Clinicians told to embrace 'messiness of life'

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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