3GREENS TIMELINE
The inspiration
Dr. Hey grew up flying with his Dad, Albert Hey, an aeronautical engineer and flight instructor. Albert taught Dr. Hey how to fly safely using CHECKLISTS with communication and standard work 100% of the time. For decades, Albert kept the crushed tail of an airplane in his garage as a constant reminder of the consequences of deviating from checklists and the path of safety.
The Vision
At age 16, Dr. Hey was hit by a car, suffering a severe tibia fracture with 2 inch loss of bone. While amputation was initially suggested, Dr. Pitman offered to help rebuild the leg and his life, which took 11 surgeries, 3 months in the hospital, and a couple years of additional therapy. The external fixator had strength problems, inhibiting healing, so Dr. Hey applied his tinkering and redesigned the frame, which decreased the pain and enhanced stability for bone healing. These experiences led to a vision of combining his experience as a patient, engineering and innovation to directly help patients in the future.
The Journey Begins
For many years since then, Dr. Hey has passionately pursued making this vision real, through a journey blessed with many great mentors, education and leadership opportunities, challenges and successes. After learning how to walk again on his reconstructed leg, he trained at MIT in Electrical Engineering. He then got a chance to further the engineering/medical combined vision through the Harvard/MIT Health Sciences and Technology (HST) MD program.
Expanding the Vision
In 2005, Dr. Hey started Hey Clinic for Scoliosis and Spine Surgery as a “living, learning lab” to focus on bringing “Compassionate Process Control” to the point of care using lean and aviation safety principles. He has performed over 6,000 spine surgeries, and continues to be clinically active with his feet firmly placed in the “clinical trench” where the problems can be seen, and then gradually solved. He is now working with other surgeons from around the country to see how information technologies and new “crew management” techniques can help bring aviation-level patient safety to healthcare.
3Greens is developed
Dr. Hey developed 3Greens, an electronic checklist, in response to the safety crisis in healthcare. As a scoliosis and spine surgeon, pilot, and electrical engineer, he brought aviation safety and Deming/Toyota lean production to the care of precious patients and the families and teams that care for them. The name “3Greens” comes from aviation, a verbal phrase his dad, Albert Hey and all pilots use every time they approach the runway to confirm that all three landing gears are down and locked – standard work and crew communication. The goal of 3Greens is to create a safer, leaner, and happier healthcare world through teamwork and standard work one surgeon and team at a time.
POSNA Grant
After over ten years of quality improvement and quality and safety software development at Hey Clinic, Dr. Hey discussed the idea of sharing what he and his team had been learning with a group of surgeons. These conversations led to a series of conference calls and then a grant application to the Pediatric Orthopedic Society of North America (POSNA). POSNA approved the grant to implement 3Greens to a group of 11 surgeons around the United States. A feasibility and effectiveness study was designed by Prof Ivy at NCSU School of Industrial Systems Engineering and two graduate students. The pilot showed a significant improvement in teamwork and team dynamics during the course of the six month study. Additionally, based on their individual and group outcomes during the trial period, all of the surgeons and their teams desired to continue use of 3Greens.
Join the Movement
There is a safety crisis in the healthcare industry: errors are responsible for over 100,000 avoidable deaths per year. Now is the time to equip surgical teams with better tools to move toward zero harm, zero waste and zero burnout. 3Greens is the tool that will provide teams a way to focus moment by moment on the next key step and navigate through the day and week safely and effectively. 3Greens creates a standard work “code” to remind surgeons and their teams what defines 100% – every patient, every procedure, every time. Just like Dr. Hey wouldn’t dream of flying his plane without a systems checklist, he won’t operate without his 3Greens checklist. It’s his personal surgery (flight) management system – and he won’t go into the OR without it.