refuse to settle: the journey from ordinary to extraordinary
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Refuse to Settle: The Journey From Ordinary to Extraordinary. Bruce Spurlock, M.D. Cynosure Health. It is natural to settle for less than the best – why ? What happens if we refuse to settle ? How do we move from ordinary to extraordinary?. Stage 1 - Becoming aware that you are settling. - PowerPoint PPT PresentationTRANSCRIPT
Refuse to Settle: The Journey From
Ordinary to ExtraordinaryBruce Spurlock, M.D.
Cynosure Health
1.It is natural to settle for less than the best – why?
1.What happens if we refuse to settle?
1.How do we move from ordinary to extraordinary?
Stage 1 - Becoming aware that
you are settling
Normalization of Deviance
violations
acceptable risk
migration
normalization of deviance
intentional non-compliance
I can handle it.
I can get away with it.
I can’t help it.
Everyone does it.
Its what they really want.
They’ll turn a blind eye.
Delay in feedback
Examples• Hand Hygiene• Readmissions• VTE prophylaxis
• Poor surveillance• Inadequate or no data collection• Overlooking the hard stop
Misinterpretation of results
Examples
• “I never have these types of complications”
• “The data are wrong”• “The problem is with X department”• Good catch – we don’t need to worry
about it
Stage 2 – Seeing what is possible
Shock Alert Outcomes
From Sebat, et al. Chest 2005
Mercy Hospital, Oklahoma City
Already Low Rates
This is excellence!
Northern New England Cardiovascular Group
Benewah Community Hospital
Stage 3 – Launching an Effective
Action Plan
Have you ever performed an RCA which resulted in the following
conclusion:
1. Policy is correct.2. Policy not followed.
Step 1 - Find one patient story a month
Step 2 – Get great ideas from each other
www.hret-hen.org
Step 3 – Use a system for improvement
Direct the Rider
Motivate the Elephant
Shape the Path
1.It is natural to settle for less than the best – why?
1.What happens if we refuse to settle?
1.How do we move from ordinary to extraordinary?