When I was learning to fly, I learned quite a bit about decision making. One useful model I discovered is the DECIDE model. I think we use a similar, perhaps informal method, in clinical practice. It’s drilled into us in a subtitle manner in our training. It can work in clinical practice, however, when we begin process improvement initiatives having a model or checklist can help make your change easier and more effective.

1. Detect the change. Define the problem. The very first step is to detect that a change has occurred or a problem exists. Ask “What is the problem? What has changed?” If a change is to be recognized, proper monitoring must be in place. If you’re not monitoring for a change of any kind, it’s less likely you will discover it. Monitoring will help you identify if and when change is needed. A change might have occurred, but if you’re monitoring a process, you can see when and what you need to change to improve the process. You are...

Being a pilot, I’ve discovered the power of using a checklist for many things in life. As an anesthesiologist, checklists are also paramount to ensure a safe anesthetic is provided to the patient.

However, when we go about changing a process in our businesses, it frequently seems there is no rhyme or reason to the decisions that are made. This perception, whether real or imaginary, can have a deleterious effect on your efforts.

To help you approach your change management efforts, I’d like to share a few questions I have on my process improvement checklist. I recommend spending some time asking and jotting down the answers to each of these questions. You will discover you will not only have greater focus but also easier implementation of your change.

Questions

1. Will this change benefit your customers? How will this change benefit your customer? Does this change make it easier for the customer to receive our services? Will this change delight the customer or increase their...

You’ve worked hard to build a company that is profitable and meets a need for your customers. However, like everything in life, there is a time to start, a time to build, and a time to end. You likely spent quite a bit of time and energy planning when you began and built your company, so why not plan when it’s time to sell?

Part of the planning process when you’re selling begins by asking yourself a few questions.

• What is my company worth? This can be a difficult question to answer because we are emotionally involved in the company. Even though we know our business is valued at X, do we have the data to support that position? A buyer won’t have your emotional investment in the company. All they will see if the balance sheet, the P&L, and the current state of your business in the marketplace. They will evaluate the value of the book of business you currently hold and maybe what you could potentially hold in the future. Be realistic and honest with...

Before I began working with a recent client, a couple of talented employees and the management of a group got into a tiff. The employees perceived the value of what they gave to and received from the company one way, and management saw things another way. The employees felt things were out of balance, leaning towards their inputs. The management felt the outputs were in balance with the employee’s inputs. The disagreement started small and was allowed to continue over time without any intervention until it reached a boiling point. Ultimately, a less than satisfactory outcome resulted.

I think the situation could have been resolved with a better outcome if management had considered a management theory by John Stacey Adams. His approach, Equity Motivation Theory, builds upon the work of Maslow’s Hierarchy of Needs as we all Herzberg’s Two Factor Theory.

Equity Theory is a helpful tool that will allow you to put workplace psychology in place and increase your...

Change is constant. Nothing remains the same forever. What worked in the past might not work today. Why? Because the market and environment have changed. If you’re leading change in your organization, here are a few ideas for you to consider that can help your change be easier to manage and succeed.

1. Recognize the problems for what they are. Today’s problems are actually a result of yesterday decisions and actions. Those decisions, good or bad, might not have been the best decisions. Remember the old system in place contributed to the problems you see today, and those problems are symptoms of a broader issue. Use the issues created by the old system as a launching point to change the system into something new.
2. Set a marker. When you’re leading change, set a specific point in time, an event, that signifies the end of the old system and the beginning of the new. Mark it as a point of no return. You’ve crossed the Rubicon, and there is no going back. Share with...

Human communication is a complicated process with many moving parts. It’s easy to get it wrong or not as precise as intended. Good communicators understand their message goes beyond merely the words they use. They know how to say things. They know when to say things. They know how to use analogies and other tools to share understanding. They recognize the importance of inspiring others to act. Good communicators realize they share their opinion of the relationship with those they are communicating with. Base your communication upon your audience, not yourself.

Communication is a complicated give and takes process. Sometimes it’s a two-way street. Other times, it’s a one-way street. As a communicator, you only have control of what and how you project your message. The other variable in the equation you have no power over is the way the recipient receives your information. The audience hears not only what is said, but what you do not say. They pick up on the more...

The other evening I was involved in an “intervention” or counseling session with a fellow physician. Complaints were raised by nursing staff regarding his demeanor and type of communication he has with them. Technically, he’s a good physician, very well-read, and does a good job of caring for his patients. However, he continually has “run-in’s” with the support staff. This was the topic we were addressing at this particular meeting.

As we began to discuss the events, his body language shouted “I’m right. Everyone else is wrong.” The tone and tenor of his voice were coated with pride. Why am I here? I don’t deserve this. I’m the best in the group. He had a hard time displaying any empathy towards the nurses. “I’m sorry they received the message that way," was his typical reply. Suffice it to say, but his attitude was impairing the progress of the meeting.

A few of the members of the meeting wanted to...

Last week I was asked to attend a multi-departmental meeting to solve some process issues one of our hospitals was facing. Members representing each department sat around the table, each with their desires and objections. After about an hour, we had designed a plan, and everyone was on board. How did that happen? Someone walked into the meeting prepared. Here are a few ideas you might want to implement.

Start with Mission and Purpose

Your mission and purpose is the what and why you do what you do. What you do are the actual services or goods you produce. Why is the reason behind your what. If you want to be successful in business, your why should be centered in the world of the customer.

In the case of this meeting, our what is providing safe, efficient patient care. The why is to improve their lives. Every decision and action we take should be to benefit the patient. We spent a brief bit of time reviewing this premise before we began to discuss the issues facing the departments....

Since the new year is almost upon us, I thought I would share how I go about setting goals and objectives. It’s a simple process, and I’ve found it to be reliable and successful.

Start with Mission and Purpose

If you have been following my work for a while, you’ve heard me use the term mission and purpose. I use these words because they have specific meanings and help me stay focused. My mission is the what I am doing. It’s the thing I actually do. It’s my writing. It’s my teaching at conferences. It’s providing patients medical care. The purpose is the why I do these things.

For my writing and teaching activities, my mission and purpose are:

Mission - create educational material that raises the business intelligence of the consumer

Purpose - help the client have the business they desire

For my medical practice, my mission and purpose are:

Mission - provide safe and effective anesthesia to the patient

Purpose - enable the patient to...

The other day, I sent out a request to an individual to connect with them on LinkedIn. I included a brief note of how we met at a conference. Their reply to my invite was

David, just say this. Sorry.

At first, I didn’t know what to think. To me, not much time had passed between my invite and their acceptance. Their response puzzled me because they did accept the connection response. I couldn’t figure out what they meant by that statement. Was I supposed to say "sorry"? I admit I confused, and realized I was missing something, so I asked my wife for her opinion.

“Perhaps they meant to say “Just saw this. Sorry.”, she suggested. “Sometimes Siri doesn’t get it right, and people don’t check it before they hit send.”

That made sense to me. It can be difficult to practice what I preach at times. I teach that in leadership and negotiations, we shouldn’t hold on to our assumptions. If we don’t understand something or...