But ... we've always done it this way
Jacqueline Vance, RNC, CDONA/LTC
Have you ever made a boneheaded decision despite someone showing you the facts or evidence? You know the kind: You dug your heels in the sand and stuck to your guns because, daggone it, you've always done it this way (and nobody is going to come in and tell you there might be a better way)!
It doesn't matter if there are facts, new technology or evidence-based processes. Your way is the best way and no one is going to change your mind.
I've got a question: How's that approach working for you? I'll be honest. Almost nothing burns my cookies more than when someone says, “I've always done it this way,” despite having poor outcomes.
Here's an example excellently written by Joel Barker in a book titled “The Future Edge.” In 1968, the Swiss watch industry owned the market. They were creating the finest timepieces known to man. Sixty-five percent of every watch made and sold was a Swiss watch. The Swiss watch industry made 85% of all profits on watches internationally. They dominated the market.
That same year, their researchers discovered a new technology called the quartz crystal. They reported to management that this crystal would be 1,000 times more accurate than the springs and gears in the current timepieces, was electronically driven, needed no manual winding and would last a lifetime.
Now here comes the stupid decision. The managers basically said, “Who would want that, when they can have our gears and springs- a Swiss made watch?” In other words, “we've always done it this way and we're sticking to it.”
So, that year at the World Watch Conference (yeah, there is such a thing) the owner of a small Japanese Watch Company called Seiko-Casio saw the research on display from the Swiss — yes, they revealed it — and decided this was the future. So he jumped on it.
Fast-forward 10 years. The Swiss watch industry went from 65,000 employees to 10,000 employees. They lost 80% of their gross profits. And while they watched Seiko-Casio dominate the market, they still didn't adopt the new technology. With their own eyes they saw that there was a better way, but perhaps it was pride, they dug in their heels and lost their industry. Because, “we've always done it this way.”
In my many years of managerial experience, I have seen so many people make that same mistake.
Despite showing evidence that the processes they think are so perfect are not achieving measured quality results, they get insanely insulted if you attempt to question their “why” and show them a different way. It's almost like “being right” is more important than getting “to right.”
I had the privilege to work once with Dr. Daved van Stralen, who incorporated the principles of High Reliability Organization into the culture of healthcare, on a high reliability project with the Joint Commission. I learned so much from him. And I learned that to reach high reliability, we need to ask questions about why we do certain practices. That's because if we're not achieving the outcomes we want, then something along the way isn't working.
You could have the most “perfect on paper” process, but if it isn't working in real life, something is broken and needs fixing. Maybe there is a better way to do “it.” Maybe nobody is being held accountable for their part. But somewhere in there, it's not working.
So if you “own the process” don't get bent out of shape when someone tells you there might be a better way or that a piece of the process broke. Be smart, ask questions, look at the evidence and fix it.
Otherwise, one day you might just “we've always done it this way” yourself out of business.
Just keeping it real,
The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, an APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.