Critically Ill: A 5-Point Plan to Cure Healthcare Delivery


Critically Ill begins with the story of Mary, a critically ill patient who suffers multiple errors and oversights with frightening consequences. The subsequent chapters dissect the causes of and solutions for improving her poor care. Each caregiver who reads Critically Ill will acquire 5 new skill sets: he or she will be able to understand and apply the principles of effective manufacturing companies and championship athletic teams; understand the nature of human error and random variation, and be able to apply ...

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Critically Ill begins with the story of Mary, a critically ill patient who suffers multiple errors and oversights with frightening consequences. The subsequent chapters dissect the causes of and solutions for improving her poor care. Each caregiver who reads Critically Ill will acquire 5 new skill sets: he or she will be able to understand and apply the principles of effective manufacturing companies and championship athletic teams; understand the nature of human error and random variation, and be able to apply proven methods to correct and prevent medical mistakes; be able to work effectively in multidisciplinary teams; become an effective manager and adaptive leader capable of leading true change; and finally attain the skills to organize others to affect needed cultural changes within our healthcare delivery systems. In the final chapter 5-point personal plans are described for bedside and clinic nurses, nurse practitioners, nurse administrators, and nursing students. Critically Ill will empower you as an individual caregiver to truly make a difference.

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Product Details

  • ISBN-13: 9781614660163
  • Publisher: Southwick Press
  • Publication date: 6/25/2012
  • Pages: 360
  • Product dimensions: 6.00 (w) x 8.90 (h) x 1.10 (d)

Meet the Author

Dr. Southwick earned a B.S. in Educational Psychology from Yale University where he played varsity football, lacrosse and was also captain of the wrestling team. During his senior year, Yale Football was nationally ranked and won the IVY League Championship. Southwick received his MD from Columbia College of Physicians and Surgeons, where he was an International Fellow and an Edward J. Noble Foundation Scholarship recipient. He trained in Internal Medicine and Infectious Diseases at the Boston City Hospital and Massachusetts General Hospital.

Dr. Southwick has taught as an Assistant Professor at Harvard University, followed by Associate Professorship with tenure at the University of Pennsylvania. A pioneer in the field of infectious diseases, Dr. Southwick served over 19 years as the Chief of the Division of Infectious Diseases and as Vice Chair of the Department of Medicine at the University of Florida College of Medicine. An NIH funded investigator for more than 30 years, he has conducted groundbreaking research in the discovery of proteins to regulate white blood cells' ability to move and fight infection in the body. He also served on the Board of Scientific Directors of the National Institutes of Health (NIH) Warren Magnuson Clinical Center.

As a consequence of a family member’s near death while hospitalized, Dr. Southwick began to adopt a system to improve frontline care and the prevention of hospital errors.  After attending Harvard Business School as an Advanced Leadership Fellow, he became Project Manager for Quality and Safety Pilot Programs for the University of Florida & Shands Healthcare system.

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Table of Contents

Chapter 1: Who Was Caring for Mary? What can Mary’s critical illness tell us about our health care delivery system?

Recounts the story of Mary, a previously healthy mother of with two young children, who suffers complication after complication as a consequence of errors and oversights during her care in a University Hospital. Mary’s case serves as a springboard to discuss the high number of preventable deaths in the U.S. Healthcare systems, and to encourage nurses to improve our systems of healthcare delivery.

Chapter 2: Individuals Make Plays, Playbooks Win Championships: What can industry and athletics tell us about Mary’s care?

Reviews the key principles and operating systems used by three high performing companies, Toyota, Southwest Airlines and Publix Supermarkets, and then describes how a collegiate woman’s volleyball team and men’s football team have utilized these same principles to win regional and national championships. And finally describes how these principles can be applied to healthcare delivery.

Chapter 3: Managing the Game Plan: What Can the Patient Safety and Quality Movement Tell Us about Mary’s Care? 

Defines quality and describes what is meant by an operating system. Enumerates the conditions that lead to human error, and introduces the concepts of common cause and special cause variability. Provides methods for assessing variability and outlines the techniques used to reduce variability and human errors including: plan, do, study, act cycles, root cause analysis, failure mode and effects analysis, forcing functions, check lists and second checks. Finally discusses the concept of second victims and emphasizes the importance of transparency, honesty and trust.

Chapter 4: Championship Teams Make No Excuses: How could a team approach have improved Mary’s care?

Defines the conditions in health care where teams promise to be more effective than individual caregivers. Outlines the key conditions for effective teamwork: Goals, structure, the right people and right number on the team, supportive resources, and effective coaching. Describes how to effectively launch a team and manage team dynamics. Explains how multidisciplinary medical teams can improve quality and safety, and bring joy back to the workplace.

Chapter 5:  We All Can and Should Lead: How Could Effective Leadership Have Improved Mary’s Care?

Describes the concept and emphasizes the importance of distributive leadership in health care. Discusses the importance of interpersonal skills and courage to maintain the highest ethical standards. Outlines the 5 skills required to be an effective leader: effective time management, the ability to understand each person’s unique contribution, capability to see and focus on strengths, effective decision making, and a willingness to manage on the front line. Discusses how to pick effective personnel. The chapter ends with a discussion of adaptive leaders, leaders that promote a true change in the way things are done. The ways those in favor of the status quo block change and lower the disequilibrium associated with change are covered, as are strategies to effectively manage disequilibrium.

Chapter 6: Culture is Nothing more than Group Habit: How could changes in medical culture have improved Mary’s care?

Relays the story of how United States Founding Father Samuel Adams converted complacent colonist into active crusaders for freedom and independence from Great Britain, and relates how these strategies can be used to transform the attitudes of healthcare providers. Reviews the three faces of power and analyses the key constituencies within the healthcare system: patients, physicians, nurses, and students. Outlines the steps for effective organizing: one-on-one meetings, the use of personal narrative, creation of leadership campaign teams, developing strategy and tactics, and encouraging action by securing commitments, creating measurable goals and monitoring progress.


Chapter 7: Bringing Home The Ring…A Personal 5-point Action Plan to Cure Healthcare Delivery

The concept of immunity to change is introduced, and the strategies for overcoming personal resistance to change are outlined. Specific 5-point action plans are created to empower nurses, nurse practitioners, nurse administrators and nursing students to effectively transform how patient care is provided. These plans for continual improvement through multiple small personal steps promise to bring about major transformational improvements in healthcare delivery.

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