ABSTRACT
This chapter discusses observation, team approach, communication, timeline and roadmap, data/evaluation, decision-making and problem-solving. The metaphor of putting out fires relates to creating change in response to the proverbial “burning platform.” The Deepwater Horizon catastrophe points out that the only valid response to a burning platform is to get off it. Denver Health’s Executive team, like all leadership teams, developed a limited number of measures to provide a picture of our performance and present actionable targets for improvement. The actionable part is important. If a measure has critical components outside control, it may be interesting, but it is unlikely to drive improvement. Healthcare systems generally do not have the granular cost accounting systems seen in manufacturing. Cost is often equated with charges and the hospital’s uncompensated care is reported as charges.
