As You Were Saying … MGH needs checkup for possible ER bottlenecks — Steven J. Spear

MIT Sloan Senior Lecturer Steven Spear

MIT Sloan Senior Lecturer Steven Spear

From The Boston Herald

Five years after a $500 million expansion, Massachusetts General Hospital’s emergency department is again overburdened, in the words of hospital President Peter Slavin with “delays, dissatisfaction, and sometimes even concerns about quality and safety.”

Before the public, payers, policymakers and donors get on the hook — again — for more staff and more extraordinarily expensive capital expenditures, let’s ask these questions first.

• What’s the mix and volume of patients presenting at the emergency department?

• What portion of discharges occur on time, and of the rest, how long are they delayed?

• From when a patient first presents in the ED, what’s the lag until that patient is examined and treatment begins, the time from “door to doc?”

As to the first question, there are certainly patients with conditions that truly are life- or limb-threatening and arise unexpectedly. Think stroke, heart attack, or aneurysm.

Read More »

Three ideas on fixing the troubled MBTA — Steven J. Spear

MIT Sloan Senior Lecturer Steven Spear

MIT Sloan Senior Lecturer Steven Spear

From The Boston Globe

After the T’s recent collapse, the Globe asked management specialists at local business schools for recommendations to put the system on track (and maybe on time).

Steven J. Spear: Anticipate problems, then practice responses

The MBTA was walloped by January’s and February’s snow, and capital, technological, and urban planning ideas are being floated to prevent future disruptions.

For instance, the Commonwealth acquired two snow melters capable of processing 100 tons per hour to clear tracks and streets. There will certainly be calls for fleet modernization and maintenance, given the blame assigned to older equipment. Longer term planning has a role in ensuring the right type of vehicles are purchased and available to meet commuter needs.

Read More »