How healthcare leaders forge ahead in face of contradictions

Becker's asked healthcare leaders to share their problem-solving techniques when faced with contradictory information.

Here are their responses, presented alphabetically. 

Editor's Note: Responses have been lightly edited for length and clarity.

Sam Flanders, MD
Senior vice president and chief quality and safety officer of Beaumont Health (Southfield, Mich.)

Ben Franklin said, 'Believe none of what you hear and half of what you see.' When confronted with contradictory information, I like to go see the problem for myself. You can almost always get to the truth by direct, personal observation.

David James, MD
President of medical groups and ambulatory services at Sentara Healthcare (Norfolk, Va.)

As healthcare professionals, we are constantly faced with conflicting or limited data, and there can be a tendency to be hesitant to move forward for fear of failing. This can be especially true in large scale, long-standing integrated delivery networks. Healthcare is moving too fast for excessive analysis paralysis. I like to turn the fear of getting it wrong on its head and fail forward … fast!

Of course, this approach is predicated on doing all you can to maximize what one can know and getting the right stakeholders and experts in a room in order to expand fact patterns, related issues, rules, regulations and policies and precedents.

In the end, you're better off to proceed in the midst of some ambiguity, knowing that the right answer will become more clear. The remaining facts will become evident. You've picked a path or approach with the best information you can but with the full understanding you may be failing, or you may proceed on two paths at once with small pilots as experiments and assess outcomes.

The key is to recognize failing quickly, drive rapid-cycle PDC [plan–do–check–adjust], make midcourse correction, and keep moving.

It's key to remember the failure itself is information. You must proceed in the midst of ambiguity, or you'll never move. The mistake we make is not in failing but in persisting to fail once new information has made things clear.

Terri Kane
Associate COO of clinical programs and shared clinical services at Intermountain Healthcare (Salt Lake City)

I access my network. Sometimes we try to do too much on our own and forget to delegate, listen, or ask others for input. I've learned it almost always works well to reach out to those with a wide experience base. It helps increase my understanding of the problem and provides more ideas for solutions.  Multiple people usually have a better chance of solving a problem that is complicated by contradictory information.

Throughout my career I have been surrounded by amazing leaders with great insights. Strong leaders who are willing to help are never too far away.

Ira Nash, MD
Senior vice president and executive director of Northwell Health Physician Partners (New Hyde Park, N.Y.)

I have tried to apply the lessons I learned through my medical training and as a practicing physician in dealing with the challenge of contradictory information. First, recognize that in both the clinical and organizational setting, one rarely has all the information that would be helpful. Learning to provide effective care in the face of medical uncertainty (Is that really the diagnosis? Is this intervention likely to work?) is an essential skill for the clinician. Organizational leaders must get comfortable with "estimates," "projections" and other imperfect data to avoid seeking ever more information before making a decision.

Second, it is inevitable that leaders and decision-makers, especially those in large and complex organizations, will be occasionally confronted with information that is not just incomplete, but frankly internally inconsistent. I go back to the "medical" way of thinking through the problem. Just as a physician must weigh the utility and reliability of certain medical tests in the setting of different clinical circumstances, then so too should leaders ask similar questions: What sources of information am I relying on? Are they all equally reliable with regard to the question at hand? Have we applied the right tools for this job? Is there a plausible explanation for the apparent discrepancy, such as a miscommunication around the question to be addressed or an error in the analysis?

I think it is also important to apply some "organizational awareness" to the situation. To what extent is the contradiction a reflection of competing priorities or "agendas" of those providing the information?

Rajan Wadhawan, MD
Senior executive officer for AdventHealth for Women and AdventHealth for Children (Orlando, Fla.)

The ability to think critically and to effectively resolve conflict is essential to building and maintaining a sustainable business — especially when lives depend on it. We put patient care delivery and experience first and take them into consideration in every decision we make. But even with that in mind, there can be contradicting viewpoints on what will result in the best outcome.

A layered collaborative approach always works best, and generally results in the most creative solutions to difficult situations. First, I try to obtain more information on the different viewpoint by engaging additional stakeholders, contacting organizations that might have similar challenges or consulting available external data.

Once all additional information has been gathered, I'd work with subject matter experts to form a consensus based on all the evidence. I believe this collaborative approach is the best at helping make the best decision for our patients and communities we serve.


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