Monday, May 2, 2011

Don't ask people if they're satisfied with the status quo until you've shown them what's possible

As I walked by my son's room, I heard a familiar song playing on his radio.

"Hey", I said, "That's a classic!. Alone, by Heart, right?"

"Who's Heart," he asked. "Anyway, this isn't them."

As I listened to the song, I realized it was a remake of the Heart tune. A passable remake, workmanlike, but missing the beautiful original arrangement and powerful vocals. I told him so.

"Well, I think this is a good version," he replied.

I whipped out my iPod and cued up the original version.

"Oh, yeah," he said, seeing the light (circa 1987). "That is better!"

So, how do you know how good something can be if you've never experienced it?

Provincial patient surveys show a high rate of satisfaction with healthcare.  A survey late last year, showed that half of Saskatchewan residents surveyed rated their healthcare as good - the highest rating in the country.

But, "good" compared to what?  How many people surveyed know what's actually possible?

What would the results be if we showed people how their care could be delivered, such as using the US Veterans' Administration comprehensive electronic medical record?  Or Jonkoping's streamlining of patient flow through consideration of the needs of their prototype patient, Esther?  Or Alberta's systems innovations in providing joint replacement surgery?

Here's an interesting experiment: Educate one group of people about healthcare's best practices around the world.  Leave another group uninformed. Then give them the healthcare satisfaction survey.


  1. I would love to educate one group about what is possible and then administer the patient survey. I just about fell off my chair when i heard that Saskatchewan residents rated their health care as good, and then listed all the problems with it! Is this another of those don't tell them it's bad because it might hurt their feelings, so just tell them its good, becuase that's the next rating!

  2. Baseline measurement is an interesting subject. The book Good to Great by Jim Collins talks about organizations that simply keep the status quo and organizations that make the leap to great. Good (or baseline) is really about setting the bar, where are we right now versus saying “wait a minute we suck and how dare you say we are good”. It’s no different than walking into any coffee shop and asking for a regular coffee! Regular at one restaurant is different than regular at another should we spend all our energy on creating a standard for regular coffee cups? If you know where you are starting at you know where you need to get to. If the bar for Saskatchewan is set at good so be it, that’s our baseline. As a quality minded healthcare organization we should be saying how do we get to the next level of good or even great! Change has to always be compared to your own measure of current state, baseline, then make your improvements and say did we make it better or not. Too much time and energy is wasted on insignificant factors in healthcare, let’s get on with educating the people in our systems about how to move from good to great. Dale Schattenkirk

  3. Thanks for the posts.

    I agree, Dale, that baseline measurement should be considered the start of the improvement process. But, I also think it has value as a call to action. If there's a perception that the status quo is "good" or "good enough", we won't see people marching in the streets.

    I'm not interested in beating up healthcare and saying "we suck". I'm just curious to know how Saskatchewan citizens would respond to a satisfaction survey if they knew what was possible in healthcare, and what has already been achieved elsewhere. Would having that information drive people to demand change?

    As for "getting on with educating the people in our system about how to move from good to great" - you bet; let's carry on with that. But let's also think about how to turn up the heat so theory turns into action.

    May 5, 2011 6:01 AM