Good Thing Hospitals Are Not Power Companies

The great power shutoff here in Northern California is over—for now. PG&E recently instituted a series of rolling power shutoffs, some lasting for days. There were stories of people who live pay check to pay check having their week’s groceries spoiled and people dependent on power to maintain their health suffering.

The announced reason was to prevent the kind of catastrophic wild fires which destroyed or greatly damaged several cities last year. The root cause of those fires was incompetent, shortsighted top management and governance with a dose of political interference thrown in. Unfortunately, PG&E’s front line employees bore the brunt of the public’s outrage as they went about checking power lines and other equipment. They were a convenient target for the sins of management.

When power was finally restored to everyone and the smoke had cleared (pun not intended), PG&E top management began a public relations campaign to explain their incompetence. Full page newspaper ads ran for days and they continue to do so as I write this entry.

One ad proudly proclaimed “When faced with dangerous weather, WE CHOOSE SAFETY”. It explained why it was necessary to inspect power lines in times of threatening weather. It expressed its gratitude to its customers and field crews “who showed great resilience in a difficult time.” As if they had a choice. Nowhere was an acknowledgement of management culpability from years of deferred maintenance and the expenditure of funds on other endeavors that should have been spent on the power lines.

The most recent ad addressed “TO OUR VALUED PG&E CUSTOMERS: The Recent Public Safety Power Shutoff by the Numbers.” We were supposed to be impressed by the fact that the company was doing what it should always be doing–providing power in a safe manner. Except it was providing no power in a safe way. That sounds like it should be the company’s new mission statement— we exist to provide no power in a safe way.

Now, PG&E’s new CEO (poor guy must have really needed the job) is insisting that we can expect periodic power shutoffs for the next ten years. What other company can say it will provide poor service for a prolonged period of time to its valued customers? I would prefer having electricity and not being valued at all.

As all this was occurring, I was thinking about healthcare care providers and specifically hospitals where errors are an issue and safety an overriding concern. Hospitals cannot just shut down for a prolong period of time and ignore the needs of the patients they serve. When a problem of patient care or safety occurs, the root cause needs to be rapidly determined and a solution devised and implemented immediately. You cannot wait ten years.

If a hospital told the public that it would intermittently be closing for safety reasons, it would be reasonable to ask why that facility in its current form is allowed to continue to operate at all. Safety is an expectation in healthcare, not a voluntary condition which only matters after great damage has occurred. Good management and effective governance in hospitals should never allow conditions to deteriorate to such an extent that continued operation means someone will be hurt.

One of the strengths of healthcare and again especially hospitals is that we have professionals (physicians, nurses, therapists and others) who think first of patient needs and who do not hesitate to voice their concerns. They may not always be right but their voices are heard and in effective organizations their concerns seriously considered.

We acknowledge errors and safety concerns in healthcare. We have a long way to go to achieve zero errors but at least we don’t have to run newspaper ads gratuitously patting ourselves on the back for not causing damage by not providing services.

PG&E and similarly situated power companies could learn a great deal about management, governance and accountability by looking at healthcare.

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