Years ago, my father had a heart attack. Worried that our big, protective dog wouldn’t let the ambulance team into the house, he lay in bed and waited for my mom to return from running errands, rather than calling 911.
He didn’t realize how important speed was in minimizing the damage a heart attack causes.
The US death rate from coronary heart disease fell by 38 percent from 2003 to 2013, and faster emergency treatment was a key reason.
Hospitals across the country have slashed “door to balloon” time—the time from when a patient enters the hospital to when doctors clear the blockages in the patient’s arteries to get blood flowing to the heart again. They’ve done this with no new medical discoveries, no new technology and no new payment incentives. They simply uncovered existing best practices and spread the word about them.
It started when Medicare assembled data on the time it took hospitals across the country to get blood flowing after heart attacks. The results varied widely, but the worst news was that the times were not getting any better year-to-year.
Until a team of cardiologists identified the 11 hospitals with the shortest door to balloon time, and set out to find out what was different.
The fastest hospitals weren’t the big, famous institutions you would expect to see on such a list–some were small town and community hospitals. But they had a few things in common. The best-performers had ambulance paramedics transmit electrocardiogram results to the emergency room, so the ER team could prepare. They gave the emergency room doctor power to decide whether the surgery team would be summoned from their beds, rather than consulting first with cardiologists. They eliminated the need to fill out long consent forms before work got started. And they sounded the beepers for the entire surgery team simultaneously, instead of calling individuals one by one.
These procedures were common sense, but few other hospitals were using them.
In the businesses I work with, it’s amazing how often common sense procedures remain the secret of a few high-performing business units, while other business units labor without this knowledge.
Simple best practice sharing could dramatically improve results, and yet it often doesn’t happen. Business units are heads-down, dealing with their own problems. They don’t take the time to learn from other areas of the company. They often can’t recognize best practices in their own units that should be shared with others.
Here are a few tips for spotting and benefiting from best practices within your organization:
- Choose the right metrics. In comparing hospitals, researchers were wise in choosing the “door to balloon” metric. It was an easily understood metric that tied directly to what really counted – preventing deaths.
- Know who is performing well. This is harder than it seems. For example, the age and health of the population being treated by each hospital greatly affected hospital outcomes. Researchers had to understand such factors to recognize the real high-performers.
- Take a bird’s eye view. Ask an unbiased group to compare processes across business units, to find the commonalities, and to communicate what they find. I once worked with a client team to uncover best practices across a large and diverse set of third party sales agencies. We interviewed, we observed, we analyzed and compared. Our objectivity was key to being able to identify a few key performance drivers, ranging from staffing and compensation policies, to pricing and operations procedures. Implementing these across the business helped drive a 23% increase in margin.
- Create forums for sharing. International building products manufacturer Cemex has created a social-network style online forum to connect employees across continents to solve production problems, innovate new products and enhance marketing. Another company I know holds a short conference call each Friday. Over 300 employees participate, though there is no mandate that they do so. Three or four people are selected each week to share a technique they used to help a customer or make a sale. The entire call only takes 15 minutes, but is immensely valuable in improving performance and motivation.
- Create a best-practices repository that all business units can access. As a consultant at McKinsey & Company, I could tap into a database of learnings from prior, similar projects whenever I began work in an industry or function I had little experience with. Resources like this can make even the newest employee far more effective.
- Identify internal experts on various topics, and make sure employees know how to reach them. EnPro Industries has done a superlative job at this. It freed up experts’ time to answer questions, provide advice to teams, and travel to observe, advise and learn from business units outside their own. The designated “experts” may have started off with only average knowledge, but over time, they grew in capability. Like bees fertilizing flowers, these experts spread ideas between business units, and connected employees for collaborative problem solving. Soon there was a strong network of people around the company working to address the company’s biggest opportunities.
- Look at power, policy and process. In order to speed up emergency room response time, hospitals had to give emergency room doctors far more power than they previously had. They had to change long-held policies requiring time-consuming consent forms to be completed. And they had to change the process, transmitting electrocardiogram results as the ambulance was enroute. None of these three–power, policy and process–were easy to change, but they all made an immense difference to outcomes.
- Focus on the good you are trying to do, rather than competition between business units. Health care workers are highly motivated to save lives, so they worked together to bring down door to balloon time nationwide. Your company may not be saving lives, but my bet is you’re doing something important. Focus on the value you are creating for customers, the great service you provide, or creating an even better place to work. Putting the good you are doing—your noble purpose—at the forefront will stimulate creativity and collaboration across the organization.
My dad was lucky. Despite his delay in getting to the hospital, he was back to almost normal within a few months, riding his bike every day (often to the doughnut shop), traveling internationally, and enjoying life.
I’m thankful that hospitals have established these common sense procedures to save lives, and I’d love to hear what your organization has done to uncover best practices–I hope you’ll join the conversation!
Amanda Setili (@amandasetili) is author of The Agility Advantage: How to Identify and Act on Opportunities in a Fast-Changing World (learn more and read a sample here.) and managing partner of strategy consulting firm Setili & Associates – visit us to engage on this and other posts.
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