Embrace the "messiness of life" and drop "arbitrary" health
targets, a healthcare improvement expert from the United
States told clinicians, managers, and board members at
Dunedin Hospital yesterday.
Dr Robert Lloyd, whose visit was organised by Associate Prof
Robin Gauld, of the University of Otago's Centre for Health
Systems, is executive director of performance improvement at
the Institute for Healthcare Improvement in Boston.
Attended by Southern District Health Board chairman Joe
Butterfield, board member Richard Thomson, and members of the
executive management team, Dr Lloyd's talk was about using
and interpreting clinical and research data correctly to
improve health safety and systems.
Using statistics simplistically could be highly misleading,
and could misrepresent improvements or deterioration.
Dr Lloyd showed examples of how results were manipulated when
data was displayed in certain ways.
"Arbitrary" targets encouraged people to distort and cover up
information, and to "kill the messenger" if all else failed.
If the right healthcare processes were not in place, targets
would never be reached honestly.
The healthcare sector needed to embrace the "messiness of
life" and accept there were many factors influencing patient
care.
Over-reliance on computers was not good, as computing did not
encourage wisdom and knowledge.
After the talk the Otago Daily Times asked Dr Lloyd
what he thought of New Zealand's target for 95% patients in
emergency departments to stay a maximum of six hours. Noting
six hours was longer than other countries' ED targets, Dr
Lloyd said whether a target was worthwhile depended on how it
had been devised. He did not agree with the 95% requirement -
if a target was set it should be for 100%.
Dunedin Hospital has struggled with the ED time target
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