1. TEMPLATE DESIGN © 2008 www.PosterPresentations.com Leadership Lessons: Decision Making Process Physician Leaders Need to Recognize & be Vigilant for ADMINISTRATIVE THINK By Calvin J. Maestro, Jr., MD, FAAFP, MBA in Healthcare Management What is “Administrative Think?” Point: Ask the right questions http://en.wikipedia.org/wiki/Space_Shuttle_Challenger_disaster On 28 January 1986, the American Space Shuttle Challenger blew up after takeoff. This was caused by freezing temperatures compromising the O- rings in the shuttle's solid rocket boosters (SBRs). Not wishing to fall behind in their space launch schedule, NASA was too impatient for a go-launch recommendation from Morton Thiokol, the contractor for the SRBs. Thiokol assessed the situation from the perspective of whether or not it was too dangerous to launch in the cold conditions. Experts have agreed that what they should have asked is whether or not it was SAVE enough to launch. (What they didn’t know was that inspections of prior space launches had shown that some of the O-rings almost had ruptured in the past!) Lesson: Mistakes are made by improperly framing the big question(s) “There is Plenty of Time…” Administrative Think is bad Because… Points: Frequently, the approaches and solutions favored by those demonstrating Administrative Think ignore or are ignorant of all the pertinent facts and evidence, or are self-serving. Effectively, Administrative Think often is a subtle attempt to intellectually circumnavigate the core issues, or to avoid implementing effective but unpleasant or unpopular solutions or changes based on a realistic and honest appraisal of the situation. Financial considerations often are a root cause of stimulating Administrative Think in people. The vignettes in this poster are examples of Administrative Think in action. Trust, But Verify“Nothing can be Done” “It Never Happened Before”Conclusions Recommendations: 1.Do not jump to conclusions 2.Ask the right questions 3.Get all the facts 4.Study the past 5.The absence of accidents may just be due to good luck 6.Lack of news does is not the same as lack of evidence 7.Appoint a “Devil’s Advocate” 8.Challenge every assumption made 9.Keep your priorities and values straight 10.Be forthright, realistic and honest 11.Use common sense! Lastly, ask yourself if this decision is consistent with your organization’s stated Mission and Corporate Value Statements *Pictures from Yahoo.com unless stated otherwise. “There is no Evidence of…” “We Never Knew About…” As physicians move into higher leadership roles, they will need to recognize and be prepared to deal with an unusual organizational cognitive process I call Administrative Think. Administrative Think is a cognitive process, exhibited by individuals or groups, characterized by faulty thinking, altered priorities, distorted values, and, at times, amnesia of past events, decisions, or precedents. Administrative Think frequently comes disguised as a simple, logical, or fair approach to solving a particular problem or troublesome operational issue. Often, decisions made using the Administrative Think process are done in isolation of other issues or conditions; i.e., they lack situational awareness. Airborne Ebola Viruses & Unreported Blown Tires Or, how is a deadly virus and a major tire/vehicle recall in 1999-2000 related? From: Examiner.com According to Richard Preston, author of he book The Hot Zone, © 1994, in 1989 infectious disease experts believed that airborne transmission of the Ebola virus was not possible. This despite several researchers having evidence of such; they simply lacked the administrative support to publish their findings. Years later, a major U.S. Auto company replaced millions of tires due to vehicle rollover issues related in part to tire thread separation. The recall was delayed by the lack of official reporting of the accidents to the NHTSA by the plaintiff’s own lawyers! Concorde man faces suspended sentence over (July 2000) Paris crash. Paris, France (CNN) A blown tire sent debris into the wing, causing the insufficiently protected fuel tank to rupture and the plane to crash, killing 113 people. According to the accident report, there were more than 60 tire blowouts over the Concorde's 25 years in the air. Yet, the Concorde owners never corrected this design flaws in the plane. Lesson: Too many administrative levels can result in vital information not reaching the decision makers at the top until too late. Costa Concordia sinks off the Italian coast USA Today news article by Gene Sloan, February 10, 2012 Part of the chaos on board ship during the accident was due to the fact that the passenger safety briefing had been scheduled for THE NEXT DAY! Administrative policies allowed cruise ships to sail first and hold the safety briefing later! Lesson Learned (The Hard Way): “ Cruise passengers will (now) get safety briefing before sailing.” Management Space Shuttle Columbia The Columbia completed 27 missions before being destroyed during re-entry on February 1, 2003. The Investigating Board determined that a piece of insulating foam from the external fuel tank had punctured the Columbia's wing during launch. But, after analyzing the takeoff videos, and for two weeks, NASA administrators refused to act on it, or even have an Army satellite take pictures of the shuttle in space to survey the wing for any damage. 2003 Lesson Learned: Ignorance is not bliss. Columbia’s crew had a right to know the condition of their ship before re-entry.