Performance Improvement


Continuous Improvement In health care - as simple as washing your hands

Focus on the easy high impact areas

Hospitals are normally places that people go to get cured not killed, but with the rise of antibiotic resistant bacteria infectious diseases are becoming harder to treat. 

The most common form of infection to be contracted in hospitals is Golden Staph (Staphylococcus aureus).  A Staph aureus infection is dangerous; a bloodstream infection has a 12-month death rate of between 20 and 35%, compared with 3-5% for a heart attack in hospital. Antibiotic-resistant Staph aureus (MRSA) infections carry an even higher death rate.

Usually our immune system copes with bacterial infections but if compromised as a result of treatment for cancer, diabetes, or other drugs we become more vulnerable to hospital-acquired infections.

The good news is that in the majority of Australian hospitals the rate of Golden Staph infection is decreasing, and one of the major reasons this is occurring is because medical staff are washing their hands!

The Australian Commission on Quality and Safety in Health Care engaged Hand Hygiene Australia (HHA) to implement the National Hand Hygiene Initiative (NHHI) in which HHA provides training to health care workers and audits hospitals in terms of their compliance to hand hygiene procedures such as washing hands before seeing patients with alcohol based hand rubs.  Over the last six years there has been a steady decline in hospital acquired Golden staph infections, click here to see the interactive table.

Hand Hygiene Australia is based a the Austin Hospital in Victoria, and their rates of Golden staph infection can be seen in the following graph:

Screen Shot 2017 07 24 at 3.57.45 pm

It was thanks to Florence Nightingale that the need for sanitation in health care came to prominence. One hundred and fifty years later, the need is just as great and the simple task of washing ones hands with alcohol based hand rubs has had a significant impact on the well being of hospital patients.

Sometimes improvement in processes leading to enhanced beneficial outcomes does not require “rocket science” but a change in attitude as this example highlights.

Posted in Performance Improvement


The Jeremy Lin Effect

More lessons from Money Ball

The Jeremy Lin Effect

Unless you are a basketball fan you probably would not have heard of a player called Jeremy Lin, but Jeremy Lin who plays for the New York Knicks set a record in his first year of playing which surpassed the records set by players such as LeBron James, Kobe Bryant and Michael Jordan. Jeremy Lin shot more points in his first 4 games as a professional player that any of the fore mentioned players and set a new NBA record. His shirt is now highest selling basketball shirt of all time.

Everything about Jeremy Lin just doesn’t fit the basketball stereotype, he is of Asian descent, not that tall as a guard only 1.91 m, not physically imposing and came out of Harvard – not a renowned basketball school. Yet he has one thing that is probably greater than 99% of the players he competes against, mental toughness or resilience. He has done it the hard way, no college scholarship, no NBA draft and only getting into the NBA’s division 3 development squad.  Traded by three clubs before somehow managing to get to the New York Knicks where he got a game out of “desperation” because the Knicks were playing so bad. Since then he has not looked back.

Lin got lucky because he got a chance to showcase his skills, but like so many decisions we make, they are made through our own biases of what looks good or sounds good. These biases can blind us from seeing talent – Just like what was highlighted in the book Money Ball.

“Players playing that well don't usually come out of nowhere. It seems like they come out of nowhere, but if you can go back and take a look, his skill level was probably there from the beginning. It probably just went unnoticed.”

Kobe Bryant, after Lin scored 38 points on February 10, 2012.

Posted in Performance Improvement


Creating a Culture of Continuous Improvement #1

Culture is about how we do things around here

Creating a Culture of Continuous Improvement  #1

“Culture eats strategy for breakfast!” I don’t know who first said it but it’s 100% true, certainly from my 20 years of experience it is.

Simply defined culture equals “the way things are done around here.”   People do things via their actions i.e. behaviours, and these behaviours are reinforced by processes and systems companies have in place.

These processes and systems are created for logical and I am sure good reasons - It’s to keep the organisation functioning in an orderly and consistent manner, and to a significant extent they end up determining the culture of the organisation. This happens because they shape the behaviour of the individuals.

Posted in Performance Improvement


Why some athletes performance will never improve

Evidence based learning best way to go

Why some athletes performance will never improve

The Australian Open Tennis is in full swing and I have had the pleasure of attending a few matches, not only seeing the top 100 players in action but also the players in the qualifying rounds who hope to make it into the final draw. I am always interested to listen to the post game interviews to see what interesting bits of information I can glean from each player as to why they won the match. Then, if interest piqued, I will further investigate the athlete to see how they have managed to get to where they are. I also do the same for some athletes who are branded the "next big thing" or who once were rising stars to see why they (in many cases) have not realised their potential.

Posted in Performance Improvement


Cost Reduction Programs Fall to the Antecedent Effect

Cost Reduction Programs Fall to the Antecedent Effect

According to global management consulting firm McKinsey and Co only 10% of cost-reduction programs sustain their results three years on. In particular areas such as sales, general, and administrative costs are particularly hard to shift  while manufacturing efficiencies are easier to shift.

Posted in Lean, Change Management, Performance Improvement


Why England Would Be Wise to keep Capello

Why England Would Be Wise to keep Capello

In typical knee jerk reaction style, many of the English tabloids as well as aggrieved ex football players are calling for the dismissal of Fabio Capello as coach of the English football team.  Some such as Roy Keane are putting the blame for their lack lustre performance on the players. If the English FA does remove Fabio Capello as coach then they are likely to be masking the real causes of their failure and in the process making Capello the scapegoat and setting back English football even further.

Posted in Performance Improvement


Understanding Performance Improvement

What happens when you plateau

Understanding Performance Improvement

Whether you are using Six Sigma, or Lean etc, your improvement effort will reach some limit of performance, that for which you cannot seem to improve on. The pattern will follow the tradition learning curve where the gains you make will reach a plateau.

Posted in Lean, Six Sigma, Performance Improvement

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