths. One of the secrets of LDS’s success is a custom-
built clinical computer system that may serve as a national model for how
to save patient lives.”Demanding Medical Excellence: Doctors and Accountability
in the Information Age, Michael Millenson
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6. HealthCare21
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HealthCare21: 21 Ideas for Century211. Hospitals kill people. (And many of those they don’t kill, they wound.) (And they deny it.) (ERRORS RULE!) And: Hustling ambulances kill pedestrians—and don’t save patients.2. Doctors are spoiled brats—who don’t like measurements. Or any form of “interference.” Docs are also cover-up artists. The REAL Hippocritic [sic?] Oath: “DON’T RAT ON A FELLOW DOC”. 3. Most prescription drugs don’t work—for a PARTICULAR patient. Current drugs = Blunderbusses.4. Think … WELLNESS. Think … PREVENTION.5. THERE IS LITTLE “SCIENCE” IN “MEDICINE.” (See state to state variations … country to country variations … the general lack of agreed-upon treatments.)6. You could save thousands of lives—if you simply outlawed handwritten prescriptions.7. “Detailers” will disappear … when GenX docs arrive.
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HealthCare21 (Cont.)8. IS/IT in hospitals is primitive (despite smart people and enormous expenditures—think Sears v. Wal*Mart).9. Systemic IS/IT is worse—links between docs, insurers, providers, patients.10. ELECTRONIC MEDICAL RECORDS …TO UNIFORM STANDARDS. (NOW.) 11. THE WEB WILL LIBERATE. (Info = Power.) 12. 80M BOOMERS RULE. ($$$$$. Desire for c-o-m-p-l-e-t-e CONTROL. NOW. “LEADERSHIP” OF AGING PROCESS.)13. “Drug Discovery” processes at Big Pharma are … hopelessly over-complicated. (???: Bye Bye … Big Pharma.)14. 90% of the “healthcare fix”: HARVEST THE LOW-HANGING FRUIT. “They” are … NOT … the Enemy. “I have seen the enemy … and it am me.” Damn it.
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HealthCare21 (Cont.)15. The number of U.S. un-insured is the nation’s #1 disgrace. That said, insured “consumers” are spoiled brats. They/we/me act as if healthcare were a free good … and believe that an incipient hangnail calls for at least a CAT scan … or two. ANSWER: MAKE US FEEL THE PAIN.16. Genetic engineering & biotech change … EVERYTHING. (Within 15 years.)17. New Medical Devices change … EVERYTHING. (Within 15 years.)18. IS/IT changes … EVERYTHING. (Within 10 years.)19. New Docs change … EVERYTHING. (Within 10 years.)20. New Patients change … EVERYTHING. (Within 5 years.)
* *
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HealthCare21 (Cont.)
21. ALL THIS = ENORMOUS OPPORTUNITY. The
Opportunity of Several Lifetimes. (For the Bold & Brave.) H’Care WILL be … TOTALLY … re-invented in the next two decades. (And, hey, it is our largest “industry.”)
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7. Doing It RightPlanetree: A Radical
Model for New Healthcare/Healing/Wellness Excellence
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“It was the goal of the Planetree Unit to help patients not only get well faster but also to stay well longer.” —Putting
Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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The 9 Planetree Practices
1. The Importance of Human Interaction2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information3. Healing Partnerships: The Importance of Including Friends and Family4. Nutrition: The Nurturing Aspect of Food5. Spirituality: Inner Resources for Healing6. Human Touch: The Essentials of Communicating Caring Through Massage7. Healing Arts: Nutrition for the Soul8. Integrating Complementary and Alternative Practices into Conventional Care9. Healing Environments: Architecture and Design Conducive to Health
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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1. The Importance of Human Interaction
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“There is a misconception that supportive interactions require more staff or more time and are therefore more costly.
Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget.
Kindness is free. Listening to
patients or answering their questions costs nothing. It can be argued that negative interactions—alienating patients, being
non-responsive to their needs or limiting their sense of control—can be very costly. … Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring
far more time than it would have taken to interact with them initially in a positive way.” —Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
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Press Ganey Assoc/1999: 139,380 former patients from 225 hospitals
0 of top 15 factors determining Patient Satisfaction referred to patient’s health outcome
PS directly related to Staff Interaction
PS directly correlated with ES (Employee Satisfaction)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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Mgrs re staff: wages, security, promotion opportunities
Staff re staff: interesting work (M:5 of 10), appreciation (5 of 10), sense of being “in” about
what’s going on (10 of 10)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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“Planetree is about human beings caring
for other human beings.” —Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel (“Ladies and gentlemen serving ladies and gentlemen”—4S credo)
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2. Informing and Empowering Diverse
Populations: Consumer Health Libraries and
Patient Information
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Planetree Health Resources Center/1981Planetree Classification System
Consumer Health LibrariansVolunteers
Classes, lectures (CR)Health Fairs
Griffin’s Mobile Health Resource CenterOpen Chart Policy
Patient Progress NotesCare Coordination Conferences (Est goals, timetable,
etc.)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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3. Healing Partnerships: The
Importance of Including Friends
and Family
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“When hospital staff members are asked to list the attributes of the ‘perfect patient and family,’ their
response is usually a passive patient with no family.” —Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
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The Patient-Family Experience
“Patients are stripped of control, their clothes are taken away, they have little say over their schedule, and they are deliberately separated
from their family and friends. Healthcare professionals control all of the information
about their patients’ bodies and access to the people who can answer questions and connect
them with helpful resources. Families are treated more as intruders than loved ones.”
—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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“Family members, close friends and ‘significant others’ can have a far
greater impact on patients’ experience of illness, and on their
long-term health and happiness, than any healthcare professional.” —Through
the Patient’s Eyes
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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“A 7-year follow-up of women diagnosed with breast cancer
showed that those who confided in at least one person in the 3
months after surgery had a 7-year
survival rate of 72.4%, as compared to 56.3% for those who
didn’t have a confidant.”Institute for the Future
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Care Partner Programs (IDs, discount meals, etc)
Unrestricted visits (“Most Planetree hospitals have eliminated visiting restrictions altogether”) (ER at one hospital “has a policy of never
separating the patient from the family, and there is no limitation on how many family members may be present,.”)
Collaborative Care ConferencesClinical Guidelines Discussions
Family SpacesPet Visits (POP: Patients’ Own Pets)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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4. Nutrition: The Nurturing Aspect
of Food
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Meals are central events
vs
“There, you’re fed.”*
*Irony: Focus on “nutrition” has reduced focus on “food” and “service”
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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Aroma therapy (e.g., “smell of baking cookies”)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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5. Spirituality: Inner Resources for Healing
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Spirituality: Meaning and Connectedness in Life
1. Connected to supportive and caring group2. Sense of mastery and control3. Make meaning out of disease/find meaning in suffering
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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Griffin: redesign chapel (waterfall, quiet music, open prayer book)
Other: music, flowers, portable labyrinth
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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6. Human Touch: The Essentials of Communicating
Caring Through Massage
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“Massage is a powerful way to communicate caring.” —Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick Charmel
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7. Healing Arts: Nutrition for the Soul
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Planetree: “Environment conducive to healing”
Color!Light!
Brilliance!Form!Art!
Music!
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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Griffin: Music in the parking lot; professional musicians in the lobby
(7/week, 3-4hrs/day) ; 5 pianos; volunteers (120-140 hrs arts & entertainment
per month).
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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8. Integrating Complementary and
Alternative Practices into Conventional Care
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Griffin IMC/Integrative Medicine Center
MassageAcupuncture
MeditationChiropractic
Nutritional supplementsAroma therapy
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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9. Healing Environments: Architecture and
Design Conducive to Health
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“Planetree Look”
Woods and natural materialsIndirect lighting
Homelike settings
Goals: Welcome patients, friends and family … Value humans over technology .. Enable patients to participate in their care … Provide flexibility to
personalize the care of each patient … Encourage caregivers to be responsive to patients … Foster a
connection to nature and beauty
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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Access to nurses station:
“Happen to”vs.
“Happen with”Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
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Conclusion: Caring/Growth “Experience”
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Care!Control!Connect! Engage!Grow!
De-stress!
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8. Tom’s
HealthCare2
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Healthcare’s 1-2 Punch
1. Hospital “quality control,” at least in the U.S.A., is a bad, bad joke. Depending on whose stats you believe, hospitals kill 100,000 or so of us a year—and wound many times that number. Finally, “they” are “getting around to” dealing with the issue. Well, thanks. And what is it we’ve been buying for our Trillion or so bucks a year? The fix is eminently do-able … which makes the condition even more intolerable. (“Disgrace” is far too kind a label for the “condition.” Who’s to blame? Just about everybody, starting with the docs who consider oversight from anyone other than fellow clan members to be unacceptable.)
2. The “system”—training, docs, insurance incentives, “culture,” “patients” themselves—is hopelessly-mindlessly-insanely (as I see it) skewed toward fixing things (e.g. Me) that are broken—not preventing the problem in the first place and providing the Maintenance Tools necessary for a healthy lifestyle. Sure, bio-medicine will soon allow us to understand and deal with individual genetic pre-dispositions. (And hooray!) But take it from this 61-year old, decades of physical and psychological self-abuse can literally be reversed in relatively short order by an encompassing approach to life that can only be described as a “Passion for Wellness (and Well-being).” Patients—like me—are catching on in record numbers; but “the system” is highly resistant. (Again, the doctors are among the biggest sinners—no surprise, following years of acculturation as the “man-with-the-white-coat-who-will-now-miraculously-dispense-fix it-pills-for-you-the-unwashed.” (Come to think of it, maybe I’ll start wearing a White Coat to my doctor’s office—after all, I am the Professional-in-Charge when it comes to my Body & Soul. Right?)
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CR
07.03: 60/264/180/145-85/14010.04: 61/195/092/097-60/058
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Off …
Univasc (<1/2)BextraLipitorToprol
Propranolol
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Determinants of Health
Access to care: 10%Genetics: 20%
Environment: 20%
Health Behaviors: 50%Source: Institute for the Future