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How Important is Organization Development? It Can Even Save Lives!

In late March of 2010, I was watching the usual Sunday morning talk shows when 11 TV Hill, the local public affairs program on Baltimore’s WBAL-TV, came on. Before the opening credits, they teased the interviews they were doing that day, one of which was with Peter J.Pronovost, M.D., Ph.D. of Johns Hopkins Medicine, who was going to talk about his work to reduce the incidence of infection in hospitals.

This particular show aired about a month after my father passed away and about a year after we lost my mother. Although they each had their own separate underlying health issues, a contributory cause of death for both of them was sepsis, a serious blood infection. So, needless to say, the possibility of reducing the occurrence of infection was a topic that grabbed my attention.

Dr. Pronovost’s work in this regard dealt specifically with the use of intravenous catheters. He developed a five-step checklist for these procedures, which includes such seemingly simple things as the doctor washing his or her hands and cleaning the patient’s skin. He implemented the checklist in studies at Hopkins and in hospitals throughout Michigan, where the rate of infection was virtually eliminated. The checklist is now being implemented across the United States and in other countries such as the United Kingdom, Spain, and Peru.

What’s relevant to organization development (OD) is Dr. Pronovost’s contention that it’s not his checklist that’s important so much as changing the culture inside hospitals. The checklist is simply a tool to encourage communication and strengthen working relationships within the medical team. As he writes in an editorial for the Huffington Post, “Checklists can work, but it's not enough to merely hand doctors a piece of paper, we must respect and acknowledge each member of the care team and measure results.” The most junior nurse should be empowered to stop the procedure if he/she sees even the most senior doctor forget something like hand washing. Doctors, who are busy juggling the cases of several patients, should give themselves permission to be human and allow that they’ll occasionally forget something. Rather than seeing a nurse’s reminder as a challenge to their authority, doctors should be grateful that the rest of the team is there to back them up, and to point out an error while there is still time to correct it, before it causes harm to the patient.

It’s this kind of communication between members of work teams that lies at the heart of organization development.

Also interesting from an OD perspective is that, although Dr. Pronovost would like to see every hospital use his checklist, he doesn't want it mandated by legislation. He believes such a requirement would stifle innovation. If his specific checklist were mandated, that might inhibit another practitioner in another hospital from innovating and discovering items that should be added to the checklist or replace items already on it, or from finding another way to better engage all members of the medical team, which is really the objective. This inhibition could prevent his checklist, which is good, from giving way to something better that might save even more lives.

Given the specifics of my parents’ illnesses, it’s uncertain that Dr. Pronovost’s innovations would have saved them. But it is heartening to note that his work has saved others from the same kind of demise and spared other families from watching loved ones die this kind of death.

By devising and implementing his checklist, and by using it to enhance communication in hospitals, Dr. Pronovost is creatively improving operations within the very complex medical field, and yielding much better outcomes. Applying such OD principles as he has can have immensely positive results in any organization, across all fields of endeavor. It is gratifying to see the impact these principles can have, even to the point of saving people’s lives.

For more information on Dr. Pronovost's work, I recommend the book he wrote with Eric Vohr, Safe Patients, Smart Hospitals: How One Doctor's Checklist Can Help Us Change Health Care from the Inside Out, available at Amazon.

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