When you don’t know what to measure, you measure everything
Greetings, we’re in the midst of an ongoing series based on the characters created in my book, Heroes Need Not Apply, “How to build a patient-accountable culture without putting more on your plate.” The story of how a small town physician from Montana teamed with a CEO to transform the culture of a large Seattle hospital. The book shows how focusing on what matters most to patients, the right mind-set and a common direction can bring two people together to ignite an entire organization.
Some of the most powerful scenes in the book are strategic conversations between our fictional CEO Jane Carolli and her new, game-changing VPMA from Montana, Dr. Jack Martin. In the last issue, Jack and Jane agreed that they wanted to build their culture around what matters most to patients… and we left off talking about how that happens…
Q: In our attempts to fix everything, we track just about everything - what do we do with all the data?
A: Jack had a few minutes before rounds so he dropped by Jane’s office to check in and offer support. Although he knew that Jane was 100% on board for the new direction they were taking Angels of Seattle, developing a common direction to become more patient-accountable was definitely a paradigm shift for her, and he wanted her to feel he was by her side for the long haul.
As he walked into her open door he could see she was wound pretty tight, “Morning Jane, how are you this am?”
“Glad to see you Jack - in all candor, I’ve been here for two hours and I’m ready to jump on a plane to anywhere. I’m staring at a dashboard overflowing with a multitude of diverse metrics that I’m suppose to improve, and piles of data I’ve collected and don’t know how to utilize. I have no idea about what drives what.”
Jack waited, knowing she had more…
“We don’t know what to measure - so we measure everything. And the funny thing is, I’m trying to find solutions to an endless number of metric challenges and I don’t even know where to begin. I’m just running around in circles. And none of this data (pointing to a pile on her desk) seems relevant to what’s going on at the bedside.”
“Jane, do you think all the items on your “everything under the sun” list need specific answers?”
“That’s just it Jack - all the so-called answers I’ve been coming up with are band-aids at best. I need to find out the root cause of this mess and I know that it’s more about attitudes and behaviors… but I don’t know if we can measure that.”
“Let’s go back to what we’ve been working on Jane. Where does everything begin?”
Jane shot back, “With what matters most to patients.”
Jack smiled, “Then that’s where we start… where we measure.”
Jane replied, “Well that would be great, but can we do that?”
“You tell me. Think of a question that would elicit the data you need.”
“Well I’d like to know what kind of behaviors are compromising team performance. If I could figure that out, It would solve a good number of these problems in front of me.”
“Great idea Jane, so let’s ask them.”
Jane sat thunderstruck and slapped her forehead. “I never even thought about that. Imagine asking questions based on what matters most to patients - questions that assess the degree of teamwork and respect and listening and feeling safe from patients as well as from staff. Eureka, I have found it!”
Once Jane realized she could track the behavioral and attitudinal data necessary to literally evolve the culture, the discussion moved toward determining the questions necessary to really change what’s going on at the bedside.
In the next issue, join Jack and Jane while they begin to build out an assessment tool aimed at ferreting out the few root causes of the many challenges that every leader faces.
Is your culture aligned to what matters most to patients?...