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Challenging Assumptions, Evaluating Routines Can Aid Quality

By Nicholas Schmitz, PMP, LSSBB

Across our personal and professional lives, we all fall into many routines; it’s part of how we’re able to perform so many different tasks every day. Have you ever arrived at work (or home), only to realize you don’t even really remember the drive? That isn’t to say you were unsafe or not paying attention – it’s just that driving has become so routine that we don’t always form a memory of it.

The same goes for many other things we routinely do. Sterile Processing and Surgical Services professionals get the job done in their respective disciplines that literally affect patient safety and outcomes; however, the importance of taking a close and honest look at what both disciplines do and how they do it becomes paramount for ongoing quality improvement. If we don’t remember doing something (or don’t recall paying close attention to each step) how can we think to find ways of improving? I’ve found that the best way to overcome that obstacle is to challenge our assumptions. We must strive to experience the familiar in a new way and see it from a different perspective.

What follows are a few exercises I’ve used with teams over the years to help them see some of their blind spots, identify opportunities and encourage everyone to be receptive to them.

1. Breaking out of the “But I’ve always done it that way” rut

This exercise illustrates how easy it is to develop and adopt subconscious habits; it also points out that there are often equally effective, alternative ways to accomplish an objective. Finally, it helps demonstrate that old ways of doing things may interfere with adopting new (and better!) behaviors. Sometimes, we must un-learn what we have learned.

Procedure

Ask one or more participants to stand and remove their coats. Then, ask them to put the coats back on, and take note which arm goes in first. Ask them to remove their coats once more. This time, ask them to put the coat back on, starting with the other arm.

Discussion Questions

  1. How did it feel to reverse or alter one’s normal routine?
  2. Was it difficult or awkward, and why?
  3. What prevents us from adopting new ways of doing things? How can we make changes without old habits interfering with them?
  4. How can we open ourselves to change within the program and accept that there are equally effective or even better ways to accomplish tasks?

2. Letting go of myths and misconceptions

This exercise can illustrate to a group how easy it is to hold onto misconceptions about a process, topic or practice; it can be especially helpful if a specific process or change must occur, but people in the team are resisting.

Procedure

Define “myth” for participants, explaining that it is “a fiction or half-truth that appeals to the consciousness of people while expressing some of their deep, commonly felt emotions.” From there, progressively identify common societal myths, such as:

  • One size fits all
  • You’re only as old as you feel
  • The check is in the mail
  • People hate change
  • It’ll only take a moment to fix this

Then, add a myth from your department. For example, one organization I worked with insisted that a specific tray must not be opened for inventory because it was vital to surgical procedures. Upon inspection, it was identified that it hadn’t been sterilized in more than 10 years. How vital was this tray if it hadn’t been used in more than a decade and what could have been the outcomes if that tray had been used on a patient?

Discussion Questions

  1. Where/how might this myth have originated?
  2. Which factors contributed to the perpetuation of this myth?
  3. How can the myth be dispelled? Is there a metric that would pertain to this?
  4. Is it a myth or is there a large measure of truth to it? Most myths are at least partially rooted in truth. It’s possible or even likely that an extreme event that occurred long ago triggered a change, but the facts behind the event and the rationale for change became lost or skewed over the years.

3. Releasing the team from the Pike Syndrome

This exercise helps illustrate how limits of a person’s training/learning often lie within oneself.

Procedure

Relate the story of a large fish called the Northern Pike. It was placed in one-half of a large aquarium with numerous minnows that were visible yet unreachable placed in the other side of the glass-divided tank. The hungry pike makes numerous attempts to get the minnows; however, after learning that the minnows were unreachable, the pike eventually gives up. With this learned behavior, even when the glass partition is then removed, the pike does not attack the minnows. The pike’s subsequent behavior is known as Pike Syndrome. Some actions associated with this condition include:

  • Ignoring differences
  • Overgeneralizing reactions
  • Rigidly committing to the past
  • Refusing to consider alternatives
  • Being unable to function well under stress

Discussion Questions

  1. What are some examples you’ve seen where people seemed to exhibit signs of Pike Syndrome?
  2. How can we help others and ourselves break out of this routine?
  3. Are there any benefits to the Pike Syndrome?

Conclusion

It’s important that we keep our minds open to new possibilities. Sometimes, especially with success, it can become increasingly difficult to identify new opportunities for positive change because we might assume that since an issue was already successfully addressed, it no longer deserves our attention. But quality is an ongoing pursuit. Improving our processes should be perpetuated, not the myths that often surround them.

Nicholas Schmitz, PMP, LSSBB, is president of Schmitz Consulting LLC. He holds two master’s degrees in organization development and change management, and project management, and is a certified Project Management Professional and Lean Six Sigma Black Belt.

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