I try to take a break each day and eat lunch away from the computer. Generally I turn on CNN and try to catch up on the news that my RSS reader hasn’t brought me (which isn’t much, actually).
I was watching yesterday when a piece came on by Elizabeth Cohen, who writes an “empowered patient” column on CNN.com and has just released a book by the same name. It was frightening, frankly, but it also sparked an immediate business thought which I’d like to share.
She was discussing the fact that 99,000 people a year die from infections they receive while in the hospital. That number comes from the Center for Disease Control and Prevention. She went on to interview a doctor from John’s Hopkins Hospital which is an excellent facility. He told a story about the MDs and nurses there. In order to reduce the risks of infections, they developed a checklist for procedures, including washing hands, which, when not done, is the source of most of the infections. It’s the sort of list the airlines use for pilots – they’ve flown the plane many times but the list makes sure they don’t forget anything. Since only a third of the doctors were washing their hands before every patient contact, this seemed fairly innocuous and much as copilot read to the pilots, the nurses were told to monitor the MDs and speak up.
The nurses’ reaction was it’s not our job to monitor them but if we did, and if we said something, we’re likely to have our heads bitten off. The doctors’ responses were similar – I can’t have a nurse contradict me in public – it makes me look like I don’t know what I’m doing. That’s a decision made based on ego, not on great patient care.
As I thought about it, it’s often the same in business – ego gets in the way. We find subordinates afraid to speak up, and bosses don’t like to be questioned. There are often no formal documents that lay out procedures (and if you don’t think that’s important, have your website crash with a junior person on duty late at night).
We need to encourage people to speak up. We should have checklists for important things so nothing important is left out. A co-worker asking a question about something isn’t necessarily questioning you or your judgment. We all miss things, especially when we’re trying to cram 15 hours of work into a 10 hour bag. It’s like being told you have spinach in your teeth after lunch – you’re probably grateful to have received the head’s up even if you’re a tiny bit embarrassed to have missed it yourself.
The stakes are obviously a lot higher in medicine than in business but that’s no excuse for business people to make decisions based on ego rather than on sound practice. That’s how corners get cut and disasters happen. Can you find any examples of that around? If so, have you spoken up (tactfully)?
Consult Keith 