DailyKaizen

I was listening to Mark Graban’s most recent podcast and it reminded me of several conversations involving this word with medical leaders from other organizations recently, and they have all gone a bit like this: “Ted, we would like to do the patient-centered thing X that your organization did, but we anticipate pushback.” As it so happens, I could actually relate to this feeling, because we ourselves did something new in our system recently that was different. In our case, this was the addition of several pieces of data to the printed summary that patients get when they come to our medical centers, including a complete medication list, upcoming health maintenance, and a complete list of lab tests ordered.

The thing that Mark’s podcast brought up for me was the idea that in the Toyota Motor company, staff understand why a certain thing needs to be done a certain way because it is explained to them as part of the process of training.

I reflected on my own response to the thing that we did, and in all honesty, the word “pushback” didn’t come into my mind (and why should it in a LEAN organization - a dictionary definition of it is “to repel the enemy”).

What I knew and told the team was that we were doing something a little risky, using a technology tool to drive behavior, that we do this only for very specific reasons, and that it would definitely start new conversations about why and how we support a safe health care system.

We did launch the new features, and we did have the conversations, before, during and after, and they were new conversations in many cases. In each case, they weren’t conversations about whether we would continue to do this patient-centered thing, they were about why we were doing this, which every physician I talked to understood well. We needed to know why we were doing this and how it would help patients in the first place, and we spent as much time on this as we did on doing the work. If we didn’t know why, then we wouldn’t be able to explain it to anyone who asked. And then we’d feel….the p-word.

As I have said on here before, people who choose health care as a career are really outstanding individuals - they have to be - and want to do what’s right for patients. I suggest asking, “Why are we doing what we’re doing, and what are the conversations that we’ll have before, during, and after we do this” instead of, “How will we handle pushback?” This puts the accountability where it belongs, I think.

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