There is nothing we can do…now what?
I recently attended a daily communication huddle at an inpatient nursing unit. I was coaching one of the leaders in meeting a challenge related to getting all care team members to have the same understanding of each patient’s plan of care and expected discharge date. We had just finished practicing our daily Toyota Kata routine, and she asked if I wanted to stay and observe their huddle.
The cleanliness of the patient and family visitation area came up as a problem. Staff complained that the area was dirty because visitors and patients didn’t clean up after themselves. Environmental services staff was cleaning the area once/day, but because the space was so heavily used, there were litter and spills throughout the day and evening.
As staff discussed the issue, their comments fell in one of two categories:
There is nothing we can do.
“We can’t clean it up, we’ll be grieved by the housekeeping union.”
“People will do what they want no matter what we do.”
“I would clean it up, but there is nowhere to put the liquid, and there are no garbage bags.”
A few of the staff offered suggestions.
“What about changing the time when EVS comes?”
Answer from leadership, “We’ve asked, they won’t do it.”
“Let’s put signs up that tell people they have to clean up after themselves.”
“We should stop allowing any food in this space at all.”
The time allotted for huddle ended and the leader concluded the meeting by saying,
“Well, I thought I would bring it to your attention. I think we all need to help out.”
It did to me. As humans, when problems arise, we either think of all the things we can’tdo and why improvement is impossible, or we jump right to all the things we should do to fix it.
The hard part is slowing down and understanding the problem more deeply. Asking questions such as “How often is patient dining area dirtied? How messy is it? What types of items are left behind? Are they left by patients or visitors? Is there any clean up expected from staff currently? By deeply understanding the problem and the current processes or lack of processes in place around a problem, we can begin to think about countermeasures.
Our default mode of thinking is either catastrophizing or jumping to solutions. It takes effort to create new habits that include deeply understanding the problem we are trying to solve and then beginning to experiment.
While a methodical and disciplined approach to problem solving takes more effort, it is crucial if we want to improve our work and create a better experience for colleagues and customers.
Next time you hear the words…
There is nothing we can do!
We need to implement this solution today!
…I encourage you to pause and take a few steps into your current condition. Understand the problem you’re trying to fix, write it down, add some measurement, and then decide where you want to be next. This is often hardest part of any improvement, but if done well, can make the path forward clearer.