Mark Torres of Dryden joined Upstate last summer after teaching for two years at Cornell University in Ithaca. He is a systems engineer by training, and he was anxious to apply his knowledge to health care. He and Enderli Fredericksen report to Upstate’s chief quality officer. (Listen to an interview with the two of them.)
His day: “I spend a lot of time looking at a bunch of data that’s already been collected and measured and trying to make sense of what it’s saying — because it will tell you a story if you look at it and try to determine cause and effect.
“If you look at the process from start to finish, you typically have numbers at the beginning, let’s say ‘admissions,’ and at the end, let’s say ‘discharges.’ You can compute the length of stay between the two. But what you really want to do is figure out what happens along the way, during the stay. Who sees the patient, what happens, how long it takes? That’s what you really want to find so you can focus on what’s the biggest holdup, what’s the biggest bottleneck?”
His mindset: “We focus on the concept of total quality management. It’s all about the customer, what the customer is willing to pay for, what’s valuable for them. Our patients aren’t willing to pay for all the time they spend in the emergency department waiting room, waiting to be seen. What they really want to do is come in, be treated and then leave. So in general, we try to look for improvements and efficiencies where we can find them.”
His skills: Science and math are important, but examining customer interactions can be subjective. “Some of those things are more difficult to measure than what we would do in a traditional engineering field, but we try to measure as much as we can. Because if we can’t measure it and we can’t collect data on something, then we can’t say that we’re certain about it.”
His favorite question: “Somebody working in an organization is told how and what to do, but what often gets lost through repetition is asking why. I think one of our strongest tools is to observe a process and to ask why. Why is this really happening? Because in some cases it’s because ‘well, that’s how we’ve always done it.’ Or, ‘we don’t really know.’
“Hopefully, having this kind of questioning attitude about the process is contagious. Ultimately it’s the process that achieves the end state, which is the product or the quality. A lot of times people get blamed for doing something poorly, but in reality it’s the process that allows those things to happen.”
His limitation: “We want to preserve that non-quantifiable provider-patient relationship. That’s kind of sacred. But, if you can improve efficiencies all around that, then the patient can flow and still receive that individual care that we provide.”
Listen to an interview with Mark Torres and Enderli Fredericksen, hospital systems engineers at Upstate.