Leadership Lessons from the Hospital

Leadership Lessons from the Hospital by Dr. Scott Yorkovich

Photo by melodi2, Available at www.morguefile.com

Doctor, do you think this diverticular bleeding could be caused by the reason my father checked in to the hospital in the first place?” Dr. “E” had just finished an arteriogram in an unsuccessful attempt to stop bleeding in my father’s large intestine.

“I’m not sure — why did he check in to the hospital? It wasn’t for the bleeding?” He was a little confused at this point and I was flabbergasted. Why hadn’t he looked at his medical records to understand the context of this situation?

A day or two later in the ICU, the hospitalist, Dr. “G” (the hospital doctor charged with the patient’s overall care), made a change in my father’s blood pressure medication — meds that had been ordered only a day before. A short time later, Dr. “L,” the specialist who had ordered those meds, arrived to check on my father’s status. We told him that Dr. G had made the change. Dr. L was surprised, even agitated. We discussed it further and after looking at Dr. G’s notes, Dr. L insisted that the change be reversed and assured us that this would not happen again. Why hadn’t Dr. G considered Dr. L’s expertise? Why hadn’t they talked about changes in critical meds for this ICU patient?

During a hospital stay, many good things and many bad things can happen. During this two-week stay for my father, we had a fair amount of both. There were some truly fantastic doctors and nurses and not all of the negative things were human error or lapses in judgment, some “just happen.” However, these two hospital anecdotes illustrate three common leadership errors.

Not looking at the full and accurate context — In defense of Dr. E, he was called in to conduct the arteriogram at 1am on an emergency basis. He did a fine job, even though it was unsuccessful, and my father suffered none of the serious risks of an arteriogram. Nevertheless, my experience with Dr. E is very much like a mistake that leaders often make. They collect information about a problem, but as soon as the data looks similar to a previous experience, the current problem is lumped with the previous experiences and treated in the same way. Had Dr. E looked at the full and accurate context of my father’s condition, additional data might have been discovered to suggest a different approach. Very often leaders do not stop to ask about what is going on in the environment of the current problem.

Not leveraging available expertise — Again, trying to be fair, I acknowledge Dr. G’s own expertise as a medical professional, but one of the greatest skills of experts is to recognize the limits of their own expertise and to value others’ greater expertise. In this case. Dr. G, had access to one of the best specialists available, but did not leverage that resource. Leaders do the same. We are an independent, self-sufficient breed. We are experts in certain ways. Nevertheless, we must know our own limits and have the humility to call on others who are able to fill in our gaps. Often the same conclusion will be reached, but the potential for incremental and even dramatically improved solutions increase when experts work together in a holistic approach.

Not communicating — The most pervasive problem we experienced during my father’s hospital stay is the lack of communication. Granted, I have not reviewed the medical notes in his file; I have not listened in on hallway conversations; nor have I witnessed meetings or phone calls between medical teammates as shifts change. I know that these occurred. However, there were many times when we were updating the medical staff on what their colleagues had told us. Leaders make the same mistake. They do not communicate across functions and with key stakeholders. Leaders also fail to re-communicate key messages frequently and in varied modes or styles. I challenge you to try an experiment. Go as far “down” in your organization as possible and ask 10 people, “Do you feel the senior leaders of this organization can improve how we communicate with each other and with you?” I can pretty much guarantee 8 or 9 of the 10 will say yes. Whether they are right or wrong, a perception exists that must be explored.

These leadership errors, sadly, are not the only errors leaders make. Leaders are human; we make mistakes and we cannot possibly meet every demand by everyone everyday. However, the errors above are also very strategic. Improvement and correction in these three areas has the potential to reduce and eliminate other errors in leadership!

Epilogue: I have good news to report about my father. He is supposed to be released from the hospital the day this article is published. For those of you who knew about my dad’s situation, thanks for praying. He and my family felt and appreciate your support.

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