A Culture Thing
Here’s one from today’s email:
“Dr. B, The NP you just hired has applied for access to our electronic medical records. Please fill out the attached form so I can give her a password. M.”
“M: This is non value-added bureaucracy! Her position as an NP with us conveys access to medical records. The password should come without asking. Dr. B”
“Dr. B: No. This form has been required for the past five years. We have always done this. M.”
A small waste of time. A minor inefficiency. The real problem is the failure to recognize it as such. Where is the compulsion to improve! To make processes faster, better, cheaper! How do you inspire employees to think critically about what they do.
In another life, I told an anesthesiologist the tests she had ordered were without value to the patient. “Oh no!” She replied. “They must be valuable. We do them every day.”
It’s the same thing. Thoughtless plodding in familiar tracks. “If you always do what you’ve always done . . .etc.” Some of this is a resistance to change, but mostly it’s just a failure to see the waste around us. A lack of desire to improve. A failure to think critically about what we do. This, I think is a leadership issue--to inspire a culture of quality. AHRQ has developed a survey to assess the culture of safety in institutions. Perhaps we need a survey tool to assess the culture for improvement. Most improvement isn’t expensive: A form deleted, a test not ordered. All it takes is the culture to inspire it.
“Dr. B, The NP you just hired has applied for access to our electronic medical records. Please fill out the attached form so I can give her a password. M.”
“M: This is non value-added bureaucracy! Her position as an NP with us conveys access to medical records. The password should come without asking. Dr. B”
“Dr. B: No. This form has been required for the past five years. We have always done this. M.”
A small waste of time. A minor inefficiency. The real problem is the failure to recognize it as such. Where is the compulsion to improve! To make processes faster, better, cheaper! How do you inspire employees to think critically about what they do.
In another life, I told an anesthesiologist the tests she had ordered were without value to the patient. “Oh no!” She replied. “They must be valuable. We do them every day.”
It’s the same thing. Thoughtless plodding in familiar tracks. “If you always do what you’ve always done . . .etc.” Some of this is a resistance to change, but mostly it’s just a failure to see the waste around us. A lack of desire to improve. A failure to think critically about what we do. This, I think is a leadership issue--to inspire a culture of quality. AHRQ has developed a survey to assess the culture of safety in institutions. Perhaps we need a survey tool to assess the culture for improvement. Most improvement isn’t expensive: A form deleted, a test not ordered. All it takes is the culture to inspire it.
