Prescription for Excellence

Prescription for Excellence, Leadership Lessons for Creating a World-class Customer Experience from UCLA Health System, by Joseph A. Michelli, McGraw-Hill, 2011   

Every healthcare piece  starts with a story – John Toussaint’s history of Tish as she moved back and forth through a trying sojourn in a series of  Florida clinics and hospitals; The Mill Girl’s trip into the healthcare system that my doctors and coach are still helping me to dig out of, and Joseph Micelli’s moving recitation of Janice and her family’s horrifying trip to death, paralysis and blindness – and back.   That’s what makes this industry so important – it’s not just about the money, although the costs are rising anywhere from 30 – 70% per year – but it’s the near-death and pain and confusion-filled experiences laid end-to-end across our lives, that makes fixing this industry so critical.  Fixing the system is the least we can do to honor the very well-prepared and serious professionals who at this point are tired, plain damn tired. 

The UCLA experience is one based on safety for every patient in every procedure.  Michelli believes that the UCLA lessons can serve as a template for other businesses because every aspect of patient safety was carefully considered and built into the system.  When Katherine finally arrived in surgery, Dr. Gonzales himself owned responsibility for the outcomes – he weighed and communicated the risks of the procedure against its benefits and discussed possible outcomes, including death, with Katherine’s family.  Not standing alone with sole responsibility, the author notes that Dr. Gonzalez was equipped with the best scanning technologies, and the best trained support teams.  And he believes that this otherwise risky procedure could not have been successfully performed or even attempted at other hospitals

Looking back, the surgeon comments “The surgery proved to be as challenging as I had imagined.  I never look at the clock when I work, since my only priority is to be absolutely sure that everything we do for the patient is done perfectly – that no harm comes to the patient as a result of a movement that I make while dissecting.  Very, very carefully, we removed every single vessel that was abnormal and removed the hematoma.  …. I thought I had been working for 8 hours because I was really tired; in truth it had been 16 hours!”

Michelli takes readers through the systems behind the work – lean, Toyota, mapping, technologies, training, and more, that took the UCLA organization from sheer scale to excellence.  Read this book to discover a model for patient-centered healthcare, and to understand the particular methods and designs behind the good results.  An exciting and hopeful look deep into healthcare operations.