Hospital checklists and Inviting Participation

5429335563_ebe9be20dcJohnnie Moore pointed to an interesting article on why checklists don’t always produce the kind of positive results expected in hospital operating rooms.

I remember a few years back when I had major surgery. I had been rolled into the operating room. I was looking around and I commented on the team’s use of a checklist. They looked at me, surprised that I noticed. I said I’m interested in group process. With that, they gave me my anesthesia. I think one of the things on the list was to shut up talkative patients. 🙂 But I wondered, did the checklist make a difference for that team? It seemed like they were comfortable and well-practiced…

Outside of hospital operating rooms, where I have no expertise other than as patient, I’m fascinated by what sort of invitation gets people to engage with tools that can increase their individual and collective performance. It seems to me the invitation is as important as the checklist. Here is a related snippet from the article:

Dixon-Woods did identify one exemplary ICU, in which a high infection rate fell to zero after Matching Michigan began. The unit was led by a charismatic physician who championed the checklist and rallied others around it. “He formed coalitions with his colleagues so everyone was singing the same tune, and they just committed as a whole unit to getting this problem under control,” says Dixon-Woods.

I don’t think the intention here is blind lock-step and I cringed a bit at “singing the same tune.” What I do think matters is that people understand the value of something they are asked to do, and that leadership walks the talk. That starts with an informed, intelligent invitation to participate. Not blind obedience. Not “because you have to.” And the ability to critically question an invitation, checklist or whatever, because in complex settings, not everything is predictable.

I’m currently reflecting on the last two weeks where a team of us co-facilitated 2 rounds of a week long learning experience for professors at the University of Guadalajara system in Mexico. (More to come on that.) I suspect where we created warm, intelligent INVITATIONS to experiment with mobile technologies for engaged teaching and learning, we had more professors “accept,” dive in and learn. Where we focused too much on content, we started to lose people. Interesting, eh?

Source: Hospital checklists are meant to save lives — so why do they often fail? : Nature News & Comment

Confusiasm/Confusiasmo at the UdGAgora

Many years ago at a KM4Dev community meeting, Carl Jackson coined the word “confusiasm,” a combination of confusion and enthusiasm. This has become a way of being for me. It represents, quite simply, learning in action.

We used this concept at the University of Guadalajara Diplomate program on mobile tech for engagement the last two weeks in Guadalajara with the Agora project. There is much more I want to write, but at the minimum, I want to start curating and sharing the artifacts. Here is the first one, a Storify of the Confusiasm Twitter thread. (Edited 2/3/2020 – link is dead because Storify is dead. 🙁 )

https://storify.com/NancyWhite/confusiasm-confusiasmo-at-the-udgagora

Please Donate to Help Nepal’s Earthquake Victims

Give. Just sayin…

Next of course, my attention went to the question of “Where to donate?”   I received several emails from charities that I already support that do work in the area.   I donated to Save the Children.   On Facebook, I noticed a list of vetted charitiesshared by another trusted colleague who works in the nonprofit sector, Peggy Duvette.  I shared the article on my wall.   This sparked a few other recommendations from friends about where to donate.  Knowing that Robert Rosenthal had been working and living in Nepal, I was curious to see if he had any recommendations.  He posted a link to this Global Giving Fund, a giving network of charities in Nepal, vetted for impact.  In the thread was a comment from Nancy Schwartzsuggesting that we all share this wide and far.   So, I shared it on my wall tagging friends, many of whom re-shared the post, and made a donation.

via Please Donate to Help Nepal’s Earthquake Victims Now | Beth’s Blog.

Collaborating for Impact in Large Development Organizations

km4devimage1What feels like a long time ago and far far away, Rachel Cardone of Red Thread Advisors, Aldo de Moore of Community Sense and I decided to wrestle with some questions that were cropping up across our diverse work. We kept having clients say “we want to collaborate with our distributed teams,” and “what software should we buy.” Time and again, we saw so many of these initiatives fizzle out. It was our sense that we needed to look at the problem differently, with an appreciation for complexity and the diverse contexts across large international development organizations.  That really interesting things were happening on the edges, but they didn’t seem to penetrate deeply into the organizations.

Thanks to some support from IFAD (thanks, Helen!), we had some seed money to begin thinking together, along with friends/volunteers from five development organizations (listed below). What resulted is the following paper from the KM4Dev Journal.

Learning 3.0: collaborating for impact in large development organizations

Nancy White, Rachel Cardone, Aldo de Moor

Abstract

This discussion paper builds on the body of research and practice about technology stewardship originally explored in Digital Habitats, and on the findings from an initial probe into the experiences of five development agencies using collaboration platform technologies. The probe was conducted from September 2013 through February 2014. We propose a framework for looking at productive practices in selecting, configuring and supporting use of collaboration technologies in international development organizations by focusing on the opportunities that exist in the boundaries between different parts of a development organization and different kinds of interactions that lead to learning and development impact. We suggest that there is a very useful opportunity to expand this initial probe using collaboration pattern language and a complexity lens to develop a useful repertoire of technology stewarding practices for collaboration in international development with the goal of supporting greater impact of development work.

via KM4Dev Journal.

This snippet gives a bit of the context for the action learning agenda:

We worked with key staff from the International Fund for Agricultural Development (IFAD), Oxfam International, German Federal Enterprise for International Cooperation (GIZ), the World Bank Institute, the UN Development Programme (UNDP – special thanks to the ever enthusiastic Johannes Schunter!), and the Bill and Melinda Gates Foundation (BMGF). Our objective was to determine if common patterns or dynamics exist across international development organizations that could suggest models, approaches or methods organizations could use to increase value for money when making investment decisions in support of collaboration. We drew on the collective experience of our action research partners, and our own experiences working to establish, advise and manage collaboration technology platforms. Through a series of discussions, we developed an analysis of the contextual factors relevant to the international development sector.

You can find the full text PDF here. I’d love to hear your thoughts and feedback!

Updating My Cynefin Resource Image

I had not realized I was using an older version of Dave Snowden’s Cynefin image. It is so useful, I am plopping the June 1, 2014 version here in my blog, both so you, dear readers, might see the latest, and I can always go back and find it. 🙂 (Edit: I was sensitized to this updated image via a very nice post on Cynefin in software development http://lizkeogh.com/cynefin-for-developers/  And Dave noted the post headline was not so useful, so I edited that as well. Thanks, Dave!)

Cynefin_as_of_1st_June_2014
“Cynefin as of 1st June 2014” by Snowded – Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons.

via Cynefin as of 1st June 2014 – Cynefin – Wikipedia, the free encyclopedia.