Putting it all on paper

There's a map for that

How often do you work in auto-pilot mode at work OR do simply as you were taught? This is scarily common across major health systems, and after shadowing/observing various processes and staff, we are certainly no exception. In fact, we have never created any such process flow or diagram of sorts to visualize just exactly how/what care delivery is across the hospital, including variance by service and unit. So for the last 2+ months, I've lived in scrubs (getting up 10 min prior to bus arrival has been heavenly), with the primary intent being just that-- getting a baseline of how exactly we are delivering patient care. Most of the time a hospital's focus is how to increase the profit margin, speed up throughput, decrease waste, reduce infections, etc. My focus has been quite simply "what are we trying to accomplish and how are we currently doing that?" Aside from observing the actual process steps, I've evaluated the technology/communication means, owner(s), and issues, risks, and gaps. My findings in one sentence? Duplication, omission, delays, entry error, disconnects... to name just a few. It's been fascinating to observe what seem to be basic processes become complex and ineffective process steps for multiple reasons. My findings – in the form of detailed process maps – support a risk profile proof-of-concept release, which aims to essentially "catch the bad stuff before it happens." A solid first step is understand what you have. Only time will tell, but I'm thinking that these observations are going to do soooo much more than simply identifying patient risks. Stay tuned...

Higher on the food chain... or redesigning the food chain?

As with any large organization, working at a major health system has drawbacks to go with the numerous perks such as flex time, tuition reimbursement, and telework. One challenge I've found in working at a large AMC is that, in addition to it being very bureaucratic, many people are placed in positions based on tenure or simply because they are "next in line". But take a step back and look at today's most successful organizations, and you see something completely different – a structure based on meritocracy. I experience this on a daily basis and in all forms, from the wretched, death-by-PowerPoint presentations with small essays on every slide to even the most basic time management skills or perhaps an unwillingness to stretch and learn a new skill. I find it interesting that calendars are always so full for senior management yet frequently so little actually gets done. On a daily basis, I see (or experience) inefficient meeting facilitation, presentations that totally miss the boat, or worse yet, people who simply don't effectively manage daily operations or even have no clue what the underlying objective is of their project. A large part of being a leader is breaking down barriers and empowering your team; it's not a secret sauce, but it's surely absent for many. If you look today across all job markets, yes you will see a considerable gap in the 'on-the-job experience', from college grads to seasoned, tenured professionals. However, I've frequently asked myself what happens when the younger employee is significantly more talented and/or capable of doing a job  than a more tenured or senior employee, and all that separates the two is time? As is the case at our hospital, the younger "new guy" typically gets that pass to "wait your turn". The result? An organization misses out on tremendous potential to capitalize on raw talents and disruptive innovation. 

Work at a rescue mission

Andre has encountered some hiccups over the last few months, and it all came to a head two weeks ago. After stealing money from me on numerous occasions, I confronted him and he denied ever stealing anything. Knowing that he was definitely the culprit (after marking the bills), I decided that volunteer hours would be the best way to teach him a lesson. Coming from a double-incarcerated family, he is at a pivotal age (13) for learning right from wrong, before it's too late. So I asked him-- at 18 do you want to be sitting next to your parents in prison or walking across the stage graduating from high school? Because I want the latter. Ending on a positive note, I said that we can do this together, but he's got to want to change and learn from his mistakes. This past Thursday, we volunteered at a men's rescue mission for the first of many weeks to come. We served food in the cafeteria for 2 hours; more than 400 meals served! He got to see first-hand that no matter how bad you think life is there are always 2 things constant... someone is worse off than you, and you can learn from your mistakes. He actually said this to me when driving him home, a sign that I think we're headed in the right direction. I plan to have Andre sit with some of the participants there at the mission to hear their story-- how they got there and what they have learned.