Author Archives: Barb Phillips
1. Create your caption to the photo above in five words or less. All captions with more than five words will be disqualified.
2. Type your caption in the comments section of this post by September 16.
3. If you haven’t already, subscribe to the Tuesday TapRooT® Friends & Experts e-newsletter. Only eNewsletter subscribers are eligible.
Our staff will vote on the most clever caption, and the winner will be announced via our e-newsletter and a blog post on September 20.
If you arrived at work today and was immediately met with a project that you put off last week, and the week before, and the week before … how do you begin? Visualize the desired outcome and how great it will feel to have accomplished the work. Then identify one small step you can take today. Take the step and don’t obsess over whether it was perfect or not. Then the next day, take another. Pretty soon you will have established a rhythm and the momentum will shift toward completion.
Bonnie Ware, the author of The Top Five Regrets Of The Dying, wrote in a Huffington Post blog:
“Many did not realize until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again … life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.”
If confidence doesn’t come easy to you, here are 3 tips:
- Correct your posture. Displaying confident posture will make you look and feel more confident. Roll those shoulders back and elongate the spine.
- Determine to do your best, and know that is enough. I promise other people aren’t evaluating every error and misstep you make. (Well, unless they are jealous of your confidence … and in that case, who cares?)
- Know your stuff. This is probably the best advice for building confidence. If you are speaking about a topic, do your homework and know the material. If you are meeting with someone, prepare. If you are trying something new, study up.
If you want to achieve success, you must believe you are worthy and go for it!
Don’t threaten a hippo to find out!
Our culture celebrates people who make little to no meaningful contributions to others. When we make heroes of people who can act, play a sport, or sing we are placing value on activities they perform well. Do the people you honor have the personal qualities you’d like to emulate in business and life? Think of those who have made a direct impact on your life. These people are likely those you see every week, who have overcome the odds to be successful. They are the people who will walk with you during tough times. Do one thing to honor your hero today!
Register today and join us in San Antonio, Texas, August 3-5, 2016.
The Global TapRooT® Summit offers multiple focused learning tracks. This video introduces the Medical track for healthcare professionals. Come to the Summit and maximize improvement at your company!
REGISTER for the 2016 Global TapRooT® Summit.
Interested in the Investigation Track? Learn about it here!
Interested in the Asset Optimization Track? Learn about it here!
Interested in the Safety Track? Learn about it here!
Interested in the Quality Track? Learn about it here!
“To get it done right, I do it all myself,” said no great leader … ever. Don’t be a martyr – work smarter.
My grandmother (with whom I spent many of my childhood weekends) would say to us grandkids, “You can’t see the forest for the trees!” That usually came right after something bad happened or we did something that was not considered “right” by the adults. I always wondered what that meant, I have thought about it for years and I believe from an adult perspective I finally get it… Granny Lillie, if you can hear this, “I FINALLY GET IT!” (I hear her saying, “It is about time……sheesh.”)
As I have worked with healthcare organizations over the past 20 years working to improve performance and improve their systems we always talked about examining failures and finding the causes. Finding the “Whys” is the step necessary for you to fix issues that existed. Those issues that underlie our systems and turn into incidents, accidents and breed adverse behaviors have to be removed following a problem so that we can prevent reoccurrence. This is preached, taught, and required by all organizations in today’s business world. But why do we wait, why do we have to fail to learn? That question has always concerned me. This is where my grandmother fits in…
When as kids we would go out, make decisions to do things that had adverse outcomes, she would always say to us “you can’t see the forest for the trees” and we would just nod our heads and say “ok” then continue on our merry way. Not only would we not learn from our mistakes but we could not see the mistakes and incidents they happened. The correlation in today’s adult world from an organizational perspective relates to making decisions without considering the consequences. The “Trees” from the statement above is the change you are going to make. If you focus on the “Trees” in front of you and do not consider the future beyond that “the Forest” you are taking unnecessary risk and possibly creating problems. Do you “get it”?
What got me thinking about this today came from an article I read which dealt with an investigation by the State’s Office of Inspector General at a Louisville, KY hospital. This along with the TJC visit which found many problems at the facility prompted concerns. The investigation was prompted by complaints by staff (that survived the downsizing) regarding health and safety issues due to the decreased staffing. After reading the article I immediately began thinking about our Proactive Flow within the TapRooT® process.
Notice that when we get to step 3 in the Proactive flow we take the observed issues or problems and ask the simple question, “What could result from this?” We would pose this question against our view of the future system. Let’s suppose that they had recognized these future conditions:
- A reduction in staffing would create a significantly higher workload for existing staff
- Hospital maintained customer/patient throughput with reduced staffing
- Using traveling nurses with little or no facility or system related training to supplement staffing levels
- Reduced staffing could cause difficulty in maintaining the Quality Control standards due to pressure based on census
We can now take this information and use that “What could result from this?” and we could have had this conclusion:
a) Training – No Training – Decided not to Train
b) Management System – Standards, Policies and Administrative Controls NI – Not Strict Enough
c) Work Direction – Preparation – Scheduling NI
d) Work Direction – Selection of Worker – Not Qualified
And there certainly could have been others. At this point you have the ability to re-evaluate the changes you are about to make and ensure that the programs put in place following this down-sizing remove these potential problems. This allows you to evaluate the “Forest” behind those “Trees” and ensure the safety of your future patients and staff while working through the “Forest.” If this one hospital had performed this analysis the outcome and where they are today could have been significantly different.
By using this thought process and by being Proactive we can all create safer systems, create a more effective and acceptable working environment, and protect those around us that depend on us… just as Granny Lillie tried to do for us kids so many years ago. Sometimes the simplest, most practical viewpoint is the best. If you have any questions about the TapRooT® process for Proactive assessments please contact me directly at firstname.lastname@example.org.
We reached a milestone on our Facebook page this week! It’s fun to share and have conversations with you on Facebook.
If you’re not part of the group, you can join us here!
Last year, I had the privilege of sharing investigative interviewing best practices with attendees at the 2015 Global TapRooT® Summit. This year is even *more* exciting because it’s a brand new course that I’m co-teaching with Alan Smith of Matrix Risk Control (UK).
If you are not familiar with Alan’s impressive credentials, go here and learn about him and the best practice session he is teaching at the Summit. You’ll also want to watch his keynote presentation from the 2015 Summit here.
We still have a couple seats left in our Interviewing & Evidence Collection Techniques Course, San Antonio, Texas, August 1-2. If you have questions, give me a call on my direct line: 865.357.0176!
Hope you enjoy this best practices video from last year’s Interviewing & Evidence Collection Techniques Course. Attendees at the course blew me away with their intelligent questions and thoughtful responses during our Q&A at 8 a.m.!
Come to the 2016 Global TapRooT® Summit and learn to solve your most pressing issues!
Dave Janney invites you to TapRooT® for Audits, a special 2-day course for auditors to help them find and fix the root cause of problems as well as use TapRooT® Root Cause Analysis proactively.
I was teaching a class (not in the healthcare arena) and had some interesting discussions around the use of procedures during work. First let’s recap the TapRooT® Definition of a procedure:
A procedure is a written step-by-step description of how a particular task is to be performed that is read and followed during performance of the work by the person performing the work.
A checklist is considered a procedure in our system. For this company there were two perceptions regarding procedures and their uses:
- Those are only necessary if there are people who are not knowledgable on the task.
- Those procedures always make work more difficult.
Now, I have heard these comments before from folks in the healthcare field when the work procedure is used not for a medical “procedure” but when it is used as a checklist. Many doctors and nurses don’t like having to follow a specific path towards medical treatment. And I agree because each human is different, each course of treatment is different, and every scenario is different that it is more difficult to set procedures for every medical treatment. But can tasks and scenarios benefit from the use of checklists within healthcare?
The following article talks about the use of checklists and examined 10,700 surgical procedures. The results although only showing small decreases did show that the implementation of quality checklists dealing with Surgical Safety reduced the following:
Length of Stay from 10.4 to 9.6 days
30-day Readmission Rates from 14.6 to 14.5%
90-day Death Rates from 2.4 to 2.2%
Small numerical changes equate to large numbers in the overall scheme of healthcare. From a 2010 National Hospital Discharge Survey and the National Center for Health Statistics showing some 51.4 million inpatient surgeries performed, that means that we can reduce the number of readmissions by 51,400 patients, and the 90-day death rate means we lower the number of deaths by 102,800 patients. Now I am not sure if you agree but that is a SIGNIFICANT impact on patient care. Those are numbers that could provide pause for those who don’t think checklists can be used in healthcare!
Now going back to our two objections above, let’s now think about why procedures, when implemented and designed properly, can improve performance.
Those are only necessary if there are people who are not knowledgeable on the task.
Procedures can be built to contain a level of information that can be helpful to both experienced and non-experienced practitioners. The idea that just because you have a lot of experience that you cannot make a mistake is unacceptable today. We are fallible, we are human, so why can’t we accept help? I believe it is perception, see comment 2 above:
Those procedures always make work more difficult.
Perception is reality and if people don’t believe or understand why you implement these checklists and don’t implement them effectively then this is understandable.
Here is what checklists help you do:
- Not rely on short-term memory
- Become more consistent in an approach to a job
- Remind and caution against unsafe behaviors
- Document the way work is “expected” to be performed
These four items alone are work an additional 2-3 minutes of time it takes to address and use the checklist, don’t you think?
From the numbers above, and the possible impact on patient care the use of checklists where reasonable is a very simply and effective way to raise the level of performance of your staff and have a very positive impact on patient care. If you would like more information on this or other topics around the TapRooT® system and how it impacts human and equipment performance please feel free to contact me at email@example.com.