Saturday, October 8, 2022

What can Cardiac Myocytes teach us about Teamwork and Workflow?

Hi fellow CMIOs, CNIOs, and other #HealthIT and Applied Clinical #Informatics friends,

Today's post is short, but one that I think most clinical friends will understand and appreciate. For conceptual teaching purposes only, I'm going to ask the question : 

"Q : What can Cardiac Myocytes teach us 
about Teamwork and Workflow Design?"

Here's my theory : Clinicians may actually have an advantage here. If you've ever studied the human heart - it's anatomy, it's functions, its biology, and its electrophysiology - You already know a lot about teamwork, workflow design, clinical operations, and essentially how to get things done

After all, cardiac myocytes and humans (clinical leaders and team members) both work towards a common goal. We both can function as individual units, but we function even better together as a well-organized, well-synchronized team

[ DRAFT ] TABLE - A tongue-in-cheek but honest comparison of Myocytes with Humans (Clinicians)

Let's face it, healthcare is a team sport. So when I'm working with other clinical leaders, especially new ones - For support, I often remind them of the importance of the infrastructure and tools that, especially as clinicians, we sometimes take for granted - Good : 

  • Regulations (both Federal and State)
  • Governance (e.g. Committee structures)
  • Leadership
  • Direction
  • Management
  • Communication
  • Bylaws
  • Policies/Procedures
  • Training / Onboarding
  • Continuing Education
  • Offboarding
  • Teamwork
After all, when growing a plant - it's not just the seeds you need to worry about, it's also the soil. So without enough of this 'supporting soil' (the tools above) in place, it becomes very easy to run into problems growing the seeds - And so for end-users, managers, directors, leaders, and executives alike, this can sometimes result in loss of efficiency, frustration, disorganized workflows, problems not getting solved in a timely basis, etc.

Typically, these tools don't get enough attention from new clinical leaders, because until they are in a leadership position - their focus has largely been on 'clinical things' like working with patients, diagnosing and treating diseases, performing operations and procedures, etc. While those are all the reasons we are in healthcare, it's still important to understand the many 'non-clinical' tools that make those things happen. (In truth, those tools are just as clinical as penicillin - But due to time constraints, they usually don't teach much about them in medical schools.)

What I find especially interesting is that, as a physician who during my career has treated cardiac tachyarrhythmias at the bedside (using beta-blockers, calcium-channel blockers, adenosine, cardioversion, etc.) - There are often similar analogous ways to treat these same 'human tachyarrhythmia' problems on project teams : 
So when I have the opportunity to teach a new clinical leader about how to solve problems and function in teams, I simply remind them that modern human biology has evolved over thousands of years to solve these same sorts of problems that we experience in healthcare today - And so sometimes, looking inward with a microscope is just as helpful as looking outward with a telescope

Finally, one of my clinical informatics colleagues and good friend Stefanie Shimko-Lin, BSN RN CD-L CD-PIC FHIMSS once shared this cardiac analogy with me : "Collateral circulation is a workaround, that happens when the desired workflow doesn't work. If you make it easy to do the right thing, people will do it."

These analogies may all seem a bit peculiar and tongue-and-cheek, but if you're a clinical leader - I hope this blog post helps to spark helpful discussion and learning with your own clinical leadership and project teams, so that you can better solve the workflow and operational issues you might encounter in your daily clinical routines.

Remember, this blog is for educational and discussion purposes only - Your mileage may vary! Have any other helpful analogies or advice for new clinical leaders? Feel free to share them in the comments section below!

Sunday, October 2, 2022

Advice from a Wise Business Leader

Hi fellow CMIOs, CNIOs, and other #Informatics and #HealthIT friends,

A brief pause from Applied Clinical Informatics, just for a moment. 

Today's post is related to some helpful business ethics advice I once received from a wise and successful businessman my mother used to work for. His name was James ('Jim') Everett Robison (11/22/1915 - 2/21/1998), and he was a very successful businessman and Harvard Business School graduate who, in addition to having a wonderful and loving family, also counted Roy Little and Thomas J. Watson, Jr. as some of his business associates and friends.

(L) James E. Robison as an Air Force pilot circa 1940s, and (R) as a successful business leader circa 1990s.

A retired and decorated WWII Air Force Major (who flew 63 completed missions, 402 combat hours, 26 squadron leads, 7 group leads, and 1 wing lead!), Jim Robison lived and breathed integrity.

Growing up, I would run into Mr. Robison occasionally, while my mother was working for him in Armonk, NY back in the 1980s and 1990s. During one of my visits to my mother's workplace, he shared a message with me - one that he apparently also shared with many other people - about the importance of honesty, integrity, and ethics in business.

His message was once captured beautifully by his good friend Charles Osgood, who shared it in his November 24th, 1992 Osgood File message. 

The message is still so important and relevant, that I think it bears repeating today. Transcribed from an old cassette tape I found in my attic, here it is : 


Charles Osgood
CBS 880 AM Radio 11-24-1992
[ Start of Transcript ]
The Osgood File, sponsored in part by ______ Heating and Cooling. I'm Charles Osgood.
Last night at the University Club in New York, I attended a reunion dinner of sixty (60) people who used to work for the same company my late father did. There were books of pictures, and in some of them I could hardly recognize dad because he was so much younger then, than I am now. It made me feel like Michael J. Fox in "Back to the Future".
And amongst the memorabilia I found something that impressed me so much, I wanted to share it with you, which I will do, in a moment. Stand by.
My father was in the textile business. His boss, at a company called Indianhead Mills, was a dynamic young man by the name of Jim Robison. Dad thought the world of Jim, not only because he was so smart and so successful, but also because he was such a straight shooter. Robison never wanted to outdo or get the better of anybody in a business deal. If both parties didn't benefit from the deal, he didn't want to do it.
My dad died several years ago, but last night I was invited to a reunion of Indianhead people, some of them I hadn't seen since I was a kid. Jim Robison was there, retired now and no longer a young man, but still sharp as ever. And looking through some materials they had there, I came on a company policy statement that he had issued 40 years ago. And I took a copy of it because I wanted to share it with you this morning. Here's what it said :
"There is one basic policy, to which there will never be an exception made by anyone, anywhere, in any activity owned and operated by Indianhead. That policy is as follows," Jim Robinson wrote. "Play it straight, whether in contact with the public, stockholders, customers, suppliers, employees, or any other individuals or groups. The only right way to deal with people is forthrightly and honestly. If any mistakes are made, admit them and correct them. Our commitments will be honored, and we have a right to expect the same performance from those people with whom we do business.
This is fundamental. We will not welch, weasel, chisel, or cheat. We will not be a party to any untruths, half-truths, or unfair distortions. Life is too short.
It is perfectly possible to make a decent living without any compromise with integrity."
I think I'm going to frame that and put it on the wall.
The Osgood File, Charles Osgood on the CBS Radio Network.
[ End of Transcript ]

I agree with Charles Osgood - I think I'm going to frame that and put it on the wall.
I hope this timeless message inspires you too!

Remember, this blog is for informational and educational purposes only - Your mileage may vary! Have any experience with studying business ethics? Please feel free to share in the comments below!