On the second day after surgery, he was in immense pain trying to recover from the surgeon’s surprise eleven-inch incision, out of which tubes were awkwardly hanging. And this pain was in spite of the medication. Prior to surgery, he had been told there would be no more than a two-inch incision, but once they got in there, they found the stone was embedded in the kidney – no longer a simple procedure. The night after surgery, at 2:00 a.m., the patient awakened and realized he was drenched in sweat from the morphine. The air conditioner was blowing cold air across his body. His groggy thinking was about potential pneumonia and how he didn’t need that, so he pushed the intercom button to summon a nurse. There was no answer for five minutes so he pushed the button again. Another ten minutes passed and still no answer, air still blowing directly on him, and chills increasing. Too exhausted to get angry, but beginning to feel a little desperate, he hit the button a third time. A voice, in an irritated tone, came through the intercom. “Yeah, what do you want?” And the nurse took thirty minutes after that to finally get to the room.

To add insult to injury, the next morning, a healthcare assistant came into his room and set down a container of warm water on his tray. She tossed a wash rag at him and said, “Here, wash yourself,” to a patient that needed ten minutes to plan a move from one side of the bed to the other to avoid excruciating pain. It is hard to imagine such pain if you have not experienced it. As a result, this normally rational, well-adjusted patient was beginning to experience helplessness and the attending depression. He tried to tell the physician about his lack of care, but the physician was in a hurry and was more interested in “telling” than “listening.” He was a busy, important man!

patientsFinally, on the third day when the patient was completely exhausted from little rest and even less “healthcare,” an angel walked into the room. She was an “aide,” a “healthcare assistant” with twenty-three years of experience of caring, yes, caring for and about people. She said, with a beautiful smile, “Oh honey, let me help you.” She rolled up a pillow and gently tucked it in the right spot to give the patient the support he had needed for three days. Then she took a washcloth and carefully bathed him and straightened up his room, bringing the needed order that the others carelessly ignored. While she did this, she talked to him and asked about what he was experiencing. She asked about his family and joked with him, making him laugh, which hurt. But it was a good hurt. She was so authentic, so real. This beautiful 60-year-old woman cared, really cared, and for the first time, according to this patient, the healing began.

What is the case for beauty in healthcare? Be it the physical space, or the caring of the caregiver, beauty heals. It heals the patient and it heals the healer. However manifested, be it grace, gentleness, attention, order, cleanliness, caring, or genuine smiling, beauty heals. Plotinus said, “We ourselves possess beauty when we are true to our own being.” And the poet Kathleen Raine said, “Beauty causes the soul to swell, while ugliness causes the soul to shrink.” When Lean is done right, it often produces elegant, beautiful results. It frees workers from the shackles of chaotic processes. It improves flow, simplifies, organizes and clarifies work. It helps reduce destructive and harmful variation. It creates a home for every piece of equipment and all needed supplies, eliminating the hunting, hiding, hoarding, cannibalizing and general scurrying about activities that are, at best, ugly and shrink the soul. Lean creates space, clarity, and structures for pride in work to flourish. If Lean is done right, it frees up time, and it challenges us to respect ourselves, our suppliers, our customers and our colleagues in the deepest ways. It facilitates the birthing of practical ideas from an army of problem solvers that help improve everything. It helps us sustain improvements, something healthcare has always struggled with.

Yes, technology, job descriptions, surgical technique, equipment, supplies, and medicine are all necessary. Of course they are. They are necessary, but insufficient. The spirit needs beauty to heal and to flourish. There can be artistry and beauty in any job. That healthcare assistant who started the healing for our patient was an artist. Her way of caring was a work of art, beautiful to the patient who received it. Others may not believe that, but he does. Her work should be studied. She should teach.

So what if every healthcare leader thought that their number one job, every day, in addition to everything else, was to help surround us all with beauty and encourage the beauty within all of us to flourish. How would the leader’s day be different? How would our healthcare facilities be different? How might the patient experience be different?


Terry HowellToday’s blog was written by Terry Howell, Ed. D., Senior Principal at HPP.

Terry brings more than 30 years of experience in healthcare performance improvement. Prior to HPP, Terry was the Chief Quality Officer at Hennepin County Medical Center in Minneapolis, Minnesota. His responsibilities included oversight and coordination of performance improvement, service excellence, employee safety and organization-wide planning. Prior to joining HCMC, Terry served as Vice President for Performance Improvement at Tri City Medical Center, as Senior Vice President for Performance Improvement, at HMD: The Smart Hospital Company and as President of Executive Learning, a management consulting firm specializing in healthcare performance improvement, strategic planning and customer service. Terry regularly consults with clients engaged in Lean transformations, strategic deployment, management system implementation, learning systems development and patient experience improvement. He received a Doctorate of Education degree in Counseling Psychology from the University of Tennessee followed by post-doctoral work in Organizational Development. Terry has served on the faculty of the Institute of Healthcare Quality Improvement (IHI), the Healthcare Quality Improvement National Demonstration Project and taught graduate courses in Tulane University’s International Medical Management program.

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