Role play

The last 6 weeks have been incredible. At the first of April, I began observing various services and units across our hospital in an effort to baseline current care delivery. I have been documenting things such as AM/PM rounds, rounds and action items by position, orders, issues, risks, bottlenecks, confusions, patient flow, technology, communication methods, culture, and duplicative process/entry. Thus far, I've completed assessments for 5 areas/services, 2 of which support our project in the short-term. The long-term impact will be HUGE, as this is the first time the med center has ever documented its care delivery processes, by owner and communication means. It's also uncovering much of the 'so what's causing this problem' factor-- for instance, the managers (nurse practitioners) in trauma spend an avg. of 4-5 hours of their total 12-hour shift simply updating and handing over between shifts (both outgoing shift and incoming shift). That means that approx. 40% of the manager's time is simply updating someone else!!! When I used this as a concrete example during a briefing to our vice-chancellor, he was completely floored and is very eager to see where this goes. Observations will continue for the next month or so... and it's sure to provide many more shockers. I'll update you on specific findings and provide more context (why are we doing this?) in my next post, once i've identified more themes and connected more dots.

Sure-- my observations as project manager for the above project have been valuable, but it's actually the role-play that has been the most fascinating experience. Ever seen the show Undercover Boss? Well, it's sorta like that. So over the last 2-3 months, I've played different roles in meetings and introduced myself in different formats, intentionally hiding my badge. My hope was to experience what it's like to be in various positions of an organization, from a surgeon to nurse, to admin asst. and intern. Think your job is bad? Do you feel like everyone hates you? Well, go role-play for a day. I can only speak from a hospital perspective, but I am absolutely floored from my experiences. The respect and overall demeanor of/from people when wearing scrubs and/or introducing as a physician and/or position of authority was not even on the same timescale as when introducing from the perspective of a traditionally unrespected position (secretary, intern, housekeeping). What's most interesting about the whole situation is that we typically view equality within the realm of ethnicity, but there's so many other aspects to equality, as I experienced first-hand. The sheer lack of respect, trivializing of input or roles, and even the frequent 'who the hell are you' or 'do you know who i am' look/phrase numbed me to the bone. Eye-openers like this are good for everyone, and I'm encouraging more senior leaders to do the same. On the flip-side, a quasi-role-play has worked magically for some departments, allowing "back-office" staffers (such as our call center, who schedule appts) interface with actual patients to accent their laborious job duties with realization of medicine, letting them all know that, even though they don't see patients' faces daily, they ARE making a difference. These staffers walk the halls and waiting rooms to meet patients and see first-hand that they are all indeed making a difference, one appointment at a time. So powerful....