Turning from round 2, we go finally to round three of the pig game. Hand out this set of instructions, along with another grid. Now, compare the results of the participants.
I'm guessing you will see higher quality pictures and more uniformity. All right, I know this is not a clinical procedure, with all of its potential complications, but the lesson is nonetheless powerful. After our residents took their Lean training course, several of them said this was the most powerful lesson they learned. They now apply it in clinical settings, looking for "pigs" to standardize their work where appropriate.
Remember, we are not trying here to standardize those parts of patient care that should not be standardized; but we are trying to do so for those elements of care than can be and, most importantly, should be to reduce and eliminate harm. In our hospital, we have done so in the following arenas among others. This has saved lives and reduced other harm, plus making life better for staff and patients:
Clinical pathways -- obstructive sleep apnea; Whipples;
Central line infections;
Ventilator associated pneumonia;
Rapid response teams;