Clinical Improvement is Life, too

This week in a couple of our hospital leadership meetings we took a close and very encouraging look at some new work aimed at reducing the leading cause of death in our (and most everyones’) facilities, sepsis. Although strokes and heart attacks are more familiar, sepsis kills more people. Sepsis, which is really blood poisoning, is one way the body shuts down naturally, so it can’t be eliminated. But some sepsis is unnecessary and, if detected early can be beaten back. Indeed, in just one of our hospitals (Methodist North) we are now seeing 5 fewer sepsis deaths per month because of a carefully coordinated set of tools and practices. That’s a lot of birthdays over a year.

When this was presented to managment, the story was all about the technology, which is not inappropriate because the early detection that is the key is driven by the dramatically new potentials our brand new fully eletronic medical record system have given us. When the vital signs are entered into the system (more and more this is done via monitoring devices that are directly wired into the system), the system screens for the pattern of early sepsis. Those symptoms may not be apparent to a nurse just standing next to the patient, but when that pattern is recognized by the system an email and text page is sent to the physician and response team so they can go intervene right away.

What I see is wires, but more precisely, wires allowing the leading causes of life to flourish. The whole response is highly social–its a team. And any time there are two or three in some relationship to each other, there will be life going on. In this case, the new level of connectedness, illuminates dramatic new levels of agency possible for the team. When you hear the team report on this powerful innovation, the voices vibrate with coherence — this kind of life giving work is what they have organized their life around since they entered school. This is why they come to work and the source of their creative passion. It is the reason Dr. Joe Kettracide went into the odd and arcane stream of work known as medical information management. He’s a physician who helped invent the technology of the electronic medical record and came to Methodist because he wanted to see one health system actually fulfill its promise. Those five birthdays a month ring every coherence bell in his body. But so it does for the nurses, the managers who figured out how to build the business case, the tech guy who plugged the computers together.

The word blessing pops up in this kind of conversation as something experienced not just by the patient, but by everyone involved. The successful innovation brings everyone into a living relationship in which they experience more life and deeper life.

The connection feeds the agency which resonates deeply with the coherence among the care team which creates a powerful sense of blessing. The result is a lot more life than we had going on. The new energy in the room was palpable. We were all more alive and capable of participating in more stuff like this. We found ourselves with more hope –riskable expectation– that we had before. Methodist risked $100 million so far on these electronic tools, so that is not a small thing to think about.

Life was at work in this process, which can even flow across the wires, beepers, stainless steel and odd language of a hospital.

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Professor, Faith and the Health of the Public, Wake Forest University School of Divinity. NC Certified Beekeeper Author, Leading Causes of Life, Deeply Woven Roots, Boundary Leaders, Religion and the Heath of the Public, Speak Life and God and the People. God and the People: Prayers for a Newer New Awakening. Secretary Stakeholder Health. Founder, Leading Causes of Life Initiative

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