Deaconess - Glover Hospital

Deaconess-Glover Hospital (A)

<Back ground>

"Hospitals are filled with contradictions. You come to them because you're sick and need care, But hospitals are places where infections, uncertainty, and errors might actually worsen your condition……. Unlike many business organizations, hospitals don't wrestle with the problems of the uncommitted workforce. …. " by Paul O'Neil, Alcoa chairman

Since 1999, John Carter(vascular sergeon) and Julie Bonenfant (vice president for patient service) were seeking an appropriate location within the hospital where they could test the applicability of TPS to the health care system. The long term hope was that once benefits were verified within DGH, they could be applied within Care-group health care system of which DGH was part.

*1) Cater had an experience as a patient. After spending 5 years, now as an executive in health care delivery system, pursuing better top-down management approaches

*2) Dalton and Benefant – DGH had lost $2.7 million in the previous 12 months. And Care group had lost $100million in the same period. Care group's CEO, James Reinerten, had enlisted DGH to be Care group's test site. Dalton and Bonefant agreed to have a portion of their incentive compensation tied to the experiment's outcome.

Glover memorial Hospital began serving the Needham community as a general purpose, town owned facility in 1909. In the 1980's Glover began to encounter financial difficulty due to the switch from cost-plus payment to diagnostic-related groups, which capped the amount hospitals would be compensated per treatment. In 1994, Deaconess hospital purchased Glover. But it was caught by internal and external problems about financial tribulation of the US health care system.

<Finding a model line>

Carter's primary object was to identify a site within DGH that had high potential for a model line.

Gastrointestinal unit (GI)

Carter directly observed the work of the group by following patients through a medical procedure. And saw that much of the information was situational. After that he observed Hannah, a staff nurse, preparing the examination room and equipment for the next patient and noted her procedures for admitting, discharging, and record keeping. Carter generated profile of the mix of procedures performed in the unit and the frequency with which each had performed over the course of that day and that week.

The