Isolating Root Causes

I was reading materials in preparation for a class on safety and quality improvement. It’s a multiple months-long course with a lot of physicians and statistics. It’s not material I’m naturally good at. I have a part to play as a spiritual caregiver in what we’re planning. I am useful even if I’m not a nurse or respiratory tech or, certainly, not a doctor.

I’m learning interesting things. I’m hearing even more interesting things about our hospital and about hospital systems in general. I’m learning more than I thought I would when I joined the team to work on our project.

In the pre-course work for our session on analyzing data, the final sentence on the slide was this: Please create two to three visualizations in an effort to isolate root causes / key drivers. This was a sentence about measures and hypotheses and graphs and tools.

As I think of it now, this sentence can go in many directions. What would it look like if you prepared a visual to capture the things that were causing you trouble? What would the visual addressing those causes and drivers include?

My Blog: Trauma 3

When we were checking in with each other the Wednesday after Election Day, my supervisor described our having been through a trauma. Traumas take some getting used to. He said in swift Strening fashion, “It takes time to learn what can be trusted.”

Perfect. Accurate. Compelling. I thought at the time how grateful I was for his supervision, for his way of putting things, and for his open spirit that feels. He is as great a pastor as he is a supervisor. And there he was summing up a decisive collective experience. Trauma.

I’ve learned in CPE that traumas take many forms. They are often unexpected. They leave us feeling brutalized and sometimes tired, spent. Traumas require a response when we have little energy for it. Traumas pull the soul through thick, murky sludge, and no matter when we emerge, we’ll be different.

The look of it will be up on us. The smell of it distinct. Trauma can’t remain hidden. At least at first. Naming it for what it is helps.

Calling an election trauma matters. Distinguishing the singular event – that had all those earlier moments attached it – as trauma separates it and brings it to our collective consciousness for what it is.

As you recover, take the time you need. Visit the reality of what’s happened in our country. See the fractures and fears. Witness the same in you. Slow down to appreciate how hard life is for you and for us. It will take time to learn what can be trusted.

My Blog: Trauma 2

The quickest responders are the ones who count. That’s what I usually say to myself.

Those are the medical personnel. Together, the team is between 15-20 people: physicians and nurses and respiratory techs. Security and a chaplain and a hospital administrator. We rush within minutes from all quarters in the hospital.

The medical folks address the medical crisis. They attempt to stabilize the patient all while deciding if and where the patient will be moved to a different unit in the hospital.

That could mean transporting someone from the lobby to the Emergency Department. It could mean a patient, once stabilized, is taken from a medical floor to one of the intensive care units. In most cases, movement for the patient is presumed. Even if it takes time to accomplish.

Chaplains come with the primary focus on the family in order to support anyone present who may be with the patient and with a secondary concern for our care providers. Watching trauma unfold is its own participation in trauma.

Participating in trauma does things to people. It anchors you and disrupts you. Both happen. In a trauma, someone else’s and your own, the world that you knew flips.

Time changes. People move quickly and they don’t move quickly enough. The room is noisy and the floor cluttered with needle caps and clothes and ripped packages that once held tubes and lines and other medical implements.

It is an essentially upsetting, unsettling, and uprooting experience. Have you experienced something like this? Perhaps not a medical crisis but another version of trauma? What’s helped?

My Blog: Trauma 1

In our hospital when a trauma happens, a page is sent through the system to a team. Chaplains are part of the rapid response team so our on-call chaplain gets the page and responds within 5-10 minutes to the scene. The same team responds to cardiac arrests and visitors who fall unconscious unexpectedly on the campus.

Because our hospital campus includes several buildings over several city blocks, it can take time to arrive to a trauma. It may take effort to leave a conversation that you’re in as a spiritual caregiver, for instance. A doctor may need to leave a patient’s room immediately. A nurse may need to grab a crisis cart and place some things in the hands of a colleague.

Some trauma calls turn out to be seizures, relatively bland events for the amount of resources “coming at a person” when the page is called. Still, being a part of a rapid response assumes a readiness to encounter the worst. It assumes that we’re prepared to stick around and labor through what’s next.

A family who’s grieving demonstrably. A patient who is unaccompanied and whose chest is being pumped, whose ribs are being broken. Being there assumes that we’ll see and that’ll we’ll do our work. That we’ll be steady.

It is its own walk of faith, responding to those traumas. You know and don’t know what you’ll see. Being steady is a hard job when pain is winning. How do you keep yourself steady? How do you see the traumas unfold and still show up?

 

 

My Blog: Good Decisions

I was in a room listening to physicians talk about intensive care and how timelines were important to patient care and to providing health care. Patients get better when they’re treated. Or they don’t.

If they get better, doctors know why. And the same is true if patients don’t get better. If certain things were going to happen, like recovery, then they would have happened.

The importance of recognizing that trend along with all the other information available is freeing. It can free you to choose well. It can enable a person to have a good death and a good life in the sense that there’s life to live after the next decision.