32. “Don’t just do something, sit there”

Have you ever walked through the halls of a medical center and noticed the busied nature of all the people inside?  Their rushed existence to get from point a to point b?

As the great John Lennon espoused, “Life is what happens to you while you’re busy making other plans.”

Health care happens while we plan for the future.

In a health care system with many big, challenging issues, it’s easy to forget the problems that plague us on a daily basis.  The forgotten hand wash.  The misguided patient.  The uneasy interaction of a stressed doctor and a busy nurse.  The elements of health care that affect direct delivery to the patient.  They’re overlooked for the hundreds of thousand square foot tower expansion, the hiring of the latest super specialist, and the acquisition of the greatest MRI machine.

Health care takes place between the big decisions.  And sometimes those who lead health care forget that.  There are a lot of small improvements organizations can make on a daily basis that will improve the health care we deliver, it will improve the satisfaction that patients have with our organizations, and it will help us improve our financial situations.

But how do we do that?  How do we find the areas that we need improvement?  We notice, or rather, super notice.

Steve Portigal and Dan Soltzberg published a dialog in Gain (via kottke) “about the importance of being aware and the advantages of tapping into your ‘super-noticing power’ in practicing design and specifically in user research.”

Mr Soltzberg:

It is ironic: people don’t notice that noticing is important! Or that they’re already doing it. It’s kind of like breathing—we’re not usually that aware of it. It’s much easier to recognize more “outbound” activities like brainstorming, testing, designing, refining. But noticing is just as important—it’s really where everything begins. There’s a funny Zen saying about that: “Don’t just do something, sit there.” It’s a reminder to let yourself take things in as well as output them.

In the hustle bustled, go-go-go environment that is health care today, it’s easy to stop noticing the issues that plague us on a daily basis.  But those daily issues are how we can improve health care today.  The issues that we don’t have to wait for anyone else to fix.

But noticing is a concerted effort.  It’s a process of pattern finding as Mr. Portigal comments:

This process of noticing once and then noticing again is how you start finding patterns and uncovering themes.

To embrace the power of super-noticing we must release ourselves from our ideas and thoughts and preconceptions of what’s going on.  We must notice, super notice, bias free.  See what is happening.  Experience what is happening.  Do something about it.

Mr. Soltzberg:

Which really supports what we were talking about earlier, that it all begins with noticing. There’s another classic Zen concept that everything you need to know and experience is already happening and present, but you need to get your old ways of thinking out of the way so you can experience it. Doing contextual research is like using “super-noticing power” to peel back those layers of preconception, culture and habit. When you do that you get to something fundamental and then you’ve got a really solid platform for developing new concepts.

Principle #32: Spend time super noticing.  Do it every day.  our own system will make a commitment to finding the everyday problems that prevent us from becoming a superior health care delivery organization.  We’ll also do something about them.  Planning for the future is important, too.  However, we must not forget the now.  Health care happens in the trenches, we need to focus on solutions that improve those conditions.

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