by Bonny Roberts, Vice President, Customer Experience, Aventura
I frequently hear colleagues, partners and customers talk about how slow healthcare is to change. It is true, healthcare is a big ship; yet I don’t blame the individuals and organizations for the industry’s microscopic course alterations. In the field of healthcare, and particularly when it comes to workflow, there is a strict doctrine of behavior that has been passed down for decades. While the focus of healthcare and the financial implications of actions and results have been adjusted across the years, few have gone so far as to address the actions themselves. Innovation requires someone to identify a problem and step back enough to either imagine a different result from the actions taken or to design different actions altogether. However this is far from easy if you come from a place of habit and don’t even recognize that those actions exist, much less can be altered.
Most habits are good things – they allow someone to defend and protect the individual, their credibility, their productivity, their stress level – so to break habit is uncomfortable. The book The Power of Habit: Why We Do What We Do in Life and Business, by Charles Duhigg, begins by explaining what habits are and how they become so wired in our brains that we are not only unaware of them and how they influence our actions and thinking but in many ways are seemingly powerless to change them. Duhigg states that habits make up 40 percent of our daily routine and consists of a ‘three-step, habit loop.’ “First, there is a cue, a trigger that tells your brain to go into automatic mode and which behavior to use. Then there is the routine, which can be physical or mental or emotional. Finally, there is the reward…” (19)
But what about risk? In healthcare, not only is the potential for and reality of bodily harm an everyday concern, but the legal ramifications for the clinician and to the hospital are enough to dissuade the risk taker in most all of us. In 2011, the Centre for Health Policy, Institute for Global Health Innovation (Imperial College, London), published a white paper, entitled The Five Bad Habits of Healthcare: How New Thinking about Behaviour Could Reduce Health Spending. Not to kill the journey for those planning to read this paper but the five habits cited were:
- Favoring current practice over the best available evidence
- Following what others are doing even when it is wrong
- Behaving as if more healthcare is identical to better healthcare
- Focusing on illness at the expense of prevention
- Failing to present information or choices effectively
Without apology, this paper addresses concerning behaviors and asks the industry to break habit and suggests that a cultural shift that will be necessary for ACOs, Health IT, analytics and other decision support tools to achieve success.
If we have any chance at improving our healthcare system we need to understand and analyze the bad habits in healthcare and take it upon ourselves to identify risks that, if taken, will yield valuable rewards. What are some bad habits in healthcare that you think should be addressed in the next five years?