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Critique for Fixing Healthcare from the Inside, Today

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Article Critique for: “Fixing Healthcare from the Inside, Today” by Steven J. Spear, Harvard Business Review

In this article, Spear examines a big problem in healthcare - that of too many medical errors occurring in hospitals in the U.S. He believes that there are ways of improving the quality of healthcare and reducing costs, which do not rely on external policy changes.

Current approach: Most hospitals are organized into functions where there are no reliable ways to integrate all the individual tasks that each person is required to do into a logical way that is necessary for safe, effective care. This results in ambiguities where it is difficult to find out who is responsible for doing what, when and how. This leads to breakdown situations that result in errors. Many times, the people involved with the error rush to improvise, work-around the problem and move on continuing to perform the task in the same manner. No one stops to analyze where the problem occurred, why it occurred and what steps should be taken to prevent it from happening in the future. Naturally, the problem continues to happen and it’s just a matter of time before it results in a catastrophic or fatal error. Unfortunately, it is not until this happens that management stops to examine the causes of the problem and scrutinize the situation.

Recommended approach: To effectively eliminate medical errors, Spear recommends that hospitals and clinics focus on the Toyota operational excellence principles. This includes applying a common approach to operations design and management; design operations so that the problems can be detected as they occur and are addressed right away; train employees to learn how to reduce and eliminate ambiguities in a process in a systematic way; designate problem-solving support persons to set up a process to investigate causes of problems (break big ones into

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