Tuesday, May 1, 2012

A Checklist for Bureaucracy!

What adds value?

A Long Day

It's near midnight when my husband walks through the door. He glances up as I come down the stairs. He looks weary. "Are you hungry?" I ask. He nods. When he sits down at the table he says, "We're our own worse enemy." He's talking about the Navy. I respond with a line from The Incredibles, "We're supposed to help OUR people!" His long day gets down to people not helping each other. The bureaucracy gets in the way of helping the people it is there to serve. This thought goes along with the thought that we are our own worst enemy which has an exponential effect when institutionalized.


Action Woman Stirs

As I sat at the table watching him inhale his food and listening to his thoughts at day's end, my first thought was I need a notepad. He says the best stuff when he's tired. My second thought was Can this ever be fixed? I'm action woman, I like things to work, I like to do things, and it drives me bonkers when systems don't work.


A Talk on TED

Today I listened to a TED Talk at random. It happened to be by Atul Gawande who writes about healthcare, is from a small town in Ohio, and wrote the book The Checklist Manifesto. The general idea is that by looking at failure and how other industries like the airlines and construction adapt to both failure and complex systems, the healthcare industry can benefit from using a checklist. The checklist, though it isn't sexy, has improved healthcare outcomes by thirty some percent in every hospital in which it was implemented. (A medication that could do this would be selling like a fire spreading on dry prairie grass.)


The Cowboy Vs. a Pit Crew

In the TED Talk, he pointed out the need to transition medicine from the lone cowboy to the pit crew mentality. He told a story of having met a real cowboy who explained how the cowboys manage to herd thousands of animals across thousands of acres of open lands. It involved cell phones and checklists. The talk ended with, "Complexity requires group success. We all need to be pit crews now."


A Solution!

That's when it came to me. Every bureaucracy needs a checklist which can be pulled out in moments of panic like when an airplane is crashing to refocus the bureaucracy on those killer items, you know, the ones that kill your customers!

You can have a checklist for every kind of problem just like the pilots, the cowboys, and the construction crews. Just like the operating room does. Pause points can be used when you can't go back. Checklists can remind us of of key things that can get easily missed, like the needs of military children. Checklists could indicate what each part of the crew needs to do and what has been done to care for difficult people, just like on complex building projects. Even patients need a checklist to keep them on track.


It's Elbow Grease by a Landslide

Contrary to popular belief, the mental health department does not have a magic wand that can make other people's problems disappear. That has a lot more to do with elbow grease contributions by all parties.


Still, I need a checklist

I have been avoiding making a list of priorities, needs, wants, values, etc., that are to help me focus on my purpose, life, tasks, etc. I like my aimless meanderings for the most part, and I have several big transitions looming on the horizon that will soon takeover the focus of my life. That said, a checklist can add value to every complex interaction. There is room in my messy life for a checklist, but the checklist itself must get at where failures happen and at what gets easily forgotten amongst other things.

I need to return to and review the book for further inspiration. What to consider on a checklist for a meaningful day, a meaningful life? I'd start with loves, and am I really doing those things? What to consider on a checklist for a business? I'd start with the mission statement or the purpose. It's just a start as I'm sure there is more. There is always more. The question is: What adds value? Another one is what do you value? Here is the talk to consider for yourself.

The Youtube Video of the TED Talk