Last week I went to an interview at the Hershey Medical Center for an internship opportunity with their continuous improvement group. This group, working alongside the hospital’s quality management department, identifies ways to streamline processes in order to improve outcomes for patients and lower costs. The team is led by a woman with an MBA who created and began growing this team just four years ago. She leads with the partnership of a registered nurse and Six Sigma Black Belt (a highly certified quality expert), who brings crucial perspective to the integration of care and efficiency. Their tightly knit team is comprised of individuals with Health Policy and Administration backgrounds, nurses, and (more recently) engineers, each of whom bring great insights when collaborating to improve the patient experience. The team provides workshops and training to groups of nurses, doctors, and technical staff invested in making improvements to their areas, working toward nothing less than a culture shift involving “lean” – an empowering philosophy and methodology emphasizing the identification and elimination of procedural waste in order to provide the most value to customers, specifically patients in this case.

This weekend I participated in training to earn a Six Sigma Green Belt certification, an industry credential for process improvement and statistical problem solving. I like the funky Six Sigma certification levels, from Green Belt to Black Belt to Master Black Belt – it’s like statistical karate! I found value in the three days’ worth of intensive class time by imagining how it all applies to health care at the hospital level. I realized that, although I have vacillated among different ideas for my future throughout college, the kind of career I am pursuing now seems to have been at my core even before I knew this kind of role existed. It satisfies my rational mind by making use of my engineering training while in my emotional mind allowing me to be as close to a helping profession as possible. During my interview, the R.N. Black Belt explained that nurses receive a wide variety of analytic training that cultivates their personal, intuitive sense of how to take care of patients. While this unique approach is encouraged in their education, she explained how it sometimes runs counter to the benefits of standardization from a system mindset. I am really interested in this. How can we join hands, or build a bridge, between the mode of thinking on an individual, case-by-case basis and, concurrently, the approach of taking care of patients in a consistent, repeatable way that will ensure quality at a broader level.

I have noticed similar differences in approach between the disciplines of engineering and psychology through classes for my psychology minor. Whereas engineering would espouse a “Root Cause Analysis” to tackle the foundation of a problem by identifying its causes, this wouldn’t work at all in the same way when treating someone with depression. For the latter, there is usually not a single, identifiable root cause, and exclusively searching for and going through all of the roots may not be effective for everyone in their treatment as compared to a here-and-now development of more balanced ways to cope moving forward, for example. Whereas in engineering one principle or law often builds on top of the previous, updating the current universal understanding of an idea, sometimes in psychology a set of principles do not build on top, but rather alongside, each other – all of them valid from different perspectives and none of them replacing or discounting another absolutely. I’ve found it challenging and exciting to see things from these two modes of thinking, and I think I like this health care stuff because it so intimately involves a similar kind of balance. I look forward to hearing back from Hershey Medical Center, the Mayo Clinic, and the VA in weeks to come…fingers crossed!