Essays

Essays November 2013

Can We Achieve Wholeness In Healthcare?

Kavita Singh and Hugh MacLeod

On the balcony of “personal reflection” no one is talking about wholeness. When we speak of the healthcare system, we are inferring that there is something whole to speak about, that one may move seamlessly from one component to another and experience positive outcomes as a result. Unfortunately, studies concerning the rates of medical errors, and the stories that we hear from patients directly, suggest that the system is in need of repair. Wholeness can be achieved when the system’s individual components work in harmony with one another. This harmony can only arise if there is a shared commitment to achieve goals that benefit all who encounter the system. In healthcare, our overarching priority should be to produce the best possible outcomes for patients. It is important that the goals we aim to achieve are well articulated and agreed upon by all parties. Only then will all decisions and actions align accordingly to produce the desired result.  

Most of us in the healthcare field were quite idealistic when we first began our careers – our primary aim was to help our patients, to improve the delivery of patient care and to help the community. But over the years reality likely set in, and we encountered several barriers that challenged our ideals. We faced limited time and resources, turf wars between the professions, inadequate dialogue among and between members of the system, fear of disturbing the status quo, etc. The ideal may have changed to the reality of just getting through the day!

The Ghost of Healthcare Consciousness adds a perspective and with it questions:

“To begin the venture of making the healthcare system whole, every one of you working in the healthcare field should pause for a moment and re-evaluate why you are doing what you are doing. Has your choice of work become merely a job to make ends meet, or do you still strive for higher values of patient care and optimal patient outcomes?  You should also reassess what qualities in yourselves may be inadvertently affecting the wholeness of the system?”

How many of our actions are dictated by fear? Do we just complain about the challenges we face, or do we take constructive action to overcome them? How much do we communicate with other members of the healthcare team, or even within our own team? Ultimately, wholeness in the system begins with each one of us. We must attempt to change whatever needs to be improved within ourselves. And if system-related factors beyond our individual control need to be changed, then we should bring our concerns forward to those who can affect change and initiate a dialogue to make things better. Eventually, the values of patient care should be so ingrained within the entire healthcare system that collaboration between members is effortless, and deficiencies within the system are recognized and remedied in a timely manner. Wonderful things can happen when we all work in harmony for a common goal.

Three recommendations for your consideration:

  1. Clinical peers are jointly accountable for overall performance within their control.
  2. All clinical occupations are equally valued and integrated into the quality and patient safety improvement culture and rewarded or recognized for identifying deficiencies in the promotion of a culture of patient safety.
  3. Organizational measurement, evaluation and feedback systems are focused on team performance and processes.

We close with this passage from the essay, “Self-Organizing Change”:

“It is not about tinkering on the edges, or cutting on the margins anymore. It is about introducing deep changes. Such change must combine the rich wisdom and experience of people in the system with the imagination and passion of “outsiders.” Giving employees, patients, caregivers, community leaders and citizens a greater say in the future direction and workings of our health system necessitates that we as leaders diminish and decentralize our sphere of control in favour of facilitating more local knowledge and open decision-making. Relationships built on mutual trust and respect are implicit for this process to work.

“To be truly successful at healthcare transformation, we must believe this: People matter. But we can’t just put our faith in this belief – we must act on it always. Action will build trust between employees and leaders and between organizations and communities. People will begin to realize they have the capacity to have an impact in ways that were never before possible. The motivation, ultimately, is to make a positive difference, rather than to command power and control.”

George Smitherman, the former Minister of Health and Long-Term Care for Ontario, often made this comment: “The more I look for a healthcare system, the more I do not see it.” 

Join the conversation posted today: Three Management Voices: A New Dynamic Wholeness – Both Our Minds and Our HeartsWhy Is It So Hard To Admit a Mistakeand Can We Achieve Wholeness in Healthcare?

Next week’s conversation is titled:“Stop Calling Healthcare a System”

Click here to see the First Series of Ghost Busting essays.
Click here to see essays from the Second Series: The Ghost of Healthcare Consciousness. 

About the Author

Kavita Singh … Pharmacist, Researcher, Sister, Aunt … Lifelong Learner.
Hugh MacLeod, CEO Canadian Patient Safety Institute … Patient, Father, Husband, Brother, Grandfather … Concerned Citizen.

References

MacLeod, H. and S. Sharkey. 2013. “Self-Organizing Change.” Longwoods Healthcare Ghost Busting Essays. 

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