All the charts and graphs that you see in this blog are process control charts—like every efficient, productive industry (Boeing, GE, Toyota) uses. Every day, even during the day, you use these charts to see where processes need changes to make the flow of product more efficient, profitable, and safer.  To design and use a process control chart, someone at some level needs to understand and have an intimate knowledge of the process that’s being controlled.  Where are the process control charts in medicine?

As I’ve perused the web in search of healthcare management system groups and websites, there’s  a lot of emphasis on ‘lean’ management, six-sigma, etc.  Nice words, and nice techniques.  But they are only tools–hammers and saws.  You need to be an architect, one who understands how all the aspects of a house fit together,  to build a comfortable sustainable house. Similarly, you need to be a good architect to build a good healthcare system. The tools–lean management, six-sigma, quality control, etc–without someone who has detailed knowledge of the healthcare process you’re trying to control, will be poorly and wastefully used to create an expensive shack instead of an inspired edifice.  Knowing how to use a saw is just the beginning.