Samuel Johnson wrote in 1759, “Nothing will ever be attempted, if all possible objections must be first overcome.”
I work with a lot of hospitals to help them adopt some of the best practices (things like teamwork training and checklists) from aviation to improve their patient safety and quality of care.
Hospitals, and the people who work there are largely consensus driven. Meaning that many decisions about which improvement initiatives to pursue are made based on the consensus of the staff. "Does every one agree this is a good thing? Can we get total buy in from the staff?"
Which means I rarely work with an organization which isn't overly concerned about objections, objectors, and naysayers. "Dr. Smith will never buy this." Or, "Nurse Jones doesn't think this will succeed." Or, Tom just won't do something like this."
The secret to success in getting the hospital to go ahead and press forward is to help the senior leaders realize they don't need total consensus, and that the focus on the naysayers is often misplaced.
I have seen very large hospitals be wildly successful in changing their culture and adopting best practices from aviation when starting with the support of less than 10 key leaders. Of course, those 10 must be carefully selected, and be in critical positions, but it takes far fewer supporters than most can ever imagine to start down the road to success.
Many other hospitals are no farther than they were last year because they are paralyzed by responding to the all of the "possible objections." Therefore, nothing is attempted.
I just received an email from a nurse manager in a Labor/Delivery unit at a hospital that is five months into their new patient safety initiative. When I read her comments I had to smile.
Here's what she said.
"We are doing very well here on the LifeWings project. Your LifeWings instructor, Steve Chafe, really helped us get rolling during our Hardwired Safety Tools workshop. Over the 3 day workshop we created a total of 8 tools, ( e.g. Infant Warmer Checklist, Labor SBAR, Pre Shift Huddle Briefing Guide, Post Shift Debrief Guide, Circumcision Preparation Checklist, Time Out Tool, etc.) I just had evaluations for all of the staff and during that time I asked them what they thought about the tools we created and implemented. Overall, the staff are using the tools and I have had plenty of positive feedback on them. I really am surprised at how well this initiative is going so far, and also am surprised at how some of the nurses who I thought would not embrace the concept have accepted it wholeheartedly."
She's a great example of someone who has learned the lesson of stepping off with the support you have and not being paralyzed by all the possible objections. Line up your key leaders, work with the willing few, use good change management leadership and go for it. You'll be surprised at your success.
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The thoughts, musings and experiences of the President and co-founder of LifeWings Partners...a commercial pilot who has spent the last seven years of his life helping healthcare organizations thoughtfully implement the best safety practices from high reliability organizations.
Wednesday, March 12, 2008
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About Me
- Steve Harden
- Memphis, Tennessee, United States
- Steve is the President and co-founder of LifeWings Partners LLC, a team of pilots, physicians, former NASA astronauts, nurses and risk managers that have adapted for healthcare the same teamwork skills and safety tools that have made aviation so safe and reliable. Lifewings has worked with over 75 healthcare organizations - helping them create and sustain a culture of safety and produce measurable results in efficiency, safety, and quality outcomes.

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