I remember in my Creative Writing class (oh, so long ago) that we discussed the importance of starting en medias res, or in the middle of the story. It's a great way to capture your readers attention and get them "hooked", ensuring they will continue reading. You can do retrospective exposition later...
So here I am after 5 months at CCRMC, an award winning public hospital system, trying to unlearn the things I have learned my entire life. I thought I knew about hospitals. I even thought I knew about CCRMC. I have discovered, however, that all my training was purely superficial. I knew a lot about the end-user experience, but very little about how things were run. The difference being behind the scenes is immense. Everything is so dynamic, fast-paced and merciless. People are constantly aware that lives are dependent on their actions, yet they can't stop and think about that or they run the risk of overthinking their jobs and might make a mistake. And there is nothing more scary in healthcare than making a mistake.
At CCRMC, they are trying to change that. I cannot express how refreshing that is. I have here been introduced to the concept of a Just Culture. Where mistakes are failures of the system, not people. Where managers ask not, "What did you do wrong?" but "How did we fail? What needs to change so this doesn't happen again?" It's an acknowledgement that if you have designed a system to be totally dependent on a single decision in a single moment in an unforgivingly stressful environment, you have set staff up for failure and patients and families up for harm. They..no, WE, have a different goal. Even if a mistake wasn't made, but it could have been, reporting is encouraged. System improvements are respected no matter who suggests them. Patient care isn't the lone purview of the doctor. The nurses, housekeeping staff, even the patients and their families speak up and point out what could be better.
It's like a breath of fresh air...right before rushing off to the next thing.
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