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Paul’s Post – What can we Stop doing?

17 October 2014 6 Comments
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Kate DeVuono, Program Assistant in the administrative suite was the impetus for this blog – she has some great ideas about what we can stop doing in order to create more time for the important stuff and she encouraged me to write this latest blog.

Over the past few weeks I have become extremely aware of the high degree of stress that our whole team at every level is under. While we cannot completely eliminate stress, we can control how we respond to it to a degree.

Last week, I asked all the VP’s and Directors to document their concerns as part of a creative problem solving approach to coping with stress.

The highlighted issues were as follows:

  • Deep listening! Act on what you hear. When we ask for a pause – please pause!
  • Learn how and when to say “No”
  • Define the priorities and stick to them.
  • Identify leaders and participants required (same people on multiple priorities)
  • Develop a priority de-selection process
  • Make sure the number of metrics are manageable so we don’t feel like we failed
  • Allow flexibility and autonomy so managers can take the learning and implement in a way that works best for their units

We reflected on the major large work components that we need to support throughout the year which include:

  • Clinical Daily Demands and Pressures
  • Supporting our People
  • Budgeting
  • Service Planning and Program Development
  • More Time to Care
  • All projects as a bundle

The big priority items need to be reprioritized every 3 months by the collective leadership group. For example, we agreed that budgeting and benchmarking was the priority for the next 3 months. There will be work happening consistently in all areas, but we should not be adding new components during a quarter when that large work component is not prioritized.

As a result the senior team and Directors will regroup every three months to look at affirming and deselecting priorities. For each major area, 1 or 2 sub-priorities will be selected. When looking at the priorities quarterly, we will be ensuring:

  • relative focus
  • timing
  • rates (progress)
  • consideration of participants and the demands on their time
  • communication of the list of priorities and their status to managers and the physician group

The moral of the story is we have to respect each other as team members through active listening, learn to stop doing some things that are not as critical, and constantly clarify what the priorities are.

Please consider applying this advice with managers and front line staff. Thank you all for your incredible efforts.


  • Angele said:

    Active listening is definitely a major key aspect to improved health care. Thanks for sharing; that Kate is a smart cookie 🙂

  • Robin said:

    Excellent ideas, Kate!

  • robert said:


  • robert said:

    An excellent idea we should not be adding components to ccu like race, code blue team, 16 tele packs, ekg, iv starts when the nurses already have a full work load. and now we have ebola I hope the er getts extra staff because the flu season is about to start and every fever will bring new stress and work load! more time to care is insulting to the nursing staff we have less time then ever, we take work load assessments please post results

  • Paul said:

    Robert – I agree that we need to rationalize the rate of implementing new “things” which was the point of my post. It is particularly true in Emerg where I know there are big workload challenges. However, I cannot agree that More Time to Care is insulting. It is about continuous improvement and involving staff in those efforts. It should never be called a joke. That is disrespectful of a lot of our team members and not consistent with our values.

  • robert shane said:

    name correction Robert “Shane”