Sunday, September 23, 2012

HAI, process improvement = Best Practice


 

September 23, 2012   

Jorge Palacios

   California Department of Public Health (CDPH-CHCQ-HAI)

Re: Prevention of Healthcare Associated Infections in our Veteran’s Hospitals

Dear Mr. Palacious,

 Once again thank you and the staff for your interest in our advocacy for the prevention in Healthcare Associated Infections (HAI) in our Veteran’s Hospitals and most recently the development of the concept of a “Database of Best Practices for the Prevention of HAI”.

 Below you will see one of my recent responses to an online forum. This group is attempting to implement “Lean” and Toyota quality teachings to the healthcare industry. The reason for my engagement in this forum as well as others was to challenge the concept of a database of best practices for the prevention of HAI.

 In my opinion, the reason why none of these healthcare quality professionals are having any luck on the issue is because currently the healthcare industry is monitoring “patient outcomes”, much as the CDPH is currently doing, modern manufacturing is focused on “process control”, final output is little more than verification of a good process. The concept of monitoring thousands of independent processes state wide is hard for me to comprehend, using you current monitoring process to monitoring one “best practice” state wide with the opportunity to improve that “best practice” would not only be efficient but would also save the lives of our mothers, fathers, daughters, brothers and Veteran’s in my opinion, let alone the cost of developing thousands of processes!

 My advocacy is dedicated to “supporting those who help others” so I left these professionals on a positive, “evidence based medicine” is a product developed by the medical community, specifically for the medical community and it is very impressive, even Deming would have been impressed, what he would not be impressed with, correct me if I am wrong, is that management seems to be a “no show” in the debate and seem to be headed back to the “innovation” world, some of it I have read about before in a book about the auto industry recent collapse, it is a quick read but our healthcare leadership may soon be there: OVERHALL by Steve Rattner.

 The attached video, I did not identify for the healthcare quality professionals, they should know this stuff, the project is more than likely a masters project for a Process Engineer, the process itself actually predates the Greeks, I do believe it is bronze, so I am going the “bronze age”, the significance of making 10 parts is to verify process repeatability and reliability, if you do get comments on the issue that has trouble identifying what they are looking at I would suggest a reference check! This young man in the video will return to his day job making engine castings the size of a house, just my call, I have trouble reading English let alone the title and there is no way those were Mil-spec threads but the attempt was most impressive!

 Once again, thank you for your valuable time and interst in helping others!

“hai-five” and “have fun”, just be sure and wash your hands first!

Michael H. Slavinski

Start: there was no need to post the preceding posts of title, “trust me”!

http://www.medicalofficetoday.com/article/should-medical-offices-embrace-auto-manufacturing-strategies
"5s", Monitoring spots a spike in C.DIFF, limited variables in the process due to limited amounts of cleaners available, EPA bans the best one, mystery solved, 5s on it's best day, would not have countered the spike in my opinion!


Start to responce:
 

Good point Mr. XXX, perhaps we are even past the whole "Cheese Cake Factory" process and the short lived "Taylorism" reinvention!

 More than likely they are posting these “low lying fruit” topics due to the entertainment value of my posts, obviously, little do I know about a Hospital other than that we have been making parts for ventilators for the past decade and I had no idea these things were killing so many people, some of the motivation to get out there and make a fool out of myself!

 Lean and waste, monitoring thousands of uncontrolled processes, you do not have to be a rocket scientist to figure out we are going to solve the unemployment problem long before we make any tangible and sustainable progress in the prevention of Hospital Associated Infections, "database of Best Practices for the Prevention of Healthcare Associated Infections", "evidence based medicine", the "creation" of the Medical System, you in the healthcare quality programs should be proud of the achievement and start evangelizing today!

  Oh well, now that I have totally ended this link, my work is done, so much for the fun, most of my stuff from here on out will start “Dear Honorable”, time to go to the "action" part, you guys are going to miss me so I will leave you with a small part of our culture, bear in mind I use my dad's tool box and some tools my grandfather made while building Baldwin locomotives! This is not me but how many of you healthcare professionals made the “hammer” in high school shop class complete with the sand cast aluminum handle, mine is in my dad’s toolbox, Walter Chyrsler’s office on top of the Chyrsler Building, adorned with the tools he made, no fooling! Thank you for your valuable time and our advocacy is dedicated to supporting those who help others, just like everyone on this site!

 


 

"hai-five" and "have fun" but be sure and wash your hands first!           

 


 

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars”
 
PS, a happy customer at the tree nuserey, they chopped all ot theirs down for fire wood but today it is a "smile" via U.S. Peace Corps!

Tuesday, September 11, 2012

"Best Practices for the Prevention of HAI"


“9/11/12”

 

 “Best Practices Database for the Prevention of HAI”

                              

 

Today the Advocacy for the prevention of Hospital Associated Infections(HAI) in our Veteran’s Hospitals  are going to begin the process of supporting the development of the  “Best Practices Database for the Prevention of Hospital Associated Infections” in support of those who help others and to be made available, free of charge, to all Hospitals in the United States. The Great State of California is where I live and the California Department of Public Health is in the best position to make this database happen with the results ultimately giving our veterans access to the very best practices currently underway in our private hospitals.

 The following is a letter addressed the United Sates Secretary of Veteran’s Affairs from one year ago which identifies the motivation behind the effort. Many positive things have happened over the past year, the United States Department of Health and Human Services declaring HAI a “preventable disease” being the most profound, “thank you”!

 

“hia-five”

 
 

Michael H. Slavinski

_______________________________________________________________________ 

 
To: General Eric Ken Shinseki

       United States Secretary of Veteran’s Affairs

 

Date: 11/6/11

 

Re: Infection prevention in ventilators at V.A. hospitals, page 1 of 2.

 

Dear General Shinseki,

 

 At this time I will humbly ask your office to investigate the opportunity to implement a  cost and life saving innovation currently underway in the private sector.

 





http://articles.latimes.com/2011/aug/23/business/la-fi-hospital-infections-20110823
 

 Following the teachings of  W. Edwards Demming, “quality must start from the top”, the reason for my request to your office and my enthusiasm for the effort.

 The L.A. Times did an outstanding job of identifying all of the stake holders and the benefits to society, identifying the entrepreneurial spirit from the “top”, Ms. Pam Kehaly, President, Anthem Blue Cross, Blue Shield.

 The L.A. Times has also in the recent past highlighted the great strides the Veterans hospitals have made in inpatient care, giving me the confidence that the Veteran’s hospitals are either ahead of the curve or open to improvement. 

 This program would fit well within the parameters of President Barack Obama’s current cost cutting efforts, one of his current "key initiatives"!

Although not involved in the medical field, A.S.Q. allowed me to have some insight into the complexities of the workings of hospitals, in the 90’s several nurses gave our local chapter presentations on how to implement quality programs from the “middle down” and the less than desirable results. Dissecting the space shuttle disaster was the work of the decade, keeping a few people alive for a week in space was far less complicated than running a hospital. Personally, I struggled to figure out what motivated these nurses to go to work every day during that period for the consensus was that it was far safer in the space shuttle than it was in our local hospitals. Recently a nurse auditor at Anthem Blue Cross helped me resolve the issue, “ I strive to help at least one person every day”, our veterans deserve nothing less, even in these challenging times, in my opinion.

 

Semper Fi

 

Michael H. Slavinski  

 

Continued on next page!

 

 

Re: Infection prevention in ventilators at V.A. hospitals, page 2 of 2.

 

 

Cc:                                                                                                              

 

The Honorable United States President Barack Obama

      

 The Honorable United States Senator Barbara Boxer

 

The Honorable United States Senator Dianne Feinstein

 

The Honorable Majority Whip Congressman Kevin McCarthy

 

The Honorable United States Secretary of the Navy Ray Mabus

 

General James A. Amos

Commandant of the United States Marine Corps

 

Ms. Pam Kehaly

President, Anthem Blue Cross, Blue Shield

 

Mr. Eddy W. Hartenstrin

Publisher and Chief Executive Officer, Los Angeles Times

President and Chief Executive Officer, Tribune Company

 

Staff

Anthem Blue Cross, Blue Shield

 

 

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars."
 
 


___________________________________________________________

Ps: the movie, as my knowledge develops concerning the advocacy, in the private sector, “culture” seems to be the key to preventing HAI. Thinking of our veterans , at some point someone sits down and say’s “ I want to spend over a billion dollars on training in the next three months”, no fooling! This process has been developed over the past couple of hundred years. No, the film did not cost a billion but you can clearly identify what is of value but to learn from this movie, watch the “eyes”, it is the small things that make it all work in my opinion and I really appreciate the Marine who took the time to document the complete process.

The “drowning tank”at the beginning, “train like you fight, fight like you train”, due to gravity and high temperature alloys, most things you fight in, without warning, head the bottom of the ocean upside down and on fire, from what I hear, in wartime, things do not improve very much!

Give a Veteran a break, a job and perhaps your support, think of the families of these volunteers, ten years of continuous wars, they deserve the best in my opinion and with any luck, that will happen!




http://www.youtube.com/watch?v=YxtCaGqiScI
 
The picture, baby weighing in Africa, courtesy U.S. Peace Corps!