Tuesday, March 1, 2011

A Japanese Starbucks Model for Healthcare Quality

I'm flying back from Japan to the US today and on the way I purchased a vegan (soy) Green Tea Latte from Starbucks.   I relish the Japanese version of this beverage because it is unsweetened (even a bit bitter), since the Japanese typically do not like sugary foods and drinks.   As I ordered the beverage, the clerk behind the counter handed me a special quality control token to ensure I would not receive any dairy products.

Although my choice of soy is related to a lifestyle choice and not a medical condition such as a milk allergy, Starbucks in Japan wants to ensure "zero defects" in the delivery of soy-based drinks to eliminate accidental allergic reactions.

When my beverage was ready, I handed the soy "safety token" (pictured above) to the Starbucks barista who then double checked my receipt to identify that the beverage ordered was the beverage delivered.

Imagine how this Six Sigma/LEAN approach could be applied in hospitals.   Upon admission, patients could be given a token (a bar coded wrist band, a laminated card, an upload to their smartphone etc) that is handed to every caregiver before a medication is administered.   The patient and caregiver verify accuracy together so that right drug is given to the right patient at the right time.

I realize that many hospitals including BIDMC have implemented or are planning bedside medication verification (bar code the patient, bar code the medication, bar code the caregiver and scan/scan/scan before a medication is given) and electronic medication administration records (close the loop between orders and actual administration by charting medications administered electronically), so we're headed in the right direction.  Meaningful Use Stage 2 and 3 will likely include several new medication safety workflow requirements.

However, in the meantime, if Starbucks can use laminated cards to prevent allergies and ensure zero defects in my Green Latte, hospitals should feel inspired to examine their medication workflows and think about simple solutions to do the same for our care delivery processes.

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