"I think," said Christopher Robin, "that we ought to eat all our provisions now, so we won't have so much to carry."A. A. Milne
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I found a wonderful article by Udkin, Dreger and Sousa, and have updated and adapted it. See below the fold…
I found a snippet in my Evernote file, sadly without anything citing a source. I have adapted it to fit my experience with Clinical Quality Improvement activities. I suspect it is broadly applicable…
- It will take longer than expected.
- Not everyone will understand.
- At least one key player is not engaged.
- No matter how diligent the process, the team will miss something important.
- If everyone agrees, someone is not paying attention, or is being dishonest.
- The risk manager, lawyers, and upper level management really want to say no.
- When you are done, people will complain and you'll have to remind them of the mission.
- The result will not be what you planned.
- To the extent that you succeed, the important benefits will result from solving unforeseen complications.
Like most employees of large institutions, I am subject to a variety of ‘incentives’ that are designed to meet institutional needs, which may or may not be well aligned with my needs, to say nothing of the needs of my patients.
Teaching in our local family practice residency is one of the most enjoyable parts of my week. When a colleague recently asked why I liked it so much, it took some reflection to answer.
Slow down, you move too fast. It will all be over far too soon.
At a recent clinical staff meeting, a physician complained that the new requirement that clinicians enter all orders manually into the electronic record (CPOE) is slowing us down and causing errors. The IT and administrative staff were not the least sympathetic. Their message: it’s really not a big deal, it only takes an extra minute or two, and smart people like you should be able to master a simple skill like this. On the way home, I came up with a way to help them better understand: CPOE for management.
Did you know that there is a whole branch of psychology devoted to the impact of interruptions and distractions on learning, memory, performance, productivity, and decision making?
It’s frustrating when they won’t let you be a playwright, but then complain when you become a critic.
Lisl was very good high school skier but seemed not to have the race results she was capable of and everyone expected.
A physician friend commented recently that he was being ‘meeting-ed to death’ and wondered if it was intentional. It turns out, he was on to something.
You can’t make this stuff up. I pulled into our local BJ’s gas station on a recent rainy morning. It was quite busy and I looked around for the shortest line to join, Seeing a woman in her early 20s who appeared to be finished fueling as she re-holstered the nozzle in the pump and returned to her car, I pulled in behind her, expecting to promptly be able to pull up and buy gas. A car pulled in behind me, so I was now committed.
A friend recently explained why he retired from a long and rewarding career in medicine and medical education, despite still loving his one-on-one interactions with patients.
Workplace wellness and chronic disease management programs (now encouraged by the ACA) are quite common, but being a $6 billion dollar industry doesn't make them useful. Recent personal experience with one such program has led me to look more closely at the topic.
Was the surgeon a princess, complaining about a pea under her mattress? Or am I a sheeple, accepting a woefully inadequate system? What do you think?
Patient satisfaction has become a prominent goal in health care. Is this a good thing?