Fixing Healthcare Delivery

Go to Course: https://www.coursera.org/learn/fixing-healthcare

Introduction

### Course Review: Fixing Healthcare Delivery **Overview:** The course “Fixing Healthcare Delivery” offered on Coursera confronts one of the most pressing issues in modern medicine: the alarming number of preventable medical errors that lead to the deaths of over 100,000 patients annually in the U.S. This course brings together healthcare professionals, patients, and policymakers to explore practical solutions aimed at revolutionizing healthcare delivery and safeguarding against these tragic occurrences. It promises to empower participants with the knowledge and skills necessary to drive meaningful change in their communities. **Course Structure:** The course consists of 8 comprehensive modules, designed to tackle healthcare delivery from multiple angles: 1. **Introduction: Understanding the Crisis** This module lays the groundwork for the course by discussing the magnitude of preventable errors and inviting participants to consider their role in mitigating this crisis. With poignant real-life examples, it emphasizes the urgency of reform in healthcare systems. 2. **Applying Manufacturing Principles to Improve Healthcare** Here, participants learn from successful manufacturing practices, specifically the Toyota Production System. The course covers concepts such as value streams and the 80/20 rule, offering insightful strategies for reducing waste and optimizing patient flow. 3. **Healthcare Requires Teamwork** This module highlights the importance of effective teamwork in healthcare. Drawing parallels between athletic teamwork and healthcare settings, it provides tools for building and leading multidisciplinary teams, ensuring improved patient care outcomes. 4. **Understanding and Preventing Human Error Part I & II** Spanning two modules, these sections delve deeply into the nature of human errors in healthcare. Using the heart-wrenching story of Sorrel King, participants learn about root cause analysis, common pitfalls, and avenues for cultivating a culture of safety. 5. **We All Can Lead: Becoming an Adaptive Leader** This segment focuses on the leadership qualities necessary for healthcare reform. Participants are equipped with practical strategies for adaptive leadership that fosters collaboration and innovation in complex healthcare environments. 6. **How Organizing People Can Drive Change in Healthcare Delivery** This module employs historical analogies to outline effective grassroots strategies for encouraging change in healthcare settings, emphasizing the power of collective action. 7. **Immunity to Change and Successful Patient Care Initiatives** The final content module addresses resistance to change, elucidating methods to overcome this "immunity." It consolidates learnings from previous modules, guiding participants in developing actionable plans to implement improvements. 8. **Final Exam** The course concludes with a comprehensive assessment designed to test participants on the knowledge they have gained throughout the course. **Recommendation:** “Fixing Healthcare Delivery” is an invaluable resource for anyone involved in the healthcare system—whether you are a healthcare provider, a patient advocate, or a policymaker. Its practical framework empowers individuals with the skills to enact change and improve patient safety. The course’s flexible online format is ideal for busy professionals. Participants can progress at their own pace, engage in thoughtful discussions with peers, and access a plethora of resources to deepen their understanding. In a world where healthcare delivery is continually evolving, this course stands out as a beacon of hope and practical knowledge. For those passionate about improving healthcare systems and committed to patient safety, I wholeheartedly recommend enrolling in “Fixing Healthcare Delivery.” Join the movement to create a safer, more effective healthcare experience for everyone.

Syllabus

Introduction: Who is Caring for Mary?

100,000 patients die annually as a consequence of preventable medical errors, and over 1 million patients suffer life-changing injuries. Despite the calls to action medical errors continue at the rate of 1 out of 10 patients. How can those of us who help to deliver care and those of us that receive care help to prevent harm? There are 5 fundamental areas each of us needs to understand and use to fix healthcare delivery: 1. Apply the principles of high performing manufacturers and athletic teams to continually improve our processes. 2.We all need to learn how lead and be part of multidisciplinary teams that include patients and coordinate the care they receive. 3.The human brain continually makes errors. Certain conditions increase the likelihood of errors, and these need to be avoided. Systems can be designed that force the right behavior, and second checks can help caregivers provide the right care at the right time and in the right place. 4.We all need to become effective leaders. Most importantly we must practice adaptive leadership, that is, leadership that promotes a true change in the way things are done. 5.Finally we all can utilize the campaign methods of successful politicians and advocacy groups to change the attitudes of our fellow caregivers and patients, and thereby change the culture of our healthcare systems. During this 8-module course you will be provided with the tools to accomplish all 5 of these goals, and as an individual you can truly make a difference. Why do we need to understand about systems? How do we evaluate a system and as a patient or provider what characteristics do you think are important? How does quality relate to safety? These are important questions that we all need to have answers to as we learn how to improve how we deliver and receive healthcare. The personal consequences of distracted physicians and defective systems are illustrated in Mary's frightening hospital experience.

In this module we will be discussing the manufacturing principles of the Toyota Production System. The concept of value stream or work flow diagrams will be introduced. The well known 80/20 rule in manufacturing will be applied to patient care. The 8 ways waste can be reduced in health care will be explored, and finally the problem of push medicine and how patients can guard against this all too common problem will be covered.

Teamwork is critical in modern healthcare. We will explore the state of healthcare teamwork in most healthcare systems. The 5 resources required for effective teams will be reviewed, and we will discuss how athletic principles can be used to encourage teamwork, improve efficiency and increase the quality of patient care. We will review how to launch and coach a team, and how to manage the complex dynamics of teams. Finally we will discuss how to create a self-improving team.

This module will be discussing the consequences of medical errors, and you will learn from Sorrel King's loss of her daughter, Josie, and from my personal experience that preventable injuries not only cause death but also can lead to permanent life changing injuries. Sitting around and doing nothing is not an option. However we all need to understand and use three key tools to determine the causes of medical errors and to fix them, Root cause analysis, Driver Diagrams, and PDSA cycles. Finally we will discuss the issue of small errors and our tendency to ignore and workaround them. Unfortunately this approach to small problems is one of leading causes for the continued high rate of preventable injuries and deaths in our hospitals and clinics. It is time to fix the little things.

This module introduces you to the famous W. Edwards Deming red bead experiment that illustrates the tyranny of random variation, and introduce the use of run charts to differentiate random or common cause from specific cause variation. Next we will introduce you the concept of reliability and will illustrate why we need to dramatically improve the reliability in health care. Strategies for reducing human errors are reviewed, and the effectiveness hierarchy of different interventions discussed. We end with a discussion of how health systems and providers should be treating patients and families who they have inadvertently harmed.

In this module, we will be discussing the need in healthcare for distributive leadership that is adaptive. The complexity of healthcare prevents one leader from micromanaging a healthcare system, and leadership must be encouraged on the front lines of care. Effective leaders are good listeners, empathetic, follow their principles (North Star) and are courageous. Adaptive or innovative leaders are a necessity for improving the quality and safety of healthcare. The strategies for controlling emotional disequilbrium will be addressed, and specific analogies presented to assist students in understanding how to practice leadership that will bring about change.

Change requires those on the front lines to embrace new approaches to care and to work across department barriers. This session will use our Founding Father Samuel Adams to exemplify the approaches that have been used for decades to encourage others to come together to bring about change. Samuel Adams campaign led to United States independence from Great Britain and these methods if applied throughout the world can lead to a revolution in healthcare delivery. One-one techniques, personal narrative, creation of leadership teams, and the creation of effective strategies and tactics to bring about action will all be covered. You can make a difference.

In this final module we will review why many of us fail to change our viewpoints and behavior. We will discuss how you can overcome your natural immunity to change. Next we will review the key points from each of the past 7 module, and then outline a general plan of action that will allow you to create your personal plan to fix one component of your healthcare system. Your learning has just begun. Now you will be able to apply what you learned, you will achieve greater and greater understanding by doing.

This is the final exam.