There's a comment I remember really clearly from a Flowopoly workshop I facilitated at King's College Hospital in 2019. One of the managers said "Oh, we've done data! But it didn't work! So the last thing we want is more data!"
In my view, if you're trying to use data to engage with the patient flow problem—and it doesn't matter if you're just trying to get a better understanding of it, or if—more ambitiously—you're trying to improve it—then you're not 'doing' data unless you are plonking the data right under the noses of the people* whose behaviour needs to change in order for the improvement to happen. In fact, not just 'plonking it under their noses', but talking them through the numbers, engaging in a dialogue with them, making appointments to speak to them again after you've re-analysed the numbers according to their observations and comments.
But we don't do this. We don't do anything like this. We're a million miles from this. What we actually do is either not 'do' any data at all for these coalface people, or we hide the data away on some obscure dashboard that nobody ever looks at.
What is going on here? Why are we not engaging clinicians with our patient flow data?
Here are three reasons.
Firstly, we don't fully appreciate that the default position for most managers and clinicians is to not engage with data. Data is difficult. Data is 'System Two' thinking writ large. So managers and clinicians are reluctant—extremely reluctant—to engage with it, unless they are highly motivated to do so. Looking at data takes time, attention and effort.
Secondly—and this is closely related to the first reason—data is a foreign language to most people and we've got subtitles turned off. We assume that our customers can understand this foreign language. But they can't. Or maybe they can, but they don't have the time or energy or motivation to do it for themselves. So it doesn't happen.
Thirdly, we haven't grasped that managers and clinicians like to look at data with other people at the same time. Looking at data is a social activity, a collaborative undertaking. But data professionals—not realising this—default to displaying their work on screens, which are designed to be looked at by one person at a time. Two at most. Screens—unless they're cinema screens—are hopeless if you want more than two people to be looking at the data simultaneously.
So if we fail to take account of these three issues, we end up in a situation where we're effectively saying to people: "I want you to look at some data that's really important. But I'm not going to acknowledge (a) that your default setting is to avoid looking at this data at all costs; (b) that even if you do look at it, you won't understand it, because I've written it in a foreign language and (c) even though I know you'll probably prefer to look at this data with colleagues, I'm going to deliver it to you via a medium (a screen) that is completely unsuited to that.
*I mean the people who make the actual decisions about which patients get admitted and which don't, and how long those patients stay in hospital before they are discharged
[2 September 2024]