What Engineers Need to Know about Clinicians

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Leadership and Cultural Change

Joseph Quetsch
Consultant, Care Process Remodel Associates

Management Engineers (MEs) have a set of world views, methods and traditions that are often foreign to clinicians. As MEs move from pure business operations toward clinicians providing care, ME awareness of the clinician's beliefs or what the clinician hears when the ME speaks may facilitate improvement and teams.

The word "Quality" has for decades been a euphemism. Clinicians are wary because "quality" initiatives sometimes degraded patient care and cost clinician time or money. Alternate words and thoughtful approaches are required to keep clinicians' cooperation.

Clinicians think systematically but are likely to think of external organizations, imposed guidance schemes, or game mechanisms when they hear "system". MEs may have to cleverly educate clinical colleagues in systems thinking and make extra effort to communicate which aspect is being addressed now by the ME.

Clinicians have legitimate objections to simplistic or naïve guidelines, measures, standards or systems. Unfortunately, good ideas may be pre-judged as yet another attempt. MEs are advised to employ the science of Complex Adaptive Systems when communicating with clinicians or improving systems. Example: define clinical guidelines as attractors.

Knowledge and values define health professionals. Skills or performance or results were less important. Medicine, nursing and technical professions are reviewed. Fear of malpractice or professional discipline is rational. MEs are advised to address core values and reframe the presentations of an idea to match health professionals' concerns.

Method: Speaker's observations back up by review of healthcare or adaptive systems literature per topic or point or specific suggested advice.