This week I
have been working with a client who has high and exacting standards. They boldly
put excellence on their website and marketing materials as one of their values.
However,
under the surface, in some areas, there is little in common between their
values and what happens in practice.
Standards are
slipping, the team is beginning so signs of a high turnover of staff,
management structure is resorting to a dictatorial approach, and the is a
creeping feeling of despondency.
Some of the
team are superb, great communicators, going above and beyond, always anticipating,
planning, looking to make things better for everyone else not least the patients.
Others are very different.
As I spend
time in the practice listening, I was reminded of this little story
“Whose Job Is
It, Anyway?”
This is a story about four
people named Everybody,
Somebody, Anybody and Nobody.
There was an
important job to be done and Everybody was sure that Somebody would do it.
Anybody could
have done it, but Nobody did it.
Somebody got
angry, because it was Everybody’s job.
Everybody
thought Anybody could do it, and Nobody realized that Everybody wouldn’t do it.
It ended up
that Everybody blamed Somebody when Nobody did what Anybody could have done.
Does this
sound familiar, do you notice any similarities to your place of work?
Remember, a problem
can only be present in absence of a truth-full conversation.
I invited the practice to define the journey their patients through
the practice. Each step of the way clarifying, leaving no element of guesswork,
who is responsible for each function and who is the back up?
We also discussed the Swiss cheese model of risk management.
A receptionist told us how they had had an angry patient
call, incensed that a dentist had not returned the requested call.
When we unpacked the events, we realised that the dentist
had tried to call and the number on the computer was incorrect. It transpired
that the patient had been in several times and the number had not been updated.
The team recognised they needed to add more layers of cheese
to stop the hazard. These included.
- Very clear and specific request for patients to check their personal details and medical history, rather than a casual “can you check this.” The reception team amend the details.
- The clinician asks the patient to confirm their personal details.
- The nurse is at the computer updating as the clinician is speaking with the patient, confidently asking for clarification where needed.
- When telephone calls come in the receptionist, confirms the number they want to be called back on.
This may seem like duplication, and we all have experienced busy
practices and things being missed without malintent. Multiple layers of systems and processes
prevent the hazards getting through.
Where in your practice would these concepts be useful?
