Who is responsible?

Who is responsible?

We had another publicly highlighted case from our health service recently. It would be nice to think that the ‘individual responsible’ will be offered any support to deliver his or her recommendations to improve this situation. The political response suggests that the problem lies with individuals and doesn’t seem to question the process.

So what is the process? Whether it is a 91-year old patient or any other person in need of medical attention, is our process getting better or worse? Are the measures we use in our hospitals centred around patient care and patient outcomes?

I had the pleasure of listening to David Fillingham in Cork recently. I learned that he had worked at Pilkingtons in St Helens (the location of my first post with Courtaulds in the UK) and joined the NHS in 1989. He spent 6 years as Chief Executive at the Royal Bolton Hospital where he introduced ‘lean’ principles to empower staff and involve patients to improve quality of care. I visited Bolton hospital a few years ago and spoke to staff involved in their lean programmes. Through Value Stream Mapping staff transformed outcomes for stroke patients. Collaborative work with new mothers helped re-design the maternity unit. Lab staff reduced the wait on test results from 24 hours to one hour to deliver quicker decisions on outcomes and release precious beds earlier.

Interestingly, David said that a lot more process engineering went into producing a windscreen at Pilkingtons than into the patient processes in the NHS. Unfortunately, the hard-working staff in our HSE are working with little support or budget to develop their processes. My view is that the best solutions to most issues come from the staff engaged daily in the processes in any organisation. They need a safe environment and supportive leadership to deliver great outcomes.

Submitted by our Lean tutor, Steve Halpin

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