I need advice . . .

[Michael M Pannwitz]

Dear Laurel,
what a great challenge!
Before really being through your message I started thinking about
involving patients, scientists, operating room design experts,
professors from a nursing school, people from the board of directors
of the hospital, etc. Then the crunch. Wonderful. So they are always
late getting home (here is another thought: have their
spouses/partners and children attend).
I can just picture you at 6:48 after the sponsor took 3 minutes to
open the space you are introducing the procedure (people already half
dressed for work since the patient is waiting on the operating table)
and then 12 minutes later people posting issues and by 7:15 the first
round of work, followed by two more at 7:40 and 8:05, the circle
convening again at  8:35 sharp with 12 reports 30 seconds each, so
that by 8:41 you have 4 minutes left to leisurely prioritize and
agree on action steps.
Finished by 8:45, everyone proceeds to get ready to work by 9:00  to
immediately implement the efficiency increasing  procedures they just
discovered.
A probable scenario?
My hunch is, that they are already damn efficient. And if they became
even more efficient they would increase their caseload.
My hunch is, that they really are enthusiastic about their work and
perhaps want something rather different then getting home on time.
And as far as the can of worms is concerned whose responsibility is
it to pull it together?
I would go back to the sponsor or the planning team and try to make
it even more specific. What is it that they want to be different
after the open space or whatever they do in those 2 hours?
All the conditions for os seem to be in place:complexity, conflict,
diversity, urgency and no one with an answer.
One last thought: what would the team say to a patient that came in
knowing that a bypass operation takes about 6 hours whether they
couldnt shorten it a bit and get it done with in 4 hours?
Greetings from Berlin where I am inundated with all kinds of
perplexing requests around open space
michael
On Tue, 27 Jun 2000 10:20:52 -0700, Doersam, Laurel wrote:

>I've been asked to facilitate a group in the cardiac surgery section of the
>Operating Room in a large urban hospital.  The issue to be explored is:
>"Given our current caseload, how can we increase efficiency so we all get
>home on time?"  (Generally everyone involved is late getting off).  This may
>seem straight forward, but it's a very complex problem involving everyone
>from cleaning staff to nursing staff to cardiac surgeons to
>anaesthesiologists to equipment attendants.  Add to the stew the traditional
>hierarchy within health care (and the attendant prima-dona-ism), half a
>dozen hidden agendas (or not-so-hidden), and the involvement of several
>layers of self-employed professionals as well as employees from five
>different unions.  It's a mess.
>
>Here's the crunch . . . they only have two hours to devote to addressing
>this problem.  They are able to push their OR time back by an hour, and come
>in an hour early (Yikes! 0645!!), but must be ready to operate by 0900.
>It's a very tight timeline for an Open Space, however the question is very
>specific and action-oriented.  Dare I try to use OST?  I guess the real
>attraction for me in this case is the community-building component inherent
>in opening space - each person's job (not to mention the patient's life) is
>totally dependant on everyone else on the team performing to capacity.  So
>it sure would be a good thing for them to understand each others'
>challenges.  However, once the can of worms is opened, how do I pull it
>together in such a short space of time?
>
>What do you much more seasoned experts think?  I'd sure appreciate some
>advice.
>
>Laurel.





Michael M Pannwitz
Draisweg 1
12209 Berlin, Germany
FON +49 - 30-772 8000     FAX +49 - 30-773 92 464
www.michaelMpannwitz.de

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