This is an area I get really excited about – it's one of the biggest issues I see with my clients, and I need to be able to explain it better. How do I demonstrate the importance of setting up your organization so work moves on its own, instead of relying on individuals to move it?
Enter: The Pitt! Everyone’s favorite spiritual successor to ER.
Note: If you’re not watching The Pitt — first of all, I’m sorry for your hospital trauma. All you need to know is that The Big Thing this season (besides the water slide collapse, which is really not helping my fear of water slides) is that they have to go off the grid. There’s some sort of cyber attack looming or something and they decide to disconnect from the WiFi to go analog.
OK, so basically:
Relational databases are the way the ER was functioning before they went offline. Spreadsheets are the way the ER functions after.
Before
- Patients come in and get entered into the system
- The system automatically sorts patients by priority/severity and queues them up for the ER
- The medical team takes patients as they can, putting all their notes into the patient’s chart
- Any tests they administer are sent to the lab, the lab sends the results back to the chart (again, connected to the patient)
- Any treatment plans get sent up to surgery or over to the pharmacy or wherever, idk I’m not a doctor!
- The patient’s health insurance or lack thereof is notated in the chart and payment plans can be worked out there
- If the patient comes back, they’ll be able to pull all this back up so they don‘t have to start over from scratch
This is basically a relational database. Any doctor can pull up the patient’s chart and figure out what’s going on — their admission, their triage, their diagnosis, the recommended care, the test results. All of these pieces are separate and moving through different work streams, but they’re all connected — informing and moving each other through the lifecycle of patient care.
After
- Patients and their maladies get put up on a whiteboard
- Someone forgets to take the patient off the whiteboard once they’ve been treated
- No one has time to take the physical prescriptions to the pharmacy or retrieve them in a timely manner
- Cross-functional communication is breaking down left and right because the doctors are busy treating patients — paperwork is the last thing on anyone’s mind
- Volunteers are being put in positions where they aren’t sure what they’re supposed to be doing, so they kind of just sit there
- They have to bring back the smoking nurse that holds all the information in her head instead of having it integrated into their processes
This is basically a spreadsheet. Static data that isn’t connected to relevant context, isn’t triggering any other work on the basis of conditionality, and isn’t presenting itself to the intended audience with any sort of direction.
The team eventually stars to figure it out, but the work suffers. People get hurt, someone almost dies, etc. And while most of our work isn’t quite so life and death — it’s a great example of how the minutiae of moving files and data around can absolutely throttle any chance at efficiency.
I love a good spreadsheet as much as the next person, they certainly have a time and a place. But the vast majority of the time, if you are doing something that is repeatable but hard every time, if you’re revisiting something again and again in slightly different contexts, if your work is relying too hard on someone Slacking someone — it’s time to level up your databases.
The value of spending time setting up and putting together a relational database (a service I just so happen to offer) is often immeasurable, with the mushier KPIs rooted in the emotional stuff like burnout, toxicity, and personal relationships — but it‘s also measured by time saved, capacity built, and the impact that compounds from freeing up your staff so they can focus on the patients.
And not for nothing, but none of this requires AI. Just so you know.