What if they held a Civic Summit and… People Came?

Last year, the president of the City Council convened the Boston Civic Summit, with the builder of the Boston Convention Center, whose center has increased visitor traffic to Boston. It was an exciting event with 400 attendees, and could have been a kickoff for energetic action. It was wonderful to see people get excited, brainstorm and share their vision for the city – the kind of discussion that generates great energy that can be funneled into action teams. Unfortunately, there were several problems, with the design and with the follow-up, that could inform future efforts of civic engagement activities.

For example, the Summit wasn’t sponsored by the city, nor by the city council, nor by the mayor – so it didn’t really have legs: No money, no ongoing support, no connection to projects other organizations were already working on. While the event generated 4 action groups to work on 4 identified action items, those groups needed ongoing support and guidance, not to mention resources. They needed to identify their goals, prioritize them, figure out how they were going to work together, and so on. Without that support, 3 of the 4 groups did not continue to meet, and the fourth group lost participants as they continued to hold meetings.

Oops, They operated on the wrong knee…

Did you see that some surgeons operated on the wrong knee of their patient last week? (Feb. 18, 2009, Providence) NECN said that “After the botched procedure, the hospital began requiring surgical staff to use permanent markers to mark where the doctor is supposed to operate.”   In a similar case at Beth Israel Deaconess 2 years ago, the patient’s leg was marked and they still operated on the wrong leg.

The Sr. VP of Health Care Quality at BIDMC said “that medical workers used a marker to correctly label the side of the patient that should have been operated on but that, somehow, the surgeon failed to notice the marking…   Perhaps most crucially, the team of medical workers hovering in the operating room neglected to conduct what’s known as a “time out” before the surgeon first placed his scalpel on the patient. Time outs are safety procedures that require the operating team to verbally call out, “Right patient, right procedure, right location.”

Accessing the Realm of Possibility

Bill Moyers recently hosted a conversation on his PBS program with Parker Palmer, author of “The Courage to Teach”, and “A Hidden Wholeness: The Journey Toward an Undivided Life.”  Palmer was describing how the Obama campaign engaged people, the electorate, in telling stories, and in thinking about the possibilities of his campaign. It was, Palmer said, the first campaign where he didn’t feel that the candidate was being “sold” to him.  “I was not asked, to buy a presidential candidate as a commodity in a consumer culture… It asked me to tell a story.”

I’m interested in the use of stories in organizations and communities to discuss values, visioning, and determining impact.  For example, employees’ stories that can tell us about the values of the company, and how they fit with the individual; stories that reveal people’s hopes and aspirations; client stories about the impact that an organization’s services have had on them. Stories about hopes and dreams take us beyond the “actual”, they give us access to the right-brain and to our emotions, and they generate energy for future actions. So I was struck by the Telling of Stories, and the Questions about Possibility, that the Obama campaign asked people.

When Deviance is Positive!

Speaking of Handwashing in Health Care Settings… Have you heard about Positive Deviance? Deviance in this case means going against the norm and achieving positive results. Sometimes, if things aren’t going well in some departments, you can look around to see if anyone in the organization is having success with that one issue. If they are, they must be doing something right! You want to figure out what they’re doing, and then you want to get other people to imitate that.

Atul Gawande is a surgeon in a Boston hospital, and he’s written 2 fabulous books on learning in health care institutions: Complications and Better. He describes how doctors, nurses, and administrators can learn – from their mistakes, from surgical errors, from places in the hospital where things are going right.

Where Cultural Competence & Organizational Effectiveness Meet

As an Organizational Development consultant, I get to think about how effective organizations are: their staff, their initiatives, their ability to deliver excellent service. As I’m also trained in cross-cultural communication, I sometimes look at organizational issues through that lens. When I’m lucky, these two fields coincide, as in my visit last year to the administrative offices of a health care organization, where I saw a patient brochure about “hand-washing for doctors”. You may know that this has been a focus in health care institutions, who are trying to reduce the spread of germs and infections. This brochure said “Have you asked your doctor if he washed his hands?”

Can you see anything wrong with this? There are power issues inherent in this question. For one thing, we tend to defer to doctors, or any authority figure, particularly when they’re wearing a white coat (or a uniform, or a stethoscope). Even I, as a white woman, feel a little intimated in front of doctors. Secondly, when you’re serving people from other countries and other cultures, who may not speak the language well, or who don’t feel fully acculturated, the authority gap is even wider. They could have saved themselves time and money if they had convened some focus groups on this question (or they could have asked people like me!