Challenge # 42 of Healthcare IT

Many who've worked in healthcare IT believe it's more difficult than IT in other contexts. Everyone has their reasons. I'd like to add mine here.

Mistakes in healthcare are really bad. They literally lead to people's health being compromised, or in the worst case, people dying. Projects are about doing something new. Doing something new is about making mistakes and learning from them, or at least trying out new ideas, some of which will turn out to be wrong.

Sometimes these two things are in direct contradiction. More often it leads to all sorts of misunderstandings between the healthcare team and the external project team that are hard for either side to recognize, let alone overcome.

For example, it's pretty standard practice on a project to do a design and put it in front of a group of people for review. While it can be hard to listen to others criticize your design after all the work you've done on it, we all get used to it.

Now imagine you're a nurse, doctor or pharmacist. All your life you've been terrified of making a mistake because someone might die because of it. Everyone around you is also terrified of making a mistake, and in fact the best way for them to feel good is to catch you making a mistake. It's pretty easy to fall into a pattern of avoiding mistakes at all costs, avoiding blame for mistakes when they do occur, and catching others' mistakes in order to appear to be a better nurse, doctor or pharmacist than the others.

You're not likely even to be able to understand a consultant who suggest you put up a proposed design and let others criticize it. And if you understand, you're not likely to want to go along with it. Every fibre in your being is about avoiding mistakes. And everyone you work with considers making a mistake to be the worst thing anyone can do. No consultant is going to convince you that you should publicly set yourself up to "make a mistake".

If you're running a project in a healthcare environment, you need to understand the depth of fear of making mistakes. To move the project forward in spite of this fear, try some of these ideas:

• Let the people you're working with tell you what makes them comfortable. They won't necessarily tell you just because you ask them. You have to listen to how they want to do the project
• Bring groups together and facilitate group decision making, rather than expecting one person to tell you an answer. It will take longer than if you could find one person to make the decision, but the reality is, you aren't going to find that one person
• Use project staff if you can. Just let them know they're going to take a beating. The passion with which many people expose other people's mistakes in healthcare is unnerving
  

By the way, I'm really glad that healthcare providers have a phobia about mistakes. If I'm ever in the hospital I want to know that everyone there is doing everything they can to avoid mistakes. It's only difficult when you're trying to run a project.