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.

As a leader on the cutting-edge, Levy is taking on that challenge, and seems to be having some success on that balancing tightrope. He understands – and makes is his job to explain to his staff, as a good leader should, – the connection between calling out problems and maintaining a safer workplace:

We need to improve the way we organize work at the hospital to make it more efficient and less expensive. We have taken some baby steps in this direction with BIDMC SPIRIT. This program incorporates “Lean” type of thinking by encouraging people to call out problems in the work place, analyze those problems to their root cause, and invent solutions. If done right, this kind of continuous process improvement makes a safer and more pleasant workplace for our staff.

I’m keeping my eye on Paul Levy’s blog- seems pioneering and “leaderful” to me!

1. In fact, there are several blogs of CEO’s, including those of Whole Foods, Marriott, NU Horizons – but they don’t seem to have the same organizational earning focus of Paul Levy’s.

2. The Boston Globe reported in July 2008 that “Figures from the Department of Public Health show that in the first five months of the year, hospitals and doctors statewide have reported five wrong-sided surgeries.”

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