Jeffrey Saltzman's Blog

Enhancing Organizational Performance

What Would MacGyver do?

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There is an old folk tale that describes a young man, mentioned as somewhat of a fool, who upon getting married was given a dowry by his father-in-law and told that he should become a merchant, in order to provide for his new wife.  Upon being swindled in his first transaction, he comes to the realization that if he could read he would stand a chance at perhaps being somewhat more successful as a merchant, and less likely to get swindled in his next transaction. He heads off to the nearest large town in order to take reading lessons, lessons which he was told would take between 6 month and 1 year to make him proficient in reading. Upon entering town on the cobblestone streets, he comes across a spectacle shop in an alley and with the door to the small ancient looking shop open he overhears the proprietor asking a customer, as he adjusts her new glasses, “Can you read now”? To which the customer replies, “Yes, that is much better, I can read now”. The newly-wed and newly minted merchant of course must enter the shop, and ask the proprietor for glasses for he too is having trouble reading. How wonderful, he thought, rather than spend 6 months to 1 year working hard at learning how to read all he would have to do to become proficient at reading is put on a pair of glasses! The proprietor after trying pair after pair of glasses comes to the realization that the reason this new customer can’t read has nothing to do with his eyesight. Upon stating that conclusion to his customer, his customer complains that the glasses worked for that other organization …ops… I meant person, so why wouldn’t they work for him as well?

Correct diagnosis of a situation is critical to successful problem solving implementation. What works for one organization may not work for another and the magic silver bullet fixes that organizations often seize upon may offer no better organizational reading ability than where they are today.  While the tools of choice may vary depending upon your specialty, comprehensive, customized organizational surveys for me have been the method of choice, along with focus groups and interviews to obtain the information necessary for a correct diagnosis on issues surrounding organizational culture and its ability to impede or enhance performance. Sometimes even if you correctly diagnose the situation though and know what has to be done to implement change, provide service to a customer, help a fellow employee or maybe even save a life, established procedures, authorizations, bureaucracy, silo thinking, inertia and organizational entropy get in the way of a successful resolution. Persistence or sometimes just flouting the system sometimes does pay off – especially when you know you are right.

I know a surgeon who was describing to me a particularly tough operation he had the other week. He was removing part of the colon of a person with colon cancer. There is a vein that runs through the pelvis which can get cut during this procedure and upon the severing of this vein, just as a band under tension retracts upon being cut, this vein will sometimes retract into the porous surface of the pelvis, with blood upwelling from multiple small openings in the boney surface. This is a life threatening situation, and patients have been known to bleed to death on the table when this happens. He spent a great deal of time trying to stem the flow of the blood. Clamping doesn’t work as there is nothing to clamp. The blood is just seeping up through the bone. He tried a type of surgical epoxy glue, covering the surface of a portion of the pelvis, he tried cauterization, staples, the blood kept oozing. He then thought of a technique that he had seen as a resident. He asked the OR staff if there were any stainless steel surgical thumbtacks available. The staff said no, that they were not standard equipment kept for surgical procedures. He sent people to scour the bulletin boards of the hospital to see if they held any stainless steel thumbtacks. They did and the OR staff began collecting them. As they were running them through the sterilizer the surgeon had to get approval to use the thumbtacks in the operating room. Not standard he was told, not according to procedure. You could fill out a form and seek approval, I guess, but there were long odds against the patient living that long while forms were approved by the powers that be. A partner in the surgical practice was called upon to see a hospital administrator and explain the necessary reasons for violating established protocol. Meanwhile for an hour and a half, the patient lay on the table and had utilized 6 units of blood as the bleeding continued. Approval was given to use the thumbtacks and the surgeon push about 10 of them into the pelvis, in the area surrounding the upwelling blood. About 10 minutes latter the bleeding stopped. The thumbtacks will be a part of this person for the rest of their life, which thanks to a surgeon willing to go outside the box, will hopefully be a long one, but I bet the patient woke up with a very sore back.

This surgeon has a track record of being able to go outside the box as evidenced by the OR staff giving him a tee shirt with the words “What would MacGuyver do?” emblazoned on the chest, in reference to the TV show popular a number of years ago.  He also sometimes sports another tee shirt that supports the use of duct tape for a variety of uses, but that is another story.

Correct diagnosis of issues, whether it is the need for glasses, or a more fundamental lack of reading ability, or reasons that prevent employees from getting their jobs done easily while providing exceptional customer service, or producing high quality products are important to uncover. Making assumptions on the causes, especially assumptions based upon what has worked or not worked elsewhere are often misguided. Additionally though organizations need flexibility, to be innovative and to get things done in ways that are not always according to protocol – and hopefully done before the patient or organization dies. Folk tales were originally designed to teach us lessons (in addition to scaring little children) and many of their messages are still relevant today. And lessons can also be learned from an environment were most people do not expect or think that innovation is happening in real time – the operating theatre. But innovation is needed in everything thing we do, it is how humans progress and cope with changing environmental circumstances. Lack of innovation or lack of innovation on the correct issues is to seal your fate into organizational oblivion.

Written by Jeffrey M. Saltzman

October 22, 2009 at 10:33 am

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