The Denver Post reported that the Colorado Orthopaedic and Surgical Hospital was shut down this week after a patient’s death. What went wrong?
- Patient was given a a pain killer in too high a dose.
- Patient was left alone for 15 minutes after receiving the drug.
- Staff was unfamiliar with the crash cart.
- The rapid reponse team had trouble reaching the patient’s room.
The nurse involved resigned.
What did the hospital pledge to do? Increase training on emergency response.
All too often, managers think that better training will lead to better results. Unfortunately, employees come and go. Training degrades over time (you lose 90% of what you learn if you don’t use it in 72 hours after training.)
Continue Reading "Surgical Hospital Shut Down"
Posted by Jay Arthur in Service, Six Sigma.
Recently at a conference, I saw a noted Six Sigma practitioner use Minitab to generate data for analysis.
In that moment it struck me: colleges have been training students to manufacture “real-looking” data for class assignments. All you have to do is enter some parameters and out pops data that varies with whatever distribution you assign it.
Isn’t this what got us into trouble in this economy: creating data that justified our behavior and inflated results?
I’d like you to consider that seemingly innocuous behaviors like this can lead to catastrophic results: market crashes, inflated bonuses and general stupidity.
If teachers want to generate data for students, that’s probably a good idea.
Continue Reading "Making Up Data"
Posted by Jay Arthur in Six Sigma.
