September 28, 2007
Jack Covert Selects: Jack Covert Selects - Better
Better: A Surgeon's Notes on Performance by Atul Gawande, Metropolitan Books, 288p, $24.00, Hardcover, April 2007, ISBN 9780805082111 Innovation research shows that almost every major innovation has an origin outside the industry it impacts. Amazon.com did not originate from a savvy retailer, just as the iPod was not developed by the consumer electronics industry. Looking for inspiration outside your normal avenues can be helpful and, in this recommendation, we take you outside the realm of business books. Atul Gawande is a staff writer for The New Yorker and his first book, Complications, was a New York Times bestseller and a finalist for the National Book Award. He writes about the difficulties facing medicine, and he has a great vantage point as a general surgeon at Brigham and Women's Hospital in Boston and assistant professor at Harvard Medical School. His new book, Better, is about the quest to improve the status quo, and in medicine, this translates directly into saved lives. Gawande suggests there are three aspects to the struggle to improve: diligence, doing it right and ingenuity. His survey starts with one of the biggest killers in hospitals: bacterial infection. Over two million people every year acquire infections while in the care of a hospital, and 90,000 die as a result. The single best way to reduce the spread of infection is medical professionals washing their hands. With nurses seeing 20 patients an hour, it is nearly impractical to stop for a 60 second scrubbing before each patient. Gawande's hospital was able to improve compliance from 40% to 70% with the introduction of an alcohol-based gel. But here's the kicker: there was no change in the infection rates. A hospital in Pittsburgh struggling with the same problem created an initiative modeled after a Vietnamese anti-starvation program that used positive deviance: get the successful minority to tell the majority how to change. With the implementation of this approach, the hospital eliminated--completely--wound infections, and the program is now being tried in other hospitals. While the backdrop from Better is the field of medicine, the continuous improvement message fits whether you are building pick-up trucks or servicing computer networks. Business people can learn from this book about health care, just as the Pittsburgh hospital learned from the Vietnamese village, and be reminded that getting better is a universal quest.