[throwaway892238]

This is similar to problems that would often happen in car manufacturing. The person assembling the car the standard way finds a problem, but the problem doesn't get addressed, or information isn't disseminated correctly, so the cars go out with problems. Toyota developed a methodology whereby such problems are addressed immediately and fixes were disseminated immediately, and would not send a car out otherwise. That kind of obsessive attention to detail and "crazy" focus on quality is what made them the top automaker. But most businesses are led by management that refuse to believe that being slow or focusing on quality first will result in more profits. And none of their lower-level workers are trained on how to spot and fix quality issues, nor are they told to care.

Hospital systems are the same way. Moronic, scared management that is fine with these kinds of problems as long as the dough keeps coming in, ignorant of the fact that more dough would roll in (in addition to better health outcomes, which of course is not their first priority) if they would just focus on quality.

[retconn]

This is my favourite ever episode of This American Life, about NUMMI, the shop floor level and individually fraternal miracle that was created by workers at Toyota and GM in a CA GM plant, until management shut them down:

https://www.thisamericanlife.org/561/nummi-2015

[throwaway2037]

This episode is incredible! I also listened to it a few years ago. It provided so much insight into (a) Japanese vs American manufactoring and (b) the impact of poor labour union relations. (Please do not read [b] as me being personally anti-labour union. Some of the revelations from union members in that podcast were shocking to me -- drinking and drugging while on the manuf line!)

[ler_]

Very cool point. In my ideal world a whole nursing unit or facility would be a self-correcting operation. There are problems that a nurse on the floor can fix but it takes up time. If those problems were prevented to begin with, it would be much easier. I would like a system where the nurse notices a problem and simply sends it up to a manager / supervisor who 1) finds a way to handle the immediate problem and 2) always writes up and enforces a new guideline to prevent it from happening again.

Good managers probably already do this, but healthcare has a very short supply of such people. It would be great if this type of improvement were the standard across the board. Let's say, for example, that you have latex and non-latex foley catheters mixed in the same bin in a supply closet. Your patients with latex allergies have gotten a latex catheter put in more than once and it now becomes a problem. Well, someone notices the issue, sends it up to someone above and now there is a new guideline to place the different catheters at least 3 feet apart, or something to that effect. It almost sounds silly, but people would be surprised how many of these mistakes happen over and over again due to equally silly reasons / lack of basic prevention.

[Aeolun]

> Moronic, scared management that is fine with these kinds of problems as long as the dough keeps coming in

That sounds like it’s the same in any sector? Especially IT.