Setting the Bar High for Organizational Learning
How many CEO’s do you know who keep a daily blog of the workings of the organization, or of a hospital? (see footnote) Can you imagine making public the reflection and problem-solving process in the organization? What a great example of organizational learning Paul Levy is setting at Beth Israel Deaconess Hospital in Boston. In a remarkable display of transparency, Levy writes:
Regular readers know that I believe in administrative, as well as clinical, transparency in our hospital. I have trouble understanding why this is unusual, but I know that it is. I just can’t imagine trying to solve the problems of an organization and having a common sense of purpose and direction unless everybody is aware of what’s going on.
Levy has openly discussed problems facing the hospital, from budget issues to health coverage, to surgical errors – all of this open to the public eye. Some people who submitted responses to Levy’s blog disagreed with the open discussion about the surgeon who operated on the wrong leg last year (July 2008). This could have implications for insurance payments, and for malpractice suits, to name just two. In a high-risk environment, the disclosing of errors can be tricky. On the one hand, leaders in a learning organization want to identify the problems and glean the lessons to be learned. On the other hand, surgeons or clinical staff whose errors are publicized might be less likely to reveal errors in the future – whereas the hospital wants to maintain an open environment where errors and problems can be discussed, at least among the staff. That’s why hospitals have Grand Rounds, so the physicians can learn from the successes and mistakes of their colleagues. In terms of making errors public, it’s also critical to maintain the public trust – so a hospital wants to have a very low error rate – and, being transparent about errors might also serve the public trust. It’s a tough balancing act.
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Enhancing Citizen Participation in Decision-Making – or Not…
Or not, as in the case of the Health Care hearings on Capitol Hill.
The conversation sponsored by the Obama administration about “Open Government Brainstorming” is continuing, as people continue to post comments about civic engagement – engaging citizens in public policy decision-making, at the local, state and federal levels. I’ve posted a few comments, about best practices. But the recent news raised a flag for me about this invitation for input, as I remarked in this post:
We’re all talking about how to engage citizens in the government’s decision making process – yet, there have been hearings this month on Capitol Hill on health care, convened by Sen. Baucus, where public input on single-payer health care has not been welcome, and has been obstructed. There were many doctors and nurses who wanted to participate and be heard, but they were excluded, and escorted out of the room. So I’m confused why we’re giving suggestions for models and tools, when there appears to be a basic question about the premise: to what extent is public input being invited?
