Follow-up from Den Bosch

Those of us involved in improving the processes of health care understand that this is always a work in progress. You never know, though, what will prompt an improvement in an organization. Sometimes, an action in a passing moment sparks a change.

In a previous post, I expressed great admiration for the quality, safety, and transparency initiatives underway at the newly constructed Jeroen Bosch hospital in the Netherlands. The hospital, in many ways, is setting a standard for others in the country and beyond, and they have cause for great pride and satisfaction.

One reason for that progress is that the staff has an almost compulsive drive for order. But, this is a new hospital, and things are still in shake-down mode. With over 1 million square feet of space, there are bound to be things that go unnoticed for some time.

As I received a tour of the place, we passed through a corridor to the operating rooms, and I saw this scene in a corridor -- a visual cacophony of clogs left behind by the OR staff. I could see that my host, Jan Olsman, the Chief of Surgery, was aghast. Jan has been meticulous about maintaining a shipshape environment around the ORs.

He and others noted that I took a picture of the scene. I just thought it created an interesting visual pattern, but I did promise not to publish the incriminating evidence for the world to see. I sent it along to Jan, and he, in good humor replied:

Thanks a lot for the nice footwear "tableau!" I actually start liking it as a piece of art. But not in this place.

Today, I received this photograph in my email. It came unadorned, with no explanatory message, but I knew immediately what had happened. I wrote:

I assume the picture came from you. Congratulations!

Sure enough, in a follow-up note, Jan said:

Correct! The threat of that picture with all the white shoes put on your weblog was enough for one of my staff members to remove them that same day!

And he also said he would be comfortable if I told the story, with illustrations. Perhaps this is another example of the power of transparency: Even the threat of disclosure prompts self-improvement!

I think, though, that is mainly an example of good humor and intellectual modesty by Jan and his colleagues at Jeroen Bosch. Thanks to them for letting me tell the story and, again, for setting such a fine example for so many in the hospital world.