The fact is that, when properly applied, the statistical process control methods are very useful and work well. Once you’re educated in the tools as a physician and you understand the nuts and bolts of them, it gives you a completely different, valuable perspective that helps organizations and teams achieve great results for patients. That’s what it’s all about. I understand the skepticism and I had it too before I was trained in these things. Then, once you get the training and you see it in action, it’s really unbelievable. It’s a lot of what we’re looking for in medicine to solve issues that we all share.
Bill: Dr. Kashmer, if this is not typically provided in medical education, how did you become familiar with these techniques?
Dr. Kashmer: I had an interest in health care administration and how we in the medical community do what we do. I saw a huge opportunity to design systems that were much safer for patients and to have improvement at the root of them.
Sometimes I would participate in cases where these great outcomes were achieved, and like capturing lightning in a bottle, almost unbelievably excellent outcomes were achieved for patients. I would wonder, “What is that? How can we make this reproducible and capture this lightning in a bottle for patients everywhere?” Even though I’ve worked full time throughout my career, that wonder led me to get an MBA. I tried to see what would this teach me about how to achieve that level of performance reliably. It was very valuable. Then, in one of those courses, I encountered Six Sigma and operational improvement in an Operational Management class. That led me to continue training in Lean and Six Sigma. That’s the path that got me here.
Bill: That’s interesting. If you’re looking in the crystal ball right now, what do you foresee in the future, let’s say, over the next five to ten year period? Do you see that there’s going to be much more acceptance in health care in these techniques?
Dr. Kashmer: There already has been, even over the last four to five years. Whether it’s been called Lean or Six Sigma, it may have different names, but the tools have become more and more adopted. These tools are becoming more accepted now. The challenge is to use them properly and it does take extra education. You don’t want to use these tools as a blunt implement. Without the proper training, I’ve seen some organizations come to the wrong conclusions and make changes either based on things that weren’t statistically rigorous or the tool wasn’t implemented properly. I believe you will see them appearing in many more health care environments over the next few years.
Bill: Dr. Kashmer, what other benefits are there to application of these statistical tools?
Dr. Kashmer: One other important consideration for CEO’s and health care administrators is the relationship of quality to the bottom line. It turns out that you often discover that the most high quality route is the most effective and lowest cost route. It’s much more cost effective to be compliant and have a high quality because you don’t get as many mistakes that have to be corrected and you obviously provide better care for patients.
One problem is, in classic accounting methodologies, it can be challenging to see how money spent on quality positively impacts their bottom line. There really is a cost of poor quality and focusing on prevention has a very positive return on investment for the organization.
Bill: Dr. Kashmer, you seem to be quite an advocate for use of these techniques in health care to improve quality. Are there some things that you’re doing to get the message out to more of the health care industry leadership on the use of these techniques?
Dr. Kashmer: Talks like this are part of it. I speak with medical administrators and surgeons about how we can not only improve patient care but also improve costs with the focus on quality. I also have a blog where a large focus is on educating about use of statistical methods in health care. We bring together people in health care, really from around the world, who read the blog. I also have a book in the works that is about use of statistical process control in health care.
Bill: Dr. Kashmer, thanks for an interesting discussion today. How can our readers get more information on use of statistical process control in health care?
Dr. Kashmer: A good starting point is at my blog where there are many articles and resources. It can be found at http://www.surgicalbusinessmodelinnovation.com. Nice to speak with you today, Bill.
