Ex-Treasury secretary visiting Maine tackles medical errors

As a former U.S. Treasury secretary and one-time CEO of the Pittsburgh industrial giant Alcoa, Paul O’Neill is no stranger to management at the highest levels. But the world of health care still strikes him as exceedingly hierarchical.

“If you’ve got a white coat and a lot of degrees, whether you’re right or you’re wrong, you’re always right,” he said Friday in an interview with the Bangor Daily News.

O’Neill, who led the Treasury under George W. Bush and later became a critic of the administration, will visit Maine on Dec. 6 to speak at the annual symposium of the Maine Health Management Coalition, an employer-led nonprofit in Portland that’s dedicated to improving the quality and value of health care.

Outside of government, O’Neill is best known for his leadership of Alcoa, one of the world’s largest aluminum manufacturers. As chairman and CEO, he doubled the company’s market share and revived its profits while flattening the management structure, creating a new corporate culture focused on worker safety.

He has since translated his private-sector philosophy to health care — as well as speaking out about the ballooning national debt and America’s education system — with an aim toward reducing medical errors and infections.

In 1997, O’Neill teamed up with the Jewish Healthcare Foundation to found the Pittsburgh Regional Health Initiative, a coalition of healthcare stakeholders that adapted the principles of the Toyota Production System to improve health care quality in the region.

At the city’s Allegheny General Hospital, the changes led to a 67 percent drop in central line infections, O’Neill said.

His approach focuses on preventing medical errors and learning from mistakes and problems when they do occur. That requires health care leadership that engages employees at every level, O’Neill said.

“The surgeon is accorded the same level of wonderful dignity and respect as the people who clean the rooms,” he said.

O’Neill sees room for significant productivity improvements that can lead to better health care and reduce costs. For example, a typical nurse spends half of her time on tasks that don’t help patients, like searching for equipment, he said.

“They’re unbelievably busy, but 50 percent of the time they’re not doing something valuable,” he said.

O’Neill isn’t optimistic that federal health reform will address the country’s health care problems to meaningfully improve patient care or reduce costs. The health care law only eats at the fringes of the $1 trillion worth of waste in America’s $2.5 trillion health care system, he said.

“We’re not going to get progress until it comes from local people doing the actual work,” O’Neill said.