I had the opportunity yesterday to hear Professor Sir Liam Donaldson speak twice. In the morning, Sir Liam spoke at Grand Rounds on “Patient Safety: Progress and Dilemmas” in his role as a World Health Organization (WHO)leader on Patient Safety & in the afternoon, he spoke about leadership, policy, and health in a talk titled “Public Health Policy: Reflections on H1N1 and tobacco control in the UK” reflecting on his career in management in the UK’s National Health Service (NHS).
Here is a brief background on Sir Liam Donaldson (taken from a University email).
Prof. Sir Liam Donaldson is the Chair of WHO’s Patient Safety Program and Chairman, National Patient Safety Agency, England and Wales and former Chief Medical Officer for the United Kingdom.
Under the leadership of Prof. Sir Liam Donaldson, the WHO Patient Safety Program has grown from a small initiative within WHO’s Health Systems activities to a robust global advocacy program embedded within the scientific community with activities in over 140 countries and all six regions of the World Health Organization. As the former Chief Medical Officer for England, in his capacity, Sir Liam advised the Secretary of State for Health, the Prime Minister and other government Ministers. Prof. Sir Liam has authored landmark reports aimed at radically transforming important areas of health care in England and globally.
A little picture to break up all this text.... Meet Liam Donaldson
It is always nice to listen to a speaker who is intelligent, humble, funny, and passionate about his/her work, regardless of the field, but I get especially jazzed & inspired when it is a leader in quality & safety. The concepts & topics that Sir Liam covered aren’t new, but I always enjoy hearing them again & thought I would share a short synopsis here.
In the afternoon seminar, we talked about the role of leadership in management, specifically in the health care delivery system, but I think the lessons are applicable in any field. In his experience as Chief Medical Officer in the NHS, hospitals did the best when management (non-clinicians) like doctors & were interested in learning about how clinical practice worked. The hospitals that were in the worst shape (as a work environment, not clinically) fell into 2 categories: managment was scared of the docs or management thought they knew better than the docs (maybe a little bit of hubris in the managerial ranks?). Sir Liam reflected that when there is an “us” versus “them” mentality, it is bad for improvement and bad for quality & safety.
I think this is universally true of any field, institution, or community. When we believe that we are all on the same team working towards the same goal, there is an environment in which progress can occur. Recognition that we have many similarities, yet acknowledging there are things we don’t know, can go a long way in creating relationships and effecting change. Showing humilty and a willingness to reach across the divide to understand is the greatest management & human skill that we can hope to achieve. If the goal is to make our health care, hospitals, schools, or communities safer & better, we can do it without creating these connections, but the change will be short lived & shallowly rooted.
We also talked a great deal about communication, another subject dear to my heart. You can have the best idea in the world, but if you cannot communicate effectively, no one will care. Alternatively, you can have the worst idea in the world, and if you are a great (or even just a good one) communicator, people will pick it up & run with it. You have to be an excellent communicator to combat all the stupid in the world (or even just some of the stupid).
Sir Liam gave four pieces of advice. First, simplify complex ideas into simple & direct statements. Second, be as open & honest as possible (read: answer the question asked). Then, seek out opportunities to communicate. By seeking out opportunities, you can practice your delivery, but most importantly, you can make mistakes when the spotlight isn’t on you. Last, learn to package your idea so that it has the maximum influence. He told a story of walking into someone’s office with 5 pictures of young children that had been killed in the UK due to medical errors & simply laying each picture 1 by 1 on the person’s desk. The recipient was confused…. “What’s all this? Who’s kids are these? Who are are these children?” Sir Liam simply stated something along the lines of ” These are 5 children we’ve killed in the last 2 years [due to medical errors]” and 10 minutes later he was walking out the door with money for more patient safety work. Maximum impact for maximum results.
It was a pleasure to hear Sir Liam talk & I thank him for sharing such wonderful insight with us. It is alwasys a treat to be re-invigorated through someon else’s passion & to learn important life & career lessons at the same time.