Business Blog: Hoover’s Business Insight Zone

In last week’s post, “Make a list of ‘crucial basics’ and check it twice,” I referred to the federal bureaucratic holdup that was impeding the implementation of Dr. Peter Pronovost’s breathtakingly effective checklist system for decreasing infection rates in hospital ICUs.

Good news! Dr. Bob Wachter — one of the country’s most eminent hospitalists — reports that the Office for Human Research Protections has cleared up the problem and will no longer impede the rollout of Dr. Pronovost’s work. He thinks it’s a historical breakthrough.

This is a seminal moment for quality improvement in the United States. The prior OHRP decision, if left standing, could have mandated regulatory approval and the need to obtain patient and provider consent every time one wanted to improve a process and measure its impact. Today’s decision recognizes the need to balance traditional “research” regulations against the harm that will result if good people are forced to leap over unnecessary bureaucratic hurdles every time they seek to implement a safety or quality practice and see if it worked.

Moreover, as more and more regulations – many sensible but some asinine – are promulgated in the name of safety and quality, I hope the OHRP story kickstarts a process in which the regulators and the regulated collaborate to ensure that the ultimate goal of better patient care is being served.

Now, whether you’ve got people’s lives at stake or not, please go back to my earlier post on “crucial basics” and ask whether your own practices are impeding basic improvements. Are you subscribing to “many sensible but some asinine” self-regulations?

This thought puts me in mind of a famous line from one of the greatest process-improvers in American history — Benjamin Franklin:

The taxes are indeed very heavy, and if those laid on by the government were the only ones we had to pay, we might more easily discharge them; but we have many others, and much more grievous to some of us. We are taxed twice as much by our idleness, three times as much by our pride, and four times as much by our folly, and from these taxes the commissioners cannot ease or deliver us by allowing an abatement.

How much is your organization taxing itself with its idleness, pride, or folly?

[ICU photo by adamci; Franklin image via the National Portrait Gallery.]