The Trouble with Change

It’s too bad President Obama isn’t for hire. I tell you–getting people to change their ways is tough! How did he get so many people to follow him so easily? It’s almost unnatural. Usually, getting people to change their ways is like pulling teeth; no one wants to change until it’s absolutely necessary (e.g., when their job/general well-being is on the line). But why is that? And on top of that, what about people who are risk averse when faced with no actual risk? For example, say that a large group of people all agree and buy-in to change a process, hoping to effect a new outcome (assuming that the outcome has no direct effect on individual livelihood), why should someone who agreed to the change respond aversely to a risk associated with undertaking the necessary adjustments? Is risk aversion natural in this regard? What/where is the risk? What so bad about betting with house money? My guess is that these people are averse because the risk involves a loss of control. But the real question is, how do you reach these people to show them that the risk they perceive to affect themselves isn’t real? This is where coaching comes into play. The other day, the CEO at Stanford Hospital said that Performance Excellence’s real job as internal consultants is to coach fellow employees. Employees are great resources for process improvement. They are involved in all hospital processes and through this involvement they see what works and what doesn’t. When faced with change–big or otherwise–it’s imperative that we help employees work through their risk aversions to make the institution function better for all.

On Professional Development

When you’re developing your professional self, you make the effort to attend networking events. When you attend these events other attendees tend to ask you about the plans for your future. To their questions, you often respond with a general structure that outlines where you see yourself in five, ten, fifteen or whatever number of years. You’re content with this answer; so is the person who asked the question. But, why? Why is this an acceptable answer? Generally, to answer like this implies that you’ve expended energy and effort planning for the future…that’s not really true though, is it?  You only identified a dream–an aspiration, an end. “I want to be the CEO of a Fortune 500 company” — Great! So, why not tell me how you’ll get there. Tell me the steps you’ll need to take to get to a point like that, if not comparable to that. Do you intend to live life the same way as you are now? Do you plan on making any adjustments? Most people can’t provide this information, and rightfully so. It’s difficult to know each and every step that you’ll need to take to reach your professional goals or each experience you must encounter. When you think about it, though, it kind of makes sense that the means to the goal are rarely discussed. The unknown is difficult to discuss. After all, it’s unknown. But, why does it being unknown preclude us from discussing it or thinking about it? And, what causes us to focus primarily on the outcome and not the process? Is it fear? Is it difficulty thinking in the abstract? Do people not have the time? When I meet someone and ask them about their future goals, the first thing I want to know is how he/she will reach those goals. Honestly, who cares about what you want to do? What you want to do matters very little if you don’t know, or at least try to know, what you need to do to get there.

T-minus 9…8…7…6… .

Friday capped off my first full week of work. I am now 10% completed with my internship and have only 9 weeks left.  It didn’t hit me how short the summer is until one of my co-workers mentioned it in passing. “Nine more weeks remaining, James.” …Wow, I need to start producing. In support, though, the first week doesn’t really define the entire internship experience–it’s an orientation week. It’s a week where you attend the new-employee presentations and have meet-and-greets with the staff with whom you’ll be rubbing shoulders with all summer. What I find funny is that in the same period of time that it took me to learn where the coffeemaker is and the bathrooms are, employees of several patient care units around me were able to collectively reduce per-patient CT utilization time at the hospital. In one week these employees identified defects and waste in processes, and devised and acted on a plan to eliminate those defects and wastes. It truly was [Toyota] production at its finest. Seeing their outcome made me realize the power of collective drive and teamwork. Sure their job just began and they will need to continue to monitor and improve on their plan to ensure the same outcomes from hereon, but I can now see what a week–just one-fiftieth of a year–of hard work can do for a hospital and its patients. Amazing to say the least.

“That’s a great question! Thank you for asking.”

Who was it that said that hospital managers should always respond to questions, comments and other concerns or inquiries openly with a smile and an accepting manner? Something about low-tech, maybe? Something about scarves? …I wish I could remember. Anyway, Stanford has this thing–this way they teach their staff to communicate with patients, families and other staff members. They call it C-I-CARE, and its process is solely proprietary to Stanford Hospital & Clinics. Amir Dan Rubin brought the concept with him when he came to Stanford and it appears that it’s something that he swears by. Anyway, what C-I-CARE does is make the customer–the patient, the visitor, the family–the focal point of communications. When presented with an issue, the employee connects with the patient, introduces himself/herself and his/her role, communicates what he/she will do to address the issue, asks questions and anticipates needs, responds in a timely manner, and exits courteously while consideration needs and concerns. All Stanford employees are empowered to communicate like this–it isn’t just senior management. C-I-CARE is pervasive. It spreads throughout all hospital-patient communications, including the communications of billers and housekeeping. This concerted effort by all Stanford employees creates consistent, positive interactions between hospital staff and patients, providing a level of openness and transparency in hospital interactions, and making the patient feel at home and secure in the patient care setting. C-I-CARE is a wonderful approach to interpersonal intra-hospital communications. …I just wish I could remember where I heard that before.

Welcome Bienvenido Bienvenue مرحبا ようこそ Willkommen 歡迎 ברוך הבא Zapraszamy

And so it begins–my summer in California interning at Stanford Hospital. I chose to write a blog because I figure it’ll be the best way to capture my thoughts and impressions of Stanford and California. To tell you the truth, this entire stream-of-consciousness typing is not something that comes easily. On one level I feel like Doogie Howser. On another I feel like a self-absorbed, pedantic academic who assumes that people actually care about what he has to say. But, let me let you in a little secret–even though most of the stuff I write over the summer will be drivel and rants, some will be good. Some will be entertaining. All, though, will provide insight into the day-to-day operations of one of the leading health care institutions in the country, if not the world. So, please, if you choose to take my opinions with a grain of salt, be sure to keep your blood pressure in mind and take note of the the whole picture–the entirety of my experience over the course of Summer 2012. It will definitely be one that I’ll remember for the rest of my life.

Enjoy.