Management

Meetings are an excellent tool for top-down hierarchies to manage and control information and decision making, but are inherently inimical to broad participation or collaborative processes.  Here are eight specific ways in which meetings, when used alone,  represent a barrier to collaboration rather than a collaborative tool…

They say, life imitates art.

Christopher Kedzie coined the term Dictator’s Dilemma in the early 1990s in reference to the fact that a dictator’s attempts to prevent opposition by controlling access to information and limiting the ability to use the internet for communication or community building has the inevitable effect of harming business and damaging the economy, resulting in conditions more conducive to rebellion.

There are four questions that should be asked AND ANSWERED as soon as a project is initiated, a problem solving process is started, or an issue is identified for analysis.  

Many discussions of improving engagement involve either complex philosophical/behavioral explanations or potentially disruptive (and therefore frightening and hard to do) widespread change. There is actually a pretty simple way to make significant change happen.

As soon as any project or issue is identified, and regularly thereafter, ask AND ANSWER the following four questions:

This week I reviewed the most recent minutes of a hospital committee charged with initiating and managing clinical quality initiatives. As usual, the minutes documented a substantial amount of conscientious hard work by a very motivated group. However, one item caught my attention: they were sending a draft of quality goals for 2012 to the four Division Chiefs for approval, with a deadline of 9 days later. 

At a recent management meeting, top leadership spoke eloquently and forcefully about the huge challenges we face from a ‘perfect storm’ combination of our ongoing national financial crisis and the health care reform act with its unknown and largely unknowable changes. They emphasized the need for innovations that are carefully considered, centrally controlled, and rapidly developed and deployed. The underlying theme was: “Major change is inevitable, and mistakes are not an option. We have to get it right the first time.” 

What do scribes and managers have in common? (And how are they different?)

The hospital where I work has recently recognized the serious negative impact our disengaged and non-participatory community of providers is having on the ability of our medical center to innovate and achieve excellence. Evolving from an apathetic to an activist staff is not easy. 

Unless you have been living in a cave for the last 5 years, you have heard lots of talk about Web 2.0 and Health 2.0, the 21st Century versions of the internet and the health care system.  Changes in technology, social structures, medical science and culture has led to huge changes. Is the same thing happening in the fields of management and leadership? Is there a management (or leadership) 2.0 just over the horizon? If so, what would it look like in health care?