Friday, December 2, 2016

The Front Office and the Front Line

There is often a huge gap between what the people doing the work of an organization know and what the senior executives know. We implemented Lean Daily Management in part to narrow this gap and I really believe that we have been successful. However, we still have work to do. This morning, I was reminded how hard it is to keep everyone “on the same page.” I was in a clinical area and the team there was very down. They were struggling with new workflows created by our Epic implementation, many “glitches” in the new system, and the inability to fill some positions on their team as the economy heats up. The net effect of this was making it much harder to perform their jobs at the high level to which they had become accustomed to while treating everyone the way that they would want their own loved ones treated.

The team in this clinical area got up the courage to tell me that they thought that no one was really listening to them. They had been reporting the problems, outside of their control, correctly and respectfully, but did not see much improvement and they thought they were getting lip service from people like me.

After the interaction this morning, I began to think of when I first started my career as a pediatrician in a large, complex organization. I remember experiencing the same feeling as my colleagues this morning. But when I was in their position, no senior leaders had ever come to my clinic. It was very easy for me to conjure up the notion of a bunch of executives who really didn’t care and were not looking out for my best interests and the best interests of my colleagues and my patients. At GBMC, we are a lot more “visible” than the executives had been when I was on the front line of care. But this morning I realized that this is not enough. I was truly grateful for how hard they were working and we clearly were in action to fix problems beyond their control but we had to do better.

Identifying the fixes, beginning to implement them and communicating to everyone where we are in the process is… very, very hard in a large complex organization. Some things are easier to fix than others and some take a very long time. I know for a fact that many excellent people were working on the myriad of problems that the clinical team this morning were concerned about…but how could I help the clinical team understand this?

One thing that I have learned the hard way is that it is a fool who believes that complex problems have simple answers. So, the best thing that I can do for my colleagues that are down is to commit to getting the right people in a room, listing the issues, creating reasonable timelines for them to be fixed, making the timelines visible, and holding ourselves accountable to meeting those timelines. I want them to know that we really do care about them and that I know that we must and we will fix these issues.

The Art of Nursing on WMAR-TV
As we bring our formal celebration of the year of nursing at GBMC to a close, I am really looking forward to seeing our nurses spotlighted on television for the great work they do every day.

The community at-large will get a first-hand look at the life of nurses in the GBMC system and understand how exceptional they truly are by watching The Art of Nursing, a 30-minute TV special, on Wednesday, December 7th on ABC 2 Baltimore (WMAR-TV) at 7 PM.  If you want a sneak peek at the special, please watch by clicking here.

I promise you that after watching it you will not want to miss this program!

Kudos to our very own, Barbara P. Messing, M.A., CCC-SLP, BCS-S, who was one of 19 fellows across the United States recently honored by the American Speech and Hearing Association (ASHA). She received this prestigious recognition for her research, teaching, and clinical service.  Barbara is the Administrative-Clinical Director of the Milton J. Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery and Johns Hopkins Voice Center at GBMC. She is also recognized as a Clinical Specialist in Head and Neck Rehabilitation and is a Board Certified Specialist in Swallowing and Swallowing Disorders. Her clinical and research interests are in the area of head and neck cancer rehabilitation, dysphagia and voice disorders.  Again, please join me in congratulating Barbara on her recent achievement!

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