The Nun and the Bureaucrat--- How They Found an Unlikely Cure for America's Sick Hospitals

The Nun and the Bureaucrat is so simple, inviting, and fascinating that it is easily read in a sitting. It should be required reading for every university program in Nursing and Management. In fact, every administrator, faculty member, and graduate must in the future know the profound lessons this book so tersely describes. What a delightful way to begin a quality journey into systems thinking and organizational transformation so demanded in American institutions from business, education, government, not-for-profits, NGOs. Ralph F. Mullin, Ph.D. Professor of Quality Management University of Central Missouri

Savary and Crawford-Mason have done an analysis of dramatic improvement in health care delivery in two hospital systems. This book provides insight into the benefits of using systmes thinking for organizational transformation. The authors allow the players--doctors, nurses, aides, administrators--to tell their stories. Those hospitals challenged to improve patient satisfaction and optimum patient care will find this book inspiring. Those hospitals already doing continuous quality improvement will find interesting supportive examples. The book is a good illustration of the benefits of total engagement of everyone involved in the process of review and recommendation for continued improvements in all processes. Dr. Marylouise Fennell, Hospital Board Member

Since we have had several personal experiences of almost dying or being infected after a medical procedure, we tuned into the PBS broadcast of the documentary "Good News... How Hospitals Heal Themselves". It was so revealing that we got the book for both personal and business reasons. In our business, ESF, Inc., we frequently deal with hospitals and those in the medical and nursing professions. Both my husband, Dr. Peter J. Esseff, and I feel this book should be read by personnel in every hospital from administrator to janitor. The "Systems Thinking" initiatives put into effect by the hospitals in the two "Good News" health care systems (SSM Health Care, St. Louis, Mo. comprised of 23 hospitals, and the Pittsburgh Regional Health Care Initiative, Pittsburgh, PA, comprised of 40 hospitals) demonstrated how a variety of "hospital diseases" could be treated and eventually eradicated. These initiatives were used initially by Dr. W. Edwards Deming in helping Japan "work smarter, not harder" in improving their auto manufacturing industry. In these two health care systems, statistics are given that demonstrate how the hospitals were able to: focus more on patients' needs; reduce costs, deaths, suffering, infections, duplication of services, waste of time and supplies; avoid deadly mistakes; streamline their bureaucracy; and work as a Team, from the top to the bottom of the chain of employees, by not placing blame for errors committed and empowering their workers to recommend changes to improve the quality of care in the hospitals. The Savary/Crawford-Mason book takes the reader through the step-by-step process used by the two "good news" health care systems and described what each step in the process achieved. "The Nun and the Bureaucrat" is filled with specific examples of what the problem was and how the hospital solved it, sometimes in creative ways, but more often in logical ways that make us wonder why someone didn't think of that sooner. The positive results achieved through these initiatives are astounding. What an incredible impact it would be on our entire health care system if these "Systems Thinking" initiatives could be enacted country wide in every medical facility. It gives us hope for curing our sick hospitals. It gives us hope for reducing our ever-increasing health care costs. It gives us hope for raising the standard of health care. Everyone should read "The Nun and the Bureaucrat--How They Found an Unlikely Cure for America's Sick Hospitals" and pressure their hospital administrators, community, state, and federal officials to apply these "Systems Thinking" initiatives to our health care system nationwide. School systems should do likewise.

Read this book and give it to your doctor and your hospital administrator and they will learn how to reduce waste, suffering, hospital-acquired infections, costs, errors and improve patient safety and save lives. And additional money or government regulations are not required to begin this improvement plan. In the book, doctors and nurses explain how they didn't believe systems thinking would improve their hospitals. But to their delight, it did and they are saving lives, making fewer errors and enjoying their work. I am the co-author of this book and believe the comments from the experts on the back cover of the book say it all. "If you think that hospital care cannot be significantly improved in quality and cost, you have another think coming. Read this book." Russell Ackoff, Professor Emeritus, The Wharton School, University of Pennsylvania. Author, Ackoff's Best, Re-creating the Corporation, and Redesigning Society (with Sheldon Roven) "This book describes the kind of leadership that's essential for making our hospitals safe and patient friendly and at the same time cutting costs by driving out waste. And that is leadership that employs systems thinking to realize an inspiring vision. Read this book to learn how two leaders educated and transformed their hospitals. They show the way that others can and should follow." Michael Maccoby, MD, Anthropologist, psychoanalyst and consultant on leadership, strategy and organization. Author, The Gamesman; Why Work?: Motivating the New Work Force; and the Productive Narcissist: The Promise and Perils of Visionary Leadership. "Most of us realize that living and doing daily work requires us to depend on other people and predictable work processes. Taking those understandings into health care and the work of improving it is a complex undertaking. These authors have created an inviting introduction to health care as a system. In the midst of widespread recognition that we must improve our health care, they offer a starting point for creating the changes we need. Their attention to the insightful people making these changes happen allows us to learn from what's working. They have seen what is hard to see at first: health care as a system. Their writing is clear and inviting. In short, this is a welcome addition to the public conversation. Read it, share it and tell your elected officials about what you now understand needs to be encouraged to make health care better." Paul Batalden, M.D., Professor, Dartmouth Medical School "If ever there was an idea whose time as has come, this is the idea and this is the time. Cal Thomas, syndicated columnist "This book gives me hope that we can make similar improvements at many hospitals around the country." Kenneth H. Cohn, MD, MBA, Cambridge Management Group. Author: Better Communication for Better Care: Mastering Physician-Administrator Collaboration, and Collaborate for Success: Breakthrough Strategies for Engaging Physicians, Nurses, and Hospital