In April I attended the BMJ/IHI Forum on Quality and Safety in Healthcare in London. Maureen Bisognano, President and CEO of the IHI was one of the main speakers.
Maureen discussed an area of healthcare we haven’t been fantastic at improving in recent years; funnily enough, she didn’t talk about innovation, but exinnovation – this term referring to what we can reduce, minimize, throw-away and do without to make healthcare run more smoothly, economically and effectively.
So much of modern healthcare involves doing more – starting from a stance of scarcity; more equipment, more time, more money, more tests, medicines, etc – part of this stems from the human necessity to do more, explore and expand – this is the basis of evolution, learning and improvement.
Yet, sometimes we don’t realize what we already have. We forget that not only are we surrounded by plenty, oftentimes we are surrounded by too much – too much information, too much clutter, to many investigations and procedures.
And this is where Bruce Lee comes-in. In 2015 Maureen Bisognano was discussing something that Bruce Lee, the legendary martial artist discussed in the 1960’s – One of his famous mantras was ‘It is not daily increase, but daily decrease – hack away the unessentials’ Lee was talking about the superfluous, often over-indulgent and at times flouncy movements of some martial arts – Lee was interested in effectiveness, not wasting time and effort perfecting moves that he didn’t feel added to the outcomes.
In how many areas of modern healthcare do we do too much? Unnecessary procedures, reports and documents – how many times is a patient asked about their history, their symptoms, how many superfluous investigations are performed, bed, ward and hospital moves? How much less could we do to become more effective?
The shortest distance between two points is a straight line – sometimes we need to wander, we need to take the scenic route to arrive at our destination; how often could we achieve for our patients equivalent and even better outcomes by exinnovating, stripping away that which is not essential?