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Atul Gawande's 80% Healthcare Solution

Joe Cantlupe, for HealthLeaders Media, September 20, 2012

Still, this was a hospital and health system trying. Outside the rooms of stroke patients were signs warning the staff that these patients had a tendency to fall. There were notes from the CEO on every floor asking for comment about the patient experience.

Our ENT doc followed up with a call to the hospital to ask how Max was doing.

And we were sent home with instructions, and a trifold invitation from the CEO to write our story—but I'm doing it here.

Even in that short time in the hospital, I witnessed the "variability of care"—those moments when a hospital has a chance to work smoothly in an assembly line fashion like the Cheesecake Factory. It worked beautifully in the ED.

Afterward, it was a tad more difficult. That's because healthcare must rely on vulnerabilities of the human condition, for better or worse. It reflects the frailties of the staff, not necessarily the patient. But the food was good.

A big hospital's take on the Cheesecake Factory

That double-edged sword, and the hope for efficiencies and the expectations of staff, are among the reasons that Merlino, the Cleveland Clinic's chief patient experience officer, doesn't see the whole Cheesecake Factory idea as being the answer for what ails healthcare.

Top officials of the Cleveland Clinic read the New Yorker article and evaluated it, while weighing the hospital's own procedures, Merlino says.

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2 comments on "Atul Gawande's 80% Healthcare Solution"


sdaniels (9/21/2012 at 9:01 AM)
Only when the hospital can rid itself of its archaic dual governance structure and adopt a top down quality culture, can it truly hope to emulate the quality and consistently of the Cheesecake Factory. With Boards and execs who are loathe to confront the "accommodating culture" that pervades most of the healthcare industry, there is little hope of successfully confronting the fragmentation and problems so artfully described in Brownlee's "Overtreated" and Markary's recent "Unaccountable."

Adrian Byrne (9/21/2012 at 8:43 AM)
Joe has correctly noted, Atul's commentary on the Cheescake Factory solution is 80% correct. In the words of my friend Dr. Ed Henegar we must plan for the normal and manage the exceptions. No amount of systems or standardization will cure all. Anyone in hospitals who has worked with Sodexho or other outsourcing companies will know the product and service is only as good as the on site manager. Meanwhile, there is still a lot Healthcare can learn from other industries.