Week 3
In Chapter 3 of Transforming Healthcare, there is a discussion about how many doctors and nurses found the most difficult change to be the standardization of work. Dr. Jacobs describes how there can be six different doctors in the same department all treating the same type of ailment six different ways. Why is it so difficult to standardize work in medicine? Why is not standardizing detrimental? What are the benefits of standardization?
Week 4
https://www.virginiamasoninstitute.org/terrible-tragedy-and-powerful-legacy-of-preventable-death/ The story of Mrs. Mary McClinton walks us through a pivotal moment in the change of culture for Virginia Mason. The tragedy of Mrs. McClinton’s case highlights a system error. Too often, individuals are blamed, and mistakes are left to happen again. Virginia Mason recognized a system error and went about creating a culture of safety. Discuss the evolution of the PSA System and its importance.