Q&A with Roger Gerard

Roger Gerard, Ph.D., is an executive business partner at ThedaCare, a healthcare delivery system serving northeast Wisconsin that is known for applying lean principles to healthcare. He also has his own consulting practice. Gerard will be giving his keynote presentation at the Healthcare Systems Process Improvement Conference on March 2, 2013, at 10 a.m. 

What is the most pervasive issue or challenge in health systems management today?

Fundamentally, given all the external and internal drivers going on in the healthcare industry today, the most pervasive and difficult challenge is the sheer complexity of navigating patient care through a patchwork quilt of services and functions. … When you’re a patient, what we’re here to do is provide you with a diagnosis if you need diagnosis. If you aren’t ill or hurt, we're here to keep you healthy. Once we diagnose you and if we find that there is something that needs to be helped, then our job is to provide the resources and the wherewithal to help you accomplish your health goals. So that’s what healthcare is for. Everything that we do should be structured to serve those ends. And quite frankly, the way healthcare has evolved, that’s not always true.

Professionals often view the healthcare industry as a place to practice their professions, and they may naturally, and unfortunately, put their professional interests before the interests of the patient going through the system. We’re starting to see examples of that all over the industry – fraud in Medicare and Medicaid programs, and many other things that are occurring every day that cause us to wonder whether we are really organized around the patient. What we’re learning when we begin improving processes is that it takes a real act of will to organize everything around the patient.

Just think about who you are going to interact with if you admit yourself [as] either an inpatient or an outpatient. You’re going to not only meet with one doctor; it may be several doctors, a nurse provider or a physician’s assistant. You’re going to have nurses, and some of these nurses are very specialized in their training. You’re going to have lab techs, radiology techs. You’re going to have people who are engaged in dietary therapies, physical therapies, occupational therapies. There are so many professional disciplines – not the least of which are housekeepers, who today have to have training in infection control and many other disciplines. So we have a very, very complex set of businesses, and trying to help you get what you need in the middle of that complexity is an act of will.

What do you plan to discuss in your keynote presentation?

The core of my presentation is about making healthcare focused on the experience of the person who comes to us for care. I’ll focus on process improvement, specifically, and the use of lean methodologies and approaches toward accomplishing that end. But it’s not just that. There’s also a human set of dynamics involved when you resolve to change things, and I will place my emphasis on the human side of that process. It is about lean. It is about efficiency. It is about quality rigor. It is about making sure that your processes deliver what they’re supposed to deliver. But if we do all of that and we don’t attend to the emotional and spiritual needs of the person who comes to us for care, then we have failed. That’s my message. And I offer an approach for doing that as well.

I read that you co-wrote a Shingo-prize-winning book focused on the lean journey at ThedaCare.

Yes, and John Toussaint and I took two very different perspectives throughout that book. He’s an internal medicine physician, so he’s focused on the clinical and on the methodologies of the processes. I’ve spent 20 years in the system as the director of organizational development and as the chief learning officer. I’m very engaged in the learning processes of lean and in the human processes of care. Between the two of us we wrote a book that covered both perspectives.

What would you like attendees to take away from your presentation?

Some people coming to this conference are likely to have a mental model suggesting that, from where they sit in their organizations, they can’t have much of an impact. They’re not the CEOs. They’re not the vice presidents. If they are in the audience, then my message is going to be they do have an impact. Actually, they may have more of an impact than if they were the CEO. But if they assume that they have no power, they’ll never exercise their power. What people have to understand is that care is delivered at the bedside. And that their power is in making sure that the right care is delivered to the right person at the right time in the right way. That’s their power. And if people walk out of this conference understanding that and not feeling like victims of their senior leaders, then we’re in a good place.

For more information about Gerard and the other conference keynote speaker, go to the Keynote Speakers Web page. 

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