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.