The wrong priorities and objectives

At the weekend I met up with a friend who is a completely dedicated doctor. She told me what had happened recently at her hospital. She looked at the new rotas and pointed out to the managers that they might be better for staff in some way, they would result in worse patient care.

“You sound as though you think we should put patient care first.” Responded the manager in tones that indicated that this was not his goal.

My friend was horrified.

Patient care is the priority

If any manager in the NHS is not intent on putting patient care first, I think we really need to ask what he or she is doing in that job. We need to know why they were recruited and who was responsible for such an error.

I would find it hard to justify their continuing employment.

Good patient care does not cost more

As we talked I was glad to see we were in complete agreement. Good patient care does not cost more. Often it costs less.

A young friend who is currently working as a healthcare assistant told us that part of her job is to move food from where one person has put it - just a few inches out of reach of the patient - to where the patient can reach it. She does the same for their drinks.

This is completely wasted effort and it is inexcusable that people are so badly managed that they are apparently completely unaware of the priorities in their work.

The objectives are wrong

In a case like this it is clear that the objectives at the top are wrong as are the priorities. These things need to be got right by those in charge. Otherwise no one stands a chance, patient or employee.

5 Big Change Mistakes - 3 No Clear Priorities

When you are making changes, often there are many things that need to be done, and it seems like they all need to be done at once.

People have to carry on with their everyday jobs, but they also have to make the changes.

Make a plan. This may seem like extra work when you are already busy, but it will save you a great deal of time and money in the long term.

Get the objective clear

Once you have clearly identified what needs to be achieved it’s vital to work out a plan. This can take some time and is more difficult when you are panicking.

The first step in working out a plan is to be really clear about what you need to achieve. Spend some time working out your objective and get it really clear.

Then work out your deadline.

I always like to leave a little leeway here, but it’s not always possible.

Make a list of your tasks

Once you have done this, one option is to work backwards from the deadline. This should help you to identify all the tasks that need to be completed in order for you to implement your change.

Don’t make it hard – check with the others who are involved and ask for their input and advice.

Estimate how long each task will take

Once you have a list of all the tasks, it’s useful to estimate how long each will take. Most people tend to be rather optimistic when they do this. So make sure you allow some slack for problems you haven’t anticipated.

If it’s something you haven’t done before ask others who have, how long it really takes and what their suggestions are for completing the task easily and efficiently.

Identify your critical path

You may also want to work out your ‘critical path’. These are the tasks that are linked and have to be done in a certain order and can’t be made shorter. For example, if you are cooking your Christmas dinner, the turkey is often the critical path.

You have to buy it, prepare it (with stuffing and so on), cook it and carve it. You can’t carve it while you’re cooking it, or prepare it while you are buying it. All the tasks have to happen in that sequence. And there is a minimum time for the whole thing that you can’t reduce.

If you buy it on Christmas Eve and prepare it then put it in the oven at midnight (depending on the size) it won’t be ready before midday on Christmas day. If you put it in the oven late or if the oven breaks down (as happened to a friend of mine) then the whole dinner is going to be late and you can’t catch up.

So this is part of your plan that you need to focus on and get right.

Finalise your plan

Put your tasks in order. What needs to be done when and who needs to do it. Be very clear about when tasks must be completed.

Let everyone know

Make sure people know what needs to be done first and why. This will make it much easier for them to prioritise all their other tasks around the changes you are implementing.

Keep people up to date with progress and any modifications to the plan. Give them reasons.

Be clear about other ongoing work and how it fits in and what needs to be done first. Make sure people get some help if their workload is going to be drastically increased.

For a summary of five big mistakes when implementing change see this article

5 Big mistakes to avoid when making change