Just a thought if the Virginia Mason Institute "Lean Medicine" theory is based on the Toyota Lean Car Production Methods did not Toyota have to recall 11.5 million cars last year ?
but the I suppose it is easier to recall a car than a hospital patient.
Did not the Virginia Mason Institute badly fail an inspection by the American Government at their flagship hospital in Seattle USA
How we respond to this challenge of Engagement within Medicine/ growing confidence in our Colleagues (such as Nurses & Therapists) who have bust through our complacent medical monopolies and sheboliths - this will be a purifying fire in my view. Like steel (which softens, warps & bends initially with heat - but then tempers to become hardened and tougher as the level of heat rises) we need to really demonstrate our worth in the new multi-directional 'fires' of new realities in health & prevention - new disease patterns- failure of established treatments such as antibiotics- and a generation of consumers (that we too are part of) in richer/developed countries that just will not tolerate failure - ageing - physical & mental degradation 'with grace & tolerance' but will rail against those. Demands will grow not lessen and we have to work with these forces. Like toughened steel we will need to withstand the searing heat!
Kings Fund leadership programmes (such as the Strategic Med Director programme I experienced 4 years ago) are facing these issues - developing the leaders of the future - and challenging policy makers to face longer-term issues and not just being tempted by the 'quick fix' / 'prod & poke'
mentality that Prof Chris Ham asserts has been the mainstay in the past.
Other key bodies - The Nuffield Trust - NHS Confed - Queens Nursing institute
- The Medical Colleges - RCN - are making their presence felt too. In my view, only together can we build a stronger 'heat proofed' and resilient Health Service. Together we need to build stronger Patient Voice organisations and a multidisciplinary environments that bring Social Care & Workers into the new world and deep-rooted/ lateral -thinking Managerial professionals.
In my own backyard of Primary Care/ General Practice we need to rebuild a service that is in many ways 'broken' and in desperate need of new impetus and focus.. No more can we expect to be rescued by successive governments- we need to rediscover our very purpose - integrate - Manage Care - Invent - Research - Educate. in fact, we probably need to sow seeds of our own dissolution and put patients in control of the health & social care Agenda - take responsibiliy - decide their own fate - deal with their own destiny.
Medical Engagement may in fact be the Nemesis we feared and Ivan Illich (and more recently Kennedy) predicted, but surely that is the only way forward as the gains of Technology increasingly deliver less and less 'bangs per buck'
and we need to assure a truly Value-Driven NHS system for the 21st Century and beyond!