Lean can be used to address many types of problems in hospitals. One of the more heartbreaking areas is highlighted in a new report from the Agency for Healthcare Research and Quality. Its title: “Potentially Avoidable Injuries to Mothers and Newborns During Childbirth.”
The report, which is based on data from 2006, actually contains good news: The rates of these types of injuries in the
The injuries to newborns during birth include broken collarbones, infections and head injuries. The injuries to mothers include tears in tissue during delivery.
The report classifies births as vaginal, with and without instruments, and caesarian. It found a variety of correlations between injury rates and certain categories of mothers and infants.
For example, newborns covered by Medicaid had higher injury rates than newborns covered by private insurance. And rates of obstetrical trauma for mothers were highest among women living in the wealthiest communities, and women with private insurance had higher obstetrical trauma rates than those with Medicaid.
The report does not discuss why the rates vary. It may have something to do with the training and skill of doctors. But from a lean standpoint, it almost certainly has something to do with standard work.
I see this as a very difficult area to tackle, as each obstetrician works pretty much independently, which means the doctor, rather than the hospital, is in charge of the process of delivery.
However, the fact that injury rates have been declining offers hope that improvements are possible.