© 2015 Olivier Lamboray, Even Behind The Closed Door
When problems occur in health care organizations, departments, or processes, management frequently targets improvements on organizational structures, work processes, and the related behaviors of employees. Such improvement initiatives are often short-lived or fail because underlying dysfunctions and hidden costs are not first recognized and addressed. One medical system implemented a new electronic medical record and accompanying workflow in an effort to eliminate mislabeled or unlabeled specimens in its lab. Management implemented these changes without fully understanding the downstream effects on the end users of the process, failing to recognize that the success of the new workflow would depend upon employees who had little or no say in creating it. As a consequence, the process did not work well, and employees were frustrated by it. The paper analyzes how underlying dysfunctions led to management's poor decisions and concludes by showing how The Socio-Economic Approach to Management (SEAM) could have produced better outcomes.