To what extent did the market-driven, efficiency-obsessed culture of hospital administration contribute to the crisis? Questions about “best practices” in management have become questions about best practices in public health. The numbers in the bean counter’s ledger are now body counts in a morgue.
Deep, deep burn.
We’ve been teaching these finance guys how to squeeze,” Willy Shih, an operations expert at Harvard Business School, told me, emphasizing the word. “Squeeze more efficiency, squeeze cost, squeeze more products out at the same cost, squeeze out storage costs, squeeze out inventory. We really need to educate them about the value of slack.”
Medicine is a business, but it shouldn’t be run as just another business.
Everyone loves analogies with Toyota. There’s even one in this story, though it’s one that doesn’t usually make it into your average managerial or quality training, where people just love their black belts in Six Sigma, Lean, and tossing around those Japanese terms like Kaizen and Kanban. As Mukherjee argues, there’s a wide gulf between actually helping professionals take care of human beings and the complex dance of people and parts that requires and just ordering the fewest and cheapest widgets sourced from a factory in China.
What you really want to measure, model, and establish is the capacity to build something when a crisis arises. And this involves human as well as physical capital. We need to measure talent, versatility, and flexibility. Overtaut strings inevitably break.
Not only have they broken, but they’ve been unraveling for years.