I Can Do That Case In 45 Minutes!

April 10, 2013
A surgeon asked the OR staff to fit in a case that “ will take no more than 45 minutes.” The staff mentioned this to their manager who pulled up the statistics for that surgeon and that case type. He had not completed that case type in under two hours according to more than a dozen relevant, recent cases with time-stamped performance data. The surgeon was humbled, gracefully stood corrected, and was, hopefully, quietly impressed with the professionalism of management.
"I Can Do That Case In 45 Minutes!"
Part of the joy of my job as a CMO at a vendor is sharing observations with and helping CMOs and CMIOs at provider organizations. The challenges almost always start as recognizable stories. Let me share a recent one with you.A surgeon asked the OR staff to fit in a case that “ will take no more than 45 minutes.” The staff mentioned this to their manager who pulled up the statistics for that surgeon and that case type. He had not completed that case type in under two hours according to more than a dozen relevant, recent cases with time-stamped performance data. The surgeon was humbled, gracefully stood corrected, and was, hopefully, quietly impressed with the professionalism of management.This story illustrates a few things worth calling out. As we all know, accurate data can be very persuasive, especially for physicians. Physicians are specifically trained to have a very strong and healthy skepticism for unproven methods; the counter corollary is that they are strongly influenced by proof data. In fact, there's a hazard of being too easily influenced by factual but misleading framing of data. For more on this, you might find value in this interview ( link to Drs. Mercola/Golomb interview).The second point illustrated by this story is more generally applicable to all people, not just docs. Quite simply, there are at least three relevant, concurrent and necessary perspectives for realistic self-management, as well as helping others to structure their work. The three perspectives are:1) what we think we do,2) what we say we do, and3) what we actually do.They are almost always different from one another.In my story, the surgeon said and thought he could do the case in 45 minutes. Historical performance was greater than two hours, and, of course, included his actual time, as well as setup, buffering, cleanup and other process considerations outside the surgeon's view. To some degree, all of us have a level of self-centeredness that blinds us to our actual behavior in the real world. And when we're into work we find interesting, consuming or stimulating, we all lose track of time. That's just part of being human.I think there are but a few ways to enhance our self-awareness to up our games: feedback (e.g. access and orientation to the performance data), coaching, and introspection (sharpening our own self-management saws, in part by simply scheduling stop-and-think time!).What do you think? How long do you think it took you to read this post? How long did it actually take? I actually have that data. It averages 2-3 minutes.Joe Bormel, M.D., MPH
CMO & VP, QuadraMed
This Post: http://bit.ly/icandothatcasein45minutes
Recent Prior Posts:
BlindSpots part one, two, three, four, and five

“Healing is a matter of time, but it is sometimes also
a matter of opportunity.”
Hippocrates Photo credit: istockphoto.com

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