The Immersion Principle

In college we were required to take a foreign language to graduate, and if you read through the information you figured out that with one additional class and a study aboard you could get a minor.  This was a no brainer for me – I got to go to Spain all in the name of education.    The purpose of the study abroad was to immerse student into the language and the culture.  Unlike a class which trickled information into your glass slowly with finite precision allowing you to drink at reasonable pace – a study abroad throws you into the lake with a small life vest and expects you to learn quickly how to tread water.   

Have you been immersed in the culture and the environments of the people you are developing products for?  Technologist, if you are in the business of creating a “business” is it really worth it?  Can you truly attach passion to it?  As for me and my house – we don’t think it’s a long term answer.   Passion comes from creating tools that really help people. 

I met some really great folks at the Connexall User conference in Toronto.   One was Craig Martin an “IT Guy” from University of Michigan Health System.  Craig and his IT team have immersed themselves into the different units to gain clear knowledge of clinical needs.    Craig described his goal of disintegrating silos and creating more effectiveness in development and decision making ideals around purchasing and creating healthcare products.   The formula is really quite simple from a high level view -  it’s to become the foreign exchange student on the clinical unit – to immerse yourself in the culture and life of the people who will be most affected by the choices on technology - the end user.  On a hospital level Craig’s “Immersion Principle” takes a person from IT and attaches them to the hip of a nurse to experience a day or week in the life of someone who is directly engaged in patient care.  Craig said  “We in healthcare IT cannot hide from the sometimes overwhelming things that go on in our hospitals.” 

I am impressed by this team they were focused on creating environments for better care by utilizing technology as an enabling tool.  I can’t say that of every hospital.   

Technologist – when was the last time you stepped foot in a hospital for something other than a sales call?  Where does your passion for product come from? Is it in a paycheck or is it in the realization that what you are doing is making a difference in the lives of the sick and helpless.  This which we do for the least of our brothers…….

After being in the hospital with #4 for a week – I will never look at a call light system the same again.  My passion is in the eyes of that sick baby.

When you immerse yourself into a culture – your perspective is forever changed.   Do you need an inspiration?  Spend a day on the floor of a hospital with a nurse doing nothing but observing – not selling, not creating, just observe.  Let their reality become your reality.  

A Coloring Page for Root Cause Analysis

The other day #2 boy brought home a coloring sheet from church.  I asked him to tell me about his picture.  He went into a wonderful description of the story of David and Goliath.   Goliath was colored blue similar to a giant smurf and David was wearing a green skirt.  He had added grass, bushes, and even some small animals.  His hands flew through the air describing his well colored picture and telling me in detail that Golliath blue from him blueberry pancakes and why David was “late to the party”.  As he talked, I began to focus in on the upper corner of his paper to the small gray airplane.  “What is that?” I asked.  Tucker’s eyes lit up and he replied “That’s the fighter pilot backing up David in case he missed.”

It's interesting when we begin see the outline of a picture and think we have the whole story.    

As I have been reviewing RCA’s from different hospitals and researching the rebuild of the incident – I find it interesting that many hospitals do not build the picture from data that is very representative of what is occurring in the room.   Many times this is simply that they do not know that the data is available or that they have systems in place that the data is locked inside and not accessible. 

I was working with a hospital on a fall analysis - extracting data to begin to layout the outline of a picture of what happened surrounding the patient fall.   The patient requests and responses are a lot like a blank coloring sheet.  The outline is your basic patient request data and based on the patterns it began to paint a picture.  The physiological alarm data, the medication data, and other bits and pieces began to color in the outlines to give a full view of what was occurring in that patient’s room.   Did the patient have a critical telemetry alarm?  Who received it? What were they doing?

Another interesting piece of the puzzle is communications between caregivers.  I was having a conversation with Voalte’s Trey Laudedale about the value of the Text Message.   As I was thinking about this blog it occurred to me – the text messages are the hand drawn fighter jet in the picture.  Sometimes the outlines and the information we are looking for does not create the whole picture. Sometimes the picture needs to have more data then what we would normally consider to complete it.  

So here is my tip for an RCA

·         Review the Patient Requests from the Nurse Call and Response of the Caregivers
·         Review the Physiological alarm data that was sent to the Caregivers
·         Review the text messages between clinicians

Remember data is always available if you are careful to set up your technology correctly.