Thinking Outside the Box

In a few weeks I will be giving a presentation and leading discussions on “thinking outside the box”.  I thought I would try out some of my ideas here on my blog.  The presentation will be for a local hospital system as part of their “Focus on Excellence”.  They are seeking new ideas for reaching ambitious performance outcomes.  I was invited to bring ideas about complexity leadership and nonlinear relationships.

Today I sat in on a presentation by a nurse leader who has a Doctor of Nursing Practice degree and observed the group work and discussions she led.  I was very impressed with the level of knowledge in the group regarding Six Sigma, Deming’s PDSA cycle, and Principles of Change.

I think I will employ the “box” metaphor by introducing four sides of the box that confine our thinking in health care and oversimplify the exquisitely complex environment within hospitals.  Those environments can become even more challenging for hospitals which operate as for-profit organizations, constrained by policies developed at a distance by persons who have little if any first-hand knowledge of the effects of those policies on actual staff and patients.

As I said, my box will have four sides.  Each side represents a limiting factor that can keep us from seeing realistic, effective, measures for improving care.  The sides include 1) the language we use to name and discuss problems and solutions; 2) our basic ideas about how the world does or should work; 3) prevailing scientific tools for solving problems; and 4) fear and mistrust of those operating within the environment.

Over the next few weeks I will cover one of those sides and would really appreciate your observations, critique, and discussion of the material.  Stay tuned.

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I am professor, emeritus, of nursing at Texas Woman's University, Denton, Texas

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