Hi, my name is Christian Terwiesch. I've been a professor of Operations Management here at the Wharton School since 1998. More recently, I was also I've been appointed as a professor of Health Policy at our Medical School. You might be a physician, a nurse, or executive in a health care organization, you might be in a government agency, or insurance company paying for health care, or you might be working for a device or software company that provides the technology that supports our health care system. What unites all of us is that we want to provide patients with great care. So our joint goal is to improve healthcare. Now you might be saying wait a minute, "How can this guy in the video help me improve how I provide care?" I went to medical school. I have practiced medicine for 10 years. This guy on the screen doesn't even speak English without an accent. I cannot tell you how to do your work. Nobody knows your work better than you do. But what I can do, is teach you some basic tools about how to analyze and how to improve your work. The academic discipline of analyzing and improving work is called Operations Management. The word operations comes from the Latin word Opus which means work, so operations management is really about helping people improve the way that they work. For almost 20 years I've taught thousands of MBA students, executive MBA students on how to use operations management. The course has become one of the most highest rated courses at the Wharton School. I created an online operations management course on Coursera which has attracted close to half a million students by now, and I've written two of the leading textbooks in the field. So you know your work, I know a bit about operations management, I'm sure together we'll make a winning team. As you and I work together, my job is to provide you with the most important tools of operations management. We talk about process maps, and patient flows, and bottlenecks, we'll talk about waste, variability and flexibility, we talk about lean and six sigma and process improvement and lots of other cool stuff. I would teach you through our collection of videos and assignments. Your job will be to take those tools and apply them to your work. The other thing you might be wondering is, what does he mean when he talks about improving my work, since he is not a doctor but a business school professor? I'm sure that he wants to cut costs. No this is not a cost cutting course. To see what I mean as improvement, let's take a look at another industry first. Let's say you and I went out to go and grab a cup of coffee. Do you like a latte, I like hot chocolate. And so we agreed to meet in a Starbucks. Now what does it take Starbucks to turn us into happy customers? For us to turn into happy customers, a couple of things have to be in place. First of all, we have to get to a Starbucks without too much inconvenience. Now for the better for the worse there are about 11,000 Starbucks in the United States. So location should really not be a problem. Then when we want to order our coffee we want to get it without too much of a waiting time. Now let's not talk about price today, I will pay, but clearly price matters to consumers. Once we have the cup in our hand we want to enjoy the consumption of the coffee, Starbucks that you ordered your coffee in a gazillion different ways. So I'm sure we find something that will match your preferences. But even when you get your medium latte with skim milk and chocolate dusting, the need for good coffee is there and it begins with good ingredients. Good coffee means also a good recipe for its brewing process, and the employees at Starbucks need to execute on that recipe and follow it correctly, so you and I don't end up with a cup of green tea. Now healthcare is more than grabbing a cup of coffee. Believe me, I have come to appreciate they are different. About 10 years ago I was riding my bike training for a triathlon. For reasons that will never be clear to me, the brake cable became loose, and the cable begotten between the wheels' center fork. This is what the fork looked like. I went head over onto the pavement, my helmet protected my skull but my face was sliding over the road. To state the obvious, at that moment I was in need of healthcare. But what made the care I got good or even great health care. Let's see if our coffee example provides any insights into how we could operationalize the idea of good care. First in an accident like this time is critical. An ambulance arrived in minutes and drove me to the Penn Medicine Trauma Center. The Trauma Center was close, by ambulance I would say about 15 minute drive, once we got to the trauma center I do not have to wait in line but I was in a trauma bay before I even noticed. Second, the doctors and the nurses, the care team, they were the specialists I needed at that moment. I needed a trauma surgeon, not a urologist or a psychiatrist. So the care team was great. They knew what to do and they just did it. Nobody took my orders for lunch but trust me that was the least of my worries and in fact I've been told they even had free Wi-Fi. And yes though my insurance did pay for most of that money, this trip to the Trauma Center was more expensive than a week in a five star hotel. So if you think about what we mean with good care we can think along the same dimensions of providing good coffee. In fact I would argue that any work that is about delivering a service fits into my framework. Fortunately, I'm not alone in postulating this framework, take a look at how the Institute of Medicine defines high quality care. In their eyes health care must be safe, following the principle do no harm. It must be effective, meaning that it must be evidence-based and match science. Healthcare should be patient-centered, really respecting the different needs of different patients. Care should be timely not requiring too much of a waiting time. The healthcare system should be efficient constantly seeking to reduce waste and hence costs. And sixth the healthcare should be equitable which oftentimes has also a financial dimension to it. So what do you think? I would argue that the words are slightly different from my words, but the spirit of the definition from the Institute of Medicine pretty damn close comes to my Starbucks example. Another dimension or another definition of good care that people oftentimes point to are the three rights. Doctors should deliver the right care, to the right patient, at the right time, every time. Again, similar in spirit, somewhat simplified but certainly easy to remember. So when I say that the challenges of running a healthcare process are similar to the ones running a coffee shop, it's not just me making this up, my definition of good care is fully in line with the definitions in the medical literature. Today we talked about the what, what does a patient need? What constitutes good care? The next session is about the how, how do we provide this good care? This is when we change from the perspective of the patient, to the perspective of the provider.
