Three ideas for Challenging Shared Assumptions of Workgroups

A New York Times article reflected on the fact that care professionals have only a 40% compliance rate on washing their hands.

That does not sound very impressive. Actually, it sounds appalling. A lot of nasty microbes hitch a ride on people. The most likely point of contact between a provider and a patient is the provider’s hands. Studies have demonstrated that increased hand washing compliance results in less frequent patient infections. There are direct causal links between hand washing and patient outcomes and health care costs. The arguments for rigorous compliance with hand washing protocols are compelling.

So, what’s going on with low rates of hand washing?

One part of the problems is health care professionals have many occasions for hand washing during a work day. Seeing 30 patients each work day is not unusual for many doctors. A 40% compliance rate means hand washing 12 times. That’s a lot of hand washing for most people. But it should be more than twice that number. So, one impediment is simply how often this chore has to happen. When asked, people note that frequent washing dries out their skin, the washing areas are poorly designed, or they don’t have any place to set down the stuff they’re carrying.

Another factor is the culture of their workgroup. Some groups are avidly committed to taking any action to increase their patients’ safety. Some groups are so driven by excessive demands that they cut corners without even registering the event. Some groups manage to suspend their grounding in science and work as if germs don’t actually move around all that much. These group illusions would not stand up to any challenges, but no one raises any objections.

Challenging assumptions is a good idea for any individual and even more so for a group. Encouraging these challenges is an essential role of leadership.

  1. Create a sense of psychological safety such that members know that they can raise difficult issues with one another.
  2. Specifically ask members to play devil’s advocate, questioning how the group operates.
  3. Manage conflict such that people argue their points while maintaining respect throughout the discussion.

Are there assumptions within your workgroup that would benefit from a challenge?

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