There are various approaches to systems thinking—such as Lean, the Deming System of Profound Knowledge, the International Organization for Standardization, and others—but the bottom line is about mindset and the ability to look broadly. Despite the complexity of our health systems, narrow views are still common. What is most amazing is that decision makers often use “proximity bias” as their answer for any blockage in patient flow. Proximity bias means that those closest to the patient must be the problem. Yet when those same executives find their flight is delayed, they don’t rush to judge the pilot or flight staff but naturally understand that there is a flow problem somewhere in the aviation system. Why some do not apply that same thinking in health care is beyond belief, but it does present an opportunity for emergency medicine to expand its leadership beyond the patient and the facility to the system and the region.
As the health care landscape changes, let’s take ownership of building an emergency care system that meets the needs of our patients 24-7 and does not require the patient to meet the needs of the system, as often happens now, leading to delays in care, duplication of testing, and unnecessary transfers. There’s opportunity for leadership, teamwork, and systems thinking and, more important, opportunity to create greater value in emergency care.
Dr. Martinez is chief medical officer and vice president of North Highland and assistant professor of emergency medicine at Emory University in Atlanta, and an ACEP Now Editorial Advisory Board member.