On being intentional

Intentional: deliberate, purposeful, planned, calculated, planned. 

As we experience change and challenge in medical practices, it’s useful to think about intention.  Are the tasks we assign intentional; and is the doer aware of the intention of the task?

Have you ever been frustrated by some routine task that seemed pointless, or didn’t relate to your job?  I have.  In a previous job as project manager, one of my tasks was to access a remote part of our enterprise-wide project management software and document three data points for each of my projects.  I didn’t use that remote part of the software further, but I did record and regularly use the same data in five other places.  So when I forgot to enter the data in this remote area for my first couple of projects and didn’t hear complaints, I figured it was an unneeded legacy task from an old process design.  To me, there was an “intention gap”, no intention by management to use the data.  So I didn’t worry about it.

I have also observed “intention gap” in medical practices.  Here’s an example from a two doctor practice in the northeast.  At the end of each day, Mary, the typically busy receptionist, would print out the next day’s schedule, highlight new patients in orange and existing patient in yellow, and then place the schedules on each doctor’s desk.  After a couple days of observing this, I remarked to one of the doctors that this paper rarely was touched, and typically ended at the bottom of a pile undisturbed. 

“Oh, that,” she explained, “we started doing that to let the staff know which paper charts to pull each evening to get ready for the next day.  We would also use it to pick out some charts to review if needed at the start of the day.  But now with our EHR software, we don’t pull paper charts.  And I can see the schedule on the computer and click on existing patients from there to view the chart.” 

So the intended purpose of the highlighted printout, to pull and review patient charts, was now served by the computer.  The printed schedule was no longer needed.

“So, doctor,” I asked, “are you going to tell Mary she can stop printing and highlighting the schedules?”   

“Yes, I guess we could”.  Then with a genuinely concerned expression she asked, “Do you think Mary will mind?”

I’m not suggesting that you should constantly question whether your office processes are intentional.  To do so would be exhausting.  But I do think it is worth examining over time.  As is making sure your staff understand the intentions (purpose) of their tasks.

One of the common intention gaps I see is where one person is asked to deliver data to another person for their own use.  Both examples above are examples of this.  In my personal project management scenario, I didn’t see a purpose for recording three data points.  But what I didn’t write above was that after a few months, the marketing team contacted my manager because they didn’t have any information on my projects, and therefore couldn’t make client satisfaction survey calls to the clients.   Turns out the task was intentional, I just didn’t see it. 

In the second example, Mary the receptionist knew the intention and faithfully produced a beautiful color-coded, but ultimately unseen, daily schedule.

Here’s one thing to try this week.  Look at the data you receive from others.  Do you use it?  Is it the right data?  Does the sender understand why they are sending it to you?  Is the process intentional? 

Straight ahead,

Bob