The Largest Threat to Patient Safety is Not Medical Errors, it’s the Patient Record

The Largest Threat to Patient Safety is Not Medical Errors, it’s the Patient Record

Despite the widespread adoption of electronic medical record (EMR) systems, new integration techniques, and innovative technical advances to avoid medical errors, problems of record matching continue to be a major challenge for healthcare organizations.  This issue is exasperated by the multitude of systems involved in a patient’s continuum of care. 

Why Do We Rely On Our Gut Feeling

Why is it that even as our ability to objectively evaluate vendor bids for outsourcing has improved, we rely as much if not more on our gut feelings than we do on hard, objective data? 

How To “Follow Your Gut”

AUTHORED BY GUY WOLF, TRANSFORMATION EXECUTIVE @ GUIDEIT

Guy Wolf, Transformation Executive @ GuideIT

Guy Wolf, Transformation Executive @ GuideIT

Early in my career, a manager told me how he made important decisions.  “I always follow my gut.  In fact, I’ve put on so much weight in this job, that my gut sticks out and I literally have to follow it wherever I go!”  Kidding aside, he did stand out among leaders as being able to cut through the fog of data – some missing, some conflicting, and some just plain wrong – to guide his team along a path that was not always the obvious conclusion. 

In leading one company through an outsourcing decision, we arrived at a point where the investigation had been completed.  Two organizations were deemed qualified, capable and willing to work with us to take on a large service obligation to support the client company.  This would have meant significant savings and access to resources for the client and significant revenue and favorable marketing publicity for the service provider.  After negotiating the contracts, a key leader at the customer told us his gut was telling him not to do this deal.  What happened next made the difference in maintaining a cohesive team that would continue to work with both vendors in other ongoing relationships. 

There are at least two paths leaders follow when making this “gut calls.”  One I would call the “trust me” path.  It’s fast.  It gets to the “right” decision very often, and it avoids the hard work of forging a consensus among people with different preferences of outcomes.  When done well, it can lead to a sense of awe and glory for the leader.  “Brilliant, if a bit abrasive,” others may say of this leader.

But we ignore our sixth sense at our peril.  “Gut Feel” or “Intuition” is the stuff we know, even though we don’t know how we know it.  Or in psychology terms:  "rapid cognition or condensed reasoning that takes advantage of the brain's built-in shortcuts." (Psychology Today, 21-Aug-13 https://www.psychologytoday.com/articles/200704/gut-almighty It is no less valid than other types of formal analysis. But because it is hard to demonstrate, it is frequently kept hidden.

The other path, and the one this leader chose, was to engage an impartial advisor to help document the pros and cons of multiple courses of action – some of it in spreadsheets, some in narrative.  And he brought together the people who spent so much time and effort in the selection process to weigh in on the topic.  It was an investment of several hours, and under a tight deadline.  But allowing the entire team to engage in bringing these other factors to light meant arriving at the decision that preserved the outstanding working relationships they had built together within the client organization, as well as with the finalist vendors who continue to support this client in other ways. 

We would like to hear from you how you use your “gut feelings” in your decision making.

Why Do IT Outsourcing Contract Negotiations Take Longer Than Expected?

AUTHORED BY GUY WOLF, TRANSFORMATION EXECUTIVE @ GUIDEIT

Guy Wolf, Transformation Executive @ GuideIT

Guy Wolf, Transformation Executive @ GuideIT

“We made the decision six weeks ago to go with the preferred vendor.  Why is it taking so long to finalize the contract with them?” a CIO asked us recently. 

Why, indeed?  We had performed the due diligence one would expect on a deal of this size, including the data center visit, the customer site visits and reference calls, and much more, yet after 7 weeks of late night meetings, we were still apart on the final contract and losing valuable time and leadership focus – not to mention the good will between the parties.  And yet we still could not nail down an agreement. 

Want to make this process go smoother for you when you are at that point? Here are some areas that will help you avoid the gap between decision and execution:

1.       Match the contract to the proposal.  A couple ways to go here: either start the Vendor’s paper or the Customer’s.  If using the vendors “boilerplate” it may be a time saver, or a time sink.  If the boilerplate contract is much different from the proposal that is being delivered, then there is needless wasted time in trying to “shoe-horn” something that doesn’t fit.   If the Customer has a standard sourcing contract (less common, but not unusual these days), it may save significant time finalizing the legal and security details.

2.       Minimize (hard to eliminate) late-breaking requirements.  In spite of your best efforts to research all the requirements and include them in the RFP, and validate them during due diligence, there is often a new requirement that comes up during negotiations that had not been provided to the vendor before.  Will there be a requirement to integrate IT Service Management tools?  A new set of security requirements that did not get entered into the RFP?  A higher limit of liability or consequential damages clause?  It’s possible to overcome some of this by getting people to commit to their requirements earlier in the process, but doubtful that will be 100% successful, as people get more focused on those things that they believe are imminent and likely. 

3.       Focus on the big gaps.  Not all issues are created equal, and if there’s going to be an agreement, there are going to be some issues that are harder and more important to agree to than small ones.  Avoid the trap of claiming to make progress by knocking out the small issues versus resolving the ones that are true show stoppers. 

4.       Know your objectives and positions and engage as partners, rather than adversaries.  You’re going to spend a lot of time together and require an open, trusting relationship.  It’s a good idea to start that way, and share with one another what the showstoppers truly are.  This will help you avoid negotiating as if it’s a competitive sport, and both partners will wind up with a deal they can benefit from.

Not an exhaustive list, but organizations (vendors and customers) who employ these techniques reach win-win agreements – or decide not to engage – sooner, and in a more positive relationship. We would like to hear what has worked (or not worked) for you.

What Defines A Good Leader?

AUTHORED BY CHUCK LYLES, CHIEF EXECUTIVE OFFICER @ GUIDEIT

Chuck Lyles, Chief Executive Officer @ GuideIT

Chuck Lyles, Chief Executive Officer @ GuideIT

A good leader is always striving toward bettering themselves as an individual and approaching every task with an attitude of servitude. The only way you are going to know what your team needs from you in order to be more successful is to listen to them. Successful teams perform much better when they know they have confidence that you chose the right team to get the job done.

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Listening, possessing confidence, and respect for, and in, your team are only a few traits that make up a great leader.  But leaders must also work toward bettering themselves as individuals if they want their team to listen, respect, and have confidence in them.  It works both ways.  Leaders must not only make a call to action to their team for these qualities, but they must make a call to action for themselves which requires lifelong tuning.

1.      Accountability

Extraordinary leaders take responsibility for everyone's performance, including their own. They follow up on all outstanding issues, check in on employees, and monitor the effectiveness of company policies and procedures. When problems arise, they identify them quickly, seek solutions, and get things back on track.

2.      Honesty

Strong leaders treat people the way they want to be treated. They are extremely ethical and believe that honesty, effort, and reliability form the foundation of success. They embody these values so overtly that no employee doubts their integrity for a minute. They share information openly and avoid spin control.

3.      Coaching

The best leaders guide employees through challenges, always on the lookout for solutions to foster the long-term success of the organization. Rather than making things personal when they encounter problems, or assigning blame to individuals, leaders look for constructive solutions and focus on moving forward.

4.      Awareness

A great leader conducts themselves in a way that sets them apart from their employees--not in a manner that suggests they are better than others, but in a way that permits them to retain an objective perspective on everything that's going on in their organization. 

5.      Decisiveness

All leaders must make tough decisions.  It goes with the job. Extraordinary leaders must possess a high level of independence and execute difficult and timely decisions made in the best interests of the entire organization. Many decisions require a firmness, authority, and finality, but an extraordinary leader also knows when not to act unilaterally but instead foster collaborative decision-making.

Human dignity, personal responsibility, and humility should always be at the forefront of a good leaders thoughts and executions, and it takes daily conditioning and effort. 

The most dangerous leadership myth is that leaders are born-that there is a genetic factor to leadership. That’s nonsense; in fact, the opposite is true. Leaders are made rather than born. —Warren Bennis

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Leader Achievement: Advancing People Forward

AUTHORED BY JEFF SMITH, VICE PRESIDENT OF SALES @ GUIDEIT

Jeff Smith, Vice President of Sales @ GuideIT

Jeff Smith, Vice President of Sales @ GuideIT

I have always been fascinated by the different leadership styles I have witnessed and have worked for in my 35 years in the IT field.  It is my belief that a leader, good or bad, has a direct impact on the achievements and accomplishments of those who work for them. I also believe that one’s leadership style is not something that is taught, rather is inherent in their overall personality.

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If someone in their everyday life is known as a caring, giving person, they will tend to lead with a style that emphasizes caring more about individual and team achievements than their own personal achievement. If someone in their everyday life is more self-centered, caring more about themselves rather than others, they will tend to focus on trying to advance their own career off the work of their subordinates, and spending the majority of their time managing UP versus managing across.

When I became a leader over an IT Business Development team in my early 30’s, I felt a calling to lead with the same personality and purpose that I believe I have in my everyday life.   I felt a responsibility to help others learn and grow, to have direct communications with them, to take responsibility, and truly wanted to contribute to the success of each individual, the team and a bigger purpose.  Our overall goal was to find, close and sign new business, which we did well.  But for me, signing business never yielded the same reward as watching the development of the team and individual team members, getting compliments about a team member, or having associates from other teams say that they would love to be part of Our Team.  And there was nothing better than having a newly signed customer tell you what they saw in us over the competition was a better team of people and a team that they wanted to partner with.

When you become a leader, it’s my belief that your greatest achievements come from the opportunities you provide team members for personal growth, from the recognition of your team members for their dedication and their hard work, and most importantly when you know and feel they embrace you and trust you as their leader.

So if you are a leader constantly ask yourself, how you can best lead them, serve them, support them and engage with them. When you are thinking of these things I believe you have achieved being a great leader. 

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Integrity - An Internal Compass

AUTHORED BY MARK JOHNSON, VICE PRESIDENT, MANAGED SERVICES @ GUIDEIT

Mark Johnson, Vice President, Managed Services @ GuideIT

Mark Johnson, Vice President, Managed Services @ GuideIT

Not long ago the call went out for a volunteer to write the next installment of our series of GuideIT Values blog entries.  With the topic being “integrity” I quickly said “I’ll take that one”, thinking to myself “hey that’s an easy one to knock out.”  Well, as it turns out, not so much.

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As I put fingers to keys I started with the predictable list of “challenges to integrity” but soon had to ask myself, how do you write about integrity in a way that doesn’t come across as either sanctimonious or overly simplistic?  And further, how do you translate a critical foundation of character into mere words?

At GuideIT our Founders adopted this approach in an attempt to express what integrity means to us:  “We will hold each other to unquestionable standards of honesty and ethics, in words and actions, and operate with transparency.”

Helpful, but still what does that mean?  If integrity in business meant simply being honest, it’s not a terribly high bar to clear, though isn’t it sad how some don’t?  No, too often we’re faced with opportunities to “pass or fail” an integrity test in far less visible ways, or ways in which there’s not necessarily a clear cut “right” answer.  That’s where the “unquestionable” part comes in.  The standard is clear, the measure remains harder to quantify.  But let’s face it – we all know it when we see it.  So do our fellow team members, and so do our customers.

Can you teach integrity?  I’d say yes and no.  Without question you can use day to day opportunities (and challenges) in business to guide your team members towards what it means to operate in the center of the ethical playing field, whether leading by example yourself, or providing specific guidance about your expectations for ethical behavior as situations arise.  So yes, you can absolutely teach integrity, but only to a point.

No matter how hard you work to establish an environment conducive to both earning and maintaining trust, inherently there is still an element of character that has to come from within, one that if missing will never consistently meet the expectation to operate with “unquestionable standards of honesty.”  To me, that internal compass is called having a conscience, emboldened with the courage to choose the harder right, rather than the easier wrong, even when the decision or the results may not be popular.  There are lots of people who know the right thing to do; at GuideIT we look for the ones actually willing to do it, and hold everyone, including our leaders, to that same standard.

At GuideIT our motto is “Do Technology Right.”  As I reflected on what I initially thought was a simple marketing slogan, my “ah-ha moment” was when I realized it also provides a straight forward approach to operating with integrity.  “Do Technology Right”, absolutely.  But how about, simply do what’s right.

I guess it wasn’t all that hard after all.

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How Do You Build A Team That Works?

AUTHORED BY DEANA EILAND, VICE PRESIDENT OF DELIVERY @ GUIDEIT

Teamwork...

Deana Eiland, Vice President of Delivery @ GuideIT

Deana Eiland, Vice President of Delivery @ GuideIT

Teams are a fundamental part of our work and personal lives.  But, creating a team is not the same as creating a team that works.  Just as joining a team is not the same as performing as a team member.  Very simply, teams do not work without teamwork. Active, collaborative teamwork towards a common goal makes all the difference.

How do you build a team that works?

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  • Be Aware of How You Work – Know your strengths and weaknesses, hold yourself accountable, course-correct and modify your approach if needed to ensure you are leading from a position of strength.
  • Get to Know the Rest of the Team – Invest the time to know your team’s individual strengths and weaknesses, how they are wired and what motivates them to excel beyond what is expected.
  • Clearly Define Roles & Responsibilities – Each of your team member’s responsibilities should be interconnected and dependent on one another.  Unique strengths and differences can convert into a powerful united force when aligned properly.
  • Be Proactive with Feedback  - Feedback is a two-way street and is key to staying on track and course correcting when needed. 
  • Acknowledge and Reward – People love recognition and appreciate respect.  Take the time to give your team the accolades they have earned and deserve.
  • Always Celebrate Success! – In today’s fast-paced world, people often don’t take the time to take a step back and truly appreciate what it took to cross the finish line.  Don’t ignore it.  Your team’s accomplishment was likely with some sacrifice by team members.  Celebrating their success and overall impact of the achievement is critical.

"The way a team plays as a whole determines its success. You may have the greatest bunch of individual stars in the world, but if they don't play together, the club won't be worth a dime." 

-Babe Ruth

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Individual Accountability, Part of A Whole

AUTHORED BY JOHN LYON, CHIEF OF FINANCE @ GUIDEIT

John Lyon, Chief of Finance @ GuideIT

John Lyon, Chief of Finance @ GuideIT

The reality of organizational life is never black and white.  More often than not, accountability is muddled and people are not fully aware of the direct connection between their efforts and results.  We tend to keep ourselves from being productive simply by not holding ourselves accountable for our actions.  It is of utmost importance to first hold yourself accountable for your own obligations, commitments, and actions before participating in a team environment. 

Accountability is about improvement.  Improve oneself, and the team will respectively improve. Tom Price nails it when he said, "One person's embarrassment is another person's accountability."  We are all in a leadership role, as all team members are responsible for contributing to the success of the organization.  As leaders, without accountability, an organization would cease to exist.  You not only betray yourself by not owning up to your responsibilities, but your team as well.

The major leagues would never send a player on the field who has consistently missed mandatory practices, for obvious reasons; such an action would diminish the collective hard work of the other team members, and scores would decline rapidly.  The same goes for any type of team. There must be rules and adherence. A pattern toward advancing success.  And that pattern begins with the individual.  

It is up to me and no one else to make sure I am doing what I know I should be doing. When someone has to hold me accountable, because I failed to do what I should have done, I have a serious conversation with myself. My belief is that no one should have to hold me accountable for my actions, responsibilities and goals. While I appreciate others helping me get better, I am the one that must hold myself to a high standard.

I am convinced if you want to advance your life personally or professionally, you must hold yourself accountable for your actions, responsibilities, and goals.  Think about it. Commitment is a choice and a decision that should be made responsibly. Why should it be someone else’s job to make sure you are doing the things that you know you should be doing?


Cyber Security Awareness

AUTHORED BY MARK JOHNSON, VICE PRESIDENT OF MANAGED SERVICES @ GUIDEIT

Mark Johnson, Vice President, Managed Services @ GuideIT

Mark Johnson, Vice President, Managed Services @ GuideIT

You pick up the paper or watch the news and it has become an all too common occurrence.  What used to surprise us is now sadly routine – breaches of cyber security.  In the early days these breaches were usually just an annoyance – most simply focused on defacing public facing websites.  Plug the vulnerability, re-upload your homepage, and you were back in business.  Almost seems quaint now doesn’t it?  Today the stakes are much higher, both from a commercial standpoint and from an international security standpoint as well.   

While much of the preventive focus for cyber-security justifiably falls on IT, the role of each and every user is critical as well.  From password security, awareness of social engineering threats, and prudent behavior when it comes to attachments and web-browsing, many enterprises are only as strong as their weakest user.  One of GuideIT’s managed services customers places significant emphasis on the importance of user awareness in their overall cyber-security program, and recently completed a Phishing exercise I thought worth sharing.

To establish a baseline from which to measure the results of an upcoming training program focused on Phishing, every employee was sent an outside email informing them that their email storage quota had been exceeded, and directing them to click an enclosed link to address the issue.  The organization’s Information Security policy dictated that they forward suspicious emails to the GuideIT Service Desk, who would either confirm/deny the authenticity of the email, or open a ticket to the customer’s Security Team for review.  So how’d they do?

·         90 people clicked the link - they failed the test outright.

·         50 people forwarded the note to the Service Desk AFTER clicking on the link, many asking, “Hey the link didn’t work; how can I get more storage??”  They also failed the test.

·         40 people forwarded the email to the Service Desk without clicking the link, and identified the email as a potential Phishing attempt – BRAVO!

Obviously no harm came of this exercise. But had the threat been real, the outcome might have been different.  The lesson?  First it’s worth emphasizing that this particular customer has an active IT Security Program using both internal dedicated IT resources, and the assistance of an outside Security vendor to audit and support their efforts.  Yet the majority of people who received the Phishing attempt “took the bait”.  With this particular customer, the next time a user fails a Phishing attempt they will be directed to a mandatory online training module to raise their awareness on the risks of Phishing – a great motivator huh?

The lesson to me is that even with strong internal programs to raise cyber awareness, your work is never done.  And if you don’t have programs in place like this customer, give serious thought to how your organization would perform if put under the same microscope.

Stay tuned; this customer plans additional testing over the course of the year to gauge the effectiveness of their training efforts.  I’ll be sure to provide an update when they do.

Adaptability. Essential to Success.

AUTHORED BY JOHN LYON, CHIEF OF FINANCE @ GUIDEIT

A common trait of reaping success is adaptability.  A multitude of challenging, unfamiliar situations inevitably occur throughout life. Both an individual and an organization must be open and adaptable to change when working through these types of situations to experience success.  To effectively serve our customers with the right solutions, we at GuideIT must have the ability to adapt as individuals, and respectively, as a team. Challenge and change are inevitable for our customers, therefore working with the flow of change is essential and crucial in assessing and helping them solve complex issues. 

John Lyon, Chief Of Finance @ GuideIT

John Lyon, Chief Of Finance @ GuideIT

Adaptability in optimizing technology means designing the business with a framework that allows for change unique to our particular customers’ needs.  This is why adaptability is one of our core values at GuideIT. We demonstrate the flexibility and agility needed to succeed in a world of complexity, ambiguity and change. Each and every one of my peers is adaptable, flexible, and collectively as a team we are able to evaluate obstacles and produce creative adaptable solutions to support the business objectives of our customers.

So with that in mind, here are some tips in personally embracing and helping to cultivate a culture of adaptability:

1.       Embrace spontaneity.  Carpe diem.

2.       Remain calm when unexpected change occurs. Very few things are forever.

3.       Find someone you admire with high adaptability and learn from them.

“There can be no life without change, and to be afraid of what is different or unfamiliar is to be afraid of life.”
― Theodore Roosevelt

Encouraging Maximum Potential

AUTHORED BY TIM MORRIS, VICE PRESIDENT, BUSINESS DEVELOPMENT @ GUIDEIT

Maximizing the greatest potential of an organization calls for an environment that fosters courage and encourages educated risks. Fostering and maintaining such an environment takes special care and attention.  However, an organization who's environment appreciates, nourishes, and respects courageous attempts will surely reap some truly amazing benefits:

Tim Morris, Vice President, Business Development @ GuideIT

Tim Morris, Vice President, Business Development @ GuideIT

  • distinctive separation from industry growth expectations and standards
  • more empowered team members
  • the best possible services and/or solutions not only suggested, but actually delivered to and realized by clients.

I recall an incident from my childhood when my father told me we were going to “paint the house”.  I was not quite six years of age at the time.  We lived in a small pier and beam house with asbestos shingles for siding.  I noticed, in the garage, paint my dad purchased. I decided to surprise my dad by helping out, and began painting the house myself.  I took the initiative to open the paint, and paint an entire side of the house.  Well, my father came out and saw me painting the siding, but his intentions were to only paint the trim instead of the entire side of the house.  However, I was not scolded nor punished for my actions, regardless of the misunderstanding and miscommunication. And regardless of the unintended outcome (clearly not a positive one), because of his gentle reaction, I was not discouraged.  That lesson taught me to always continue to try new things, and catapulted me at many times in my life into experiencing more than my peers.

Operating within existing guidelines and comfort zones is like playing in a sandbox; sustainable positive outcomes are predictable and a business can thrive and achieve consistent results within industry standards. But only with courage to be creative, and courage to take risks, is it possible to expand the sandbox and drive results that create milestones and surpass the industry standards. Indeed, each and every act of courage will not result in a positive outcome, but a leader's stoic reaction to failure is what continually fosters and enables courage in others. And it is through creativity, risk taking, and courage that opportunities open for major breakthrough changes.

Who Do YOU Trust?

AUTHORED BY WENDY DURRE, CUSTOMER EXECUTIVE @ GUIDEIT

Trust: Why is it that we use this word so often?  It is because we place great value on trust.  Trust is not a technique or a request, it is an emotional state.  To trust means to be vulnerable and accepting without evidence.  Trust is a feeling. 

Wendy Durre, Customer Executive @ GuideIT

Wendy Durre, Customer Executive @ GuideIT

Think back on your experiences....How did you learn to trust?   Was it through positive or negative experiences?  Regardless of how you answered this question you undoubtedly learned to trust. 

This life lesson applies in our work life just as it does our personal life.  Trust is a valued commodity that we may not consciously think about on a daily basis.  We have trust relationships with our employers, customers, sales people, peers and many others.  These relationships are formed based upon many factors, however several stand out:

  • Reliability
  • Perception of Confidence
  • Intentions
  • Unguarded Two Way Communication

When I experience the above in my everyday relationship with someone, I consider that to be a successful trust relationship.   They are my trusted advisor.  I strive to build these types of relationships with my customers each and every day one interaction at a time through honest open communication.   I would love to hear how your build and nurture your trust relationships.  How do you build trust?