Guest Columns

Using the right filters when looking through the lens of healthcare reform

Martie L. Moore, RN, MAOM, CPHQ
Martie L. Moore, RN, MAOM, CPHQ

The sky was brilliant blue, the evergreen trees rich in their shade of green. I knew today was going to be perfect for capturing the beauty that nature had to offer me. 

I looked upward and suddenly spotted an eagle soaring with outstretched wings. With sun streaming through his feathers, I was sure I would capture one of the best pictures I had ever taken.

I didn't. I forgot to add my polarizing filter, which helps to increase color saturation and reduce reflections. The picture was washed out and didn't give the viewer the same intense feeling of color and grandeur. I had missed the shot.

I missed a beautiful picture because I failed to use the right filter — or a filter at all — on my camera. I found myself reflecting on how many times as a healthcare leader my overuse of filters might have cost me as well. 

Healthcare is one of the most complex businesses there is right now. The use of filters influences decisions and actions on a regular basis. The human brain is capable of 10 to the power of 16 processes per second. This makes the brain more powerful than any computer currently in existence, including IBM's Watson.

But, sadly, that doesn't mean the human brain doesn't have opportunities for improvement. The use of filters can often impair the brain's ability to view issues, challenges and opportunities with the brain's full capabilities. The words “change” or “reform” usually bring on an immediate filter in the minds of most healthcare leaders. The unwarranted filter used when looking at change is the assumption that another choice or action will be inferior or make matters worse. Some call this filter the status-quo filter.

The status-quo filter helps to settle feelings of uncertainty and assure normalcy, but it is a fragile screen to use when it comes to today's environment. 

Another filter frequently used by healthcare leaders today is Occam's Razor filter, which assumes the most obvious decision is the best decision. Ockham (also called Occam) was a 14th century logician who felt one should not make unnecessary assumptions. He also believed the answer to a problem is often the simplest. While his theory has lived on in business and economic models, the migration into healthcare has been slower. Occam's Razor filter is a good one to use when looking at reduction in variation of care.

Standardization of practice must occur across care settings. Leaders need to look to the evidence and utilize what is understood practice to provide the best outcomes. That is Occam's razor filter in action.

A fallacy that leaders make is leaning too heavily on one filter over others. In the world of photography, there are six filters photographers must have in their bag. Healthcare is still developing the filters needed for the future. Two up-and-coming ones in healthcare: Filters of inquiry and silo reduction.

The filter of inquiry allows the brain to think of “What if?”  Innovation is typically the outcome.

The filter of silo reduction is a harder filter to put into practice. Here's an example: Look at the following math equation: 6 + 4 = 4. Now pretend the numbers and symbols are made of matches. How do you move one match to get the same answer?  I stared at the puzzle forever. My husband sat down, looked at the picture and said, move the match from the plus sign to make it a minus and change the six to an eight. I could only see the math problem through my filter of addition. In essence, I had used a silo filter.

The sheer magnitude of silos has often created one of healthcare's biggest challenges. Looking at how to reduce silos and truly make care transitional and seamless is the call to action for all of us.  Utilizing all of the right filters as we design a new system of healthcare will be the challenge. 

Martie Moore, RN, MAOM, CPHQ is the chief nursing officer at Medline Industries Inc., the nation's largest privately held manufacturer and distributor of medical supplies and clinical solutions. In addition, she is a corporate advisory member for the American Nurses Foundation, the philanthropic arm of the American Nurses Association (ANA). 

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