The First 3 Days

I think this new job is going to kill me. Famous last words, right? And why is it that I need a vacation already? Seriously! Regardless, I have survived the first three days of this new gig. It's going well, but I'm totally earning my paycheck!

On Monday, I met the first 100 or so of my staff and toured four departments at the Fozzie Fields campus (Diabetes Center, Bariatrics, Wound Clinic, and Occupational Medicine). Nurse Jackie took me around, introducing everyone to me. I made a concerted effort to remember each manager's name and I had to concoct unique mnemonic devices to help me remember.

Then we did our weekly ER throughput review and then spent three hours discussing our huge operations project. The huge operational project (that I'm not at liberty to discuss in detail) is going well and charging forward with frightening speed. People are looking to me for leadership and I'm discerning when to speak up and gently shepherd the conversation....when do you "think inside the box" and when is it "okay to think outside the box," etc. It's tough because they have all the real experience and I'm just organizing the whole she-bang.

My first day was 13 hours and I was so excited to have made Hamburger Helper for dinner Monday night!

Then on Tuesday, I introduced myself to the next 30 or so staff members and toured the Occupational Medicine department at the Fozzie Heights campus. I meet the other two departments later in the week. There are established cultures in each department, but there are always opportunities to standardize operations and improve processes and efficiency. I need to shadow in each department and talk to the managers so I thoroughly understand what everyone does. I'm really psyched about the Occ Med folks; they are positive, optimistic, and full of ideas.

I will soon start meeting with all my direct reports (the managers overseeing these areas) in biweekly meetings. I understand that it's going to take time to build trust. These folks haven't had a director for years and reported straight to Nurse Jackie. It'll take a while for us all to get acclimated to each other.

Then today, I led a three-hour, interactive ER Throughput Revitalization effort. Complete with skits and charades! I started the meeting by dividing everyone up in pairs and gave one person a throughput problem to solve, such as "A lab specimen is hemolyzed! How do we obtain a sample if the patient is in CT?" Or "We have a urgent case that needs to get to the cath lab and there are no available ambulances!" Then I asked everyone to put two pieces of cardstock up against their temples (to create blinders). Sitting next to their partner, each person had to communicate the struggle and how to best handle it.

It was LOUD in there as everyone tried to talk OVER the blinders. After a couple minutes of chaos, I told them to take off their blinders. The noise level decreased and they discussed the situations like normal people. A few, of course, had to nay like horses!

It worked to alert everyone to the tunnel vision that they have in their own departments and started the meeting off with some laughter. Seriously, we had to revamp our throughput process and make sure everyone understands the process and what our metrics are measuring. Part of it was to make sure we are measuring the correct processes. Plus, it just helps to draw everything out visually so everyone is on the same page. We got bogged down in the admitting process and I realized that everyone has a different perception of how we admit patients (light bulb!).

We opened about 39 cans of worms and identified several problems that folks were too shy to bring forth before or felt their department meetings weren't the right forum to discuss their issues. We probably outlined 5-6 big projects spewing forth from this one brainstorming session. However, after the meeting, I felt mentally decapitated...and like I had verbal vomit dripping off me. Sorry for the visual, but I officially got the term "verbal vomit" into the lexicon here at the hospital. I internally snicker when I here someone else refer to "verbal vomit!"

Okay, time to get back to work!