Presentation on theme: "Five Laws of Life, Medicine and Patient Flow"— Presentation transcript:
1Five Laws of Life, Medicine and Patient Flow Erica Reid,NHS Borders,June 2011
2Five Laws of Life, Medicine and Patient Flow What are they? Occam’s RazorSutton’s LawHickam’s DictumMurphy’s LawZanuck’s Corollary
314th Century Philosopher Occam’s RazorWilliam Occam14th Century Philosopher‘Razor’- shave any unnecessary assumptions from a theory
4Effective Patient Flow Occam’s Razors? Identify potential bottlenecksEDs/Assessment Units – are processes unnecessarily complicated?Simple Discharge ProcessesWhat time of day are you discharging the majority of patients?Is it matching the demand for admission?
5‘Because that’s where the money is’ Willie SuttonNever carried a loaded gun ‘someone might get hurt’Stole from the rich and kept it.Never robbed banks if women screamed or babies cried.Why did he rob banks?‘Because that’s where the money is’Robbed about 100 banks from the late 1920s to his final arrest in 1952Throughout his professional criminal career he never killed anyone.
6Sutton’s LawWhen investigating a patient look in the place most likely to give the diagnosis
7Effective Patient Flow Sutton’s Law? Have you acknowledged active management of length of stay is a key priority?Are all wards proactively managing patient flow?EDDs, Daily Board Rounds, etc
8‘Patients can have as many diseases as they damn well please’ Hickam’s Dictum‘Patients can have as many diseases as they damn well please’
9Effective Patient Flow Hickam’s Dictum? Patients can have many diseases at the same time, but may also have many and complex social care needsHow can you work more effectively with social work colleagues to reduce delays?
10"Anything that can go wrong, will go wrong" Murphy’s Law"Anything that can go wrong, will go wrong"
11Origin of Murphy’s law Dr. John Stapp, USAF Col. & Flt Surgeon 1946-7, High altitude experimentsHuman tolerance of G-forces in rapid decelerations using test sleds
12"Anything that can go wrong, will go wrong" Murphy’s LawStapp’s rocket sled team’s good safety record, explained it was due to awareness of Murphy’s Law and the need to circumvent it.Term was picked up by the aerospace industry."Anything that can go wrong, will go wrong"
13Effective Patient Flow Murphy’s Law? Mondays and Tuesdays?To board or not to board?Moving patients to the ‘wrong’ bed to avoid breaches
14Zanuck’s CorollaryIf two men on the same job agree all the time, one of them is useless. If they disagree all the time, both are uselessDarryl Zanuck quoted Oct 1949Movie Producer & owner of Fox StudiosMovies inc. 42nd Street, How Green was my Valley, The Grapes of Wrath, Longest Day
15Effective Patient Flow Zanuck’s Corollary? Some measure of disagreement and debate essentialManagement of process and clinical needStrict protocol versus case-by-case tailoring
16Kenney’s Law Just because you don’t agree with me, doesn’t mean I’m wrong!With thanks to Dr Ian Kenney,Consultant Paediatric Radiologist, Brighton.