Wednesday, August 14, 2013

Focus and Leverage Part 242

The more I read The Nun and the Bureaucrat by Louis Savary and Clare Crawford-Mason, the more I like it.  I've been writing a lot about Systems Thinking and how these two healthcare organization have embraced it, but I must tell you that it didn't come easy.  In fact, when they first started using it, there was a lot of resistance to it.  The problem they ran into was that it forced all of the employees to look at everything they and their co-workers did through a completely different set of eyes and most resisted it.  This posting will be about how these healthcare organizations became system thinkers.

The essence of what these two healthcare organizations learned in their Continuous Quality Improvement (CQI) training was a new mindset called systems thinking.  As I've written in the past two postings, systems thinking allows people to see the whole rather than just parts of it.  The whole is not the sum of its parts, like many people believe, but rather they have learned to see it as the product of the interaction of the various parts of the whole system.  In doing so, everyone learned to see things that they had never seen before.

One of the primary learnings for both organizations was that the quality of the whole system is created by how well the parts fit and work together.  They also learned that if all of the parts are to work together effectively, everyone must agree on a shared aim or purpose for the whole system.  In the case of these two healthcare organizations, the only purpose that can possibly unify the disparate parts of the healthcare system is perfect or continually improving patient care.

In most American organizations our culture has taught us to emphasize individual contributions in the short term rather than long term continuous improvement efforts by teams.  We Americans seem to love the solitary brave hero and being told what to do in isolation of the system.  System's thinkers believe that in order to do a god job, how what they do fits in with what everyone else is doing.  These two healthcare organizations believed that their "healing process" had to start by giving up the "command and control" management mentality and replace it with a systems mindset that focuses on cooperation and teamwork to achieve their shared purpose.

These two healthcare organizations discovered that the difficulty in transforming to systems thinking requires that you look at not only everything you do, but also everything others and to do so in a a very different way.  They also discovered that if small problems were left unresolved, they might grow into larger problems.  In their previous way of doing business, it was the people that solved these larger problems that seemed to receive most of the accolades.  What these organizations now understand is that they must start preventing small problems from growing into larger ones and to forget about who gets the accolades.  This change took time and considerable effort, but it was well worth the effort.

Bob Sproull

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