Why Hospitals Should Fly
by John J. Nance, JD
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2009 ACHE James A. Hamilton
Book of the Year Award-Winner!
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Did you know that a checked bag on an airline flight is still exponentially safer than a patient in an American Hospital? It is not very comforting to consider that a toothbrush has a better chance of reaching its destination than a patient has of leaving a hospital unscathed. This begs the question…why? John J. Nance, JD frames the issue this way:
“Nine long years after the Institute of Medicine told us nearly 100,000 patients die each year from avoidable errors in our hospitals (To Err Is Human, 1999), the struggle to significantly reduce major patient injuries has barely begun. The primary reason it’s so tough to change the system is that no less than the culture of medical practice has been challenged and is, in effect, resisting change. This is cultural inertia, the ‘This is the way we’ve always done it’ syndrome, yet the root cause of poor patient safety performance lies squarely in the mythology that human perfection in medicine is achievable—the presumption that humans can practice without mistakes.” |
Hospitals will truly fly when the “This is the way we have always done it,” is finally recognized as the way it should never be done again.
John Nance’s mission, “is to convince you that patient safety and service quality can be dramatically improved only when the traditional, hidebound methods of handling a human institution are abandoned and the hospital is run to directly support, and be extremely responsive to, the needs and limitations of the people who actually take care of the patient. This is not theory, but fact, based on the hard-fought experience of other industries—most notably aviation. And it means the creation of a new type of patient-centered culture dependent on the professionals who are the hospital—in other words a flip-flop of the old model in which people work for a hospital in favor of a paradigm in which the hospital’s primary purpose is building and maintaining a structure that dynamically supports the teams that provide the care.” |
Hospitals will only fly when doctors, nurses, CEOs, trustees and every healthcare stakeholder overcomes the inertia that is anchoring hospitals to the failed cultural foundations of the past and embraces a new paradigm of patient-centered care.
Because, as Nance explains, “The reality is that hospitals are people, and when, as a team, they can climb free of the failed methods of the past, they indeed can fly, in both spirit and accomplishment.
The time to take this flight is now and this is your boarding call. |
“So what does it take to dramatically improve patient safety and service quality? It takes a host of new and different (and sometimes radical) methods centered on supporting the people on the front lines – those who actually take care of the patient. It takes a hospital like the one in this story: St. Michael’s.
“St. Michael’s itself is fictional, but it is specifically designed to show how the ideal healthcare environment would look and feel. Are all the methods and ideas and organizational characteristics in use at St. Michael’s largely in use in real institutions? Not yet, though many are in the process of being adopted, and some are already producing wonderful results.
“But the bottom line is this: What St. Michael’s represents is an achievable paradigm, and if we can’t imagine what constitutes truly safe and collegial hospitals, we can’t build them.”
John J. Nance, JD
This book is a one-of-a-kind, eye-opening narrative chronicling the incredible transformational journey of St. Michael’s
Memorial
Hospital
. John Nance created this hospital to give healthcare the benefit of an experimental “laboratory” where vision, ideas, dialogue and action connect synergistically to illustrate what healthcare could, and ultimately must, do in order to realize the ultimate in patient safety and quality care.
Even though the characters and the hospital John Nance created are fictitious, the problems they face down and the solutions they develop and adopt are all too real. It will only take one visit to Nance’s St. Michael’s to leave everyone in healthcare with an understanding of why no one has ever put all the pieces of the safety and quality puzzle together before.
Although many of the pieces have been known in healthcare circles for some time, vital elements of the solution have been missing…the picture incomplete. St. Michael’s incredible journey confirms that completing the picture requires implementing the bedrock-basic cultural and systemic principles that every high-risk institution must instill as their foundation of safety and quality. It is those very principles that the aviation industry paid such a tragically bloody price to discover that prove to be the missing pieces and the new foundation of St. Michael’s safety and quality renaissance.
This book is much more than merely a great story. In these pages John Nance has challenged healthcare with an intensely urgent call to action. He has provided a guide on how to break free of the destructive cultural foundations of the past, and a comprehensive education about the realities of what it will take to make
America
’s hospitals the safest and highest reliability organizations in the world.
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Charting the Course
Sequel to Why Hospitals Should Fly
by John J. Nance, JD
&
Kathleen Bartholomew, RN, MN
In Why Hospitals Should Fly by John J. Nance, JD, the 2009 James A. Hamilton ACHE Book of the Year, he advanced a paradigm—a model of what a good, successful, safe and efficient hospital looks like. The name of the fictional hospital featured in that award-winning book could be stated in Naval terms as a class: A “St. Michael’s-class” hospital (like a Nimitz-class aircraft carrier). In this book, Charting the Course, written by John Nance, JD, and his wife, Kathleen Bartholomew, RN, MN, they address head-on the challenge of actually becoming a St. Michael’s-class institution by illuminating leadership’s role in changing the culture—and they do so by continuing from Why Hospitals Should Fly the personal and professional journey of Dr. Will Jenkins. His battle, and emerging wisdom born of tragedy, illuminates the norms of the current culture and illustrates why each member of every medical facility, regardless of rank, must be a leader and owner of the cultural revolution needed to keep our system viable and our patients safe. While the first book dealt more with the “why” of a cultural revolution, this sequel deals more with the “how” of changing an ingrained hospital culture. We hope you enjoy Charting the Course as much as you enjoyed Why Hospitals Should Fly. |
Click here to download Will Jenkins' PowerPoint Presentation to the Board.
“As physicians, we pride ourselves on our vast knowledge, skill, and experience
base. Yet, as a profession, we’ve been ignorant–certainly I have been–that the most
fundamental knowledge deficit of all is not knowing what you were unaware you
even needed to know. Teamwork, for instance, was never taught, never practiced,
and we never knew it was of any real value to medicine.” |
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