Broken Systems Are Need Satisfying ... To Someone!

I work in healthcare and I'm fascinated with "systems" thinking (e.g., Dr. Deming, Lean, Six Sigma, etc.). For me it meets my need to feel significant if I can be a part of a positive organizational change which I know will be need satisfying for the long term for all people involved with the organization. If I can help make things better for the staff, the patients, the physicians, etc... it's a "power" trip for me!

As an educator I feel one of the best ways to make positive organizational changes is through training. Systems thinkers look for ways to reduce waste, remove variances, improve efficiencies. "Dr. Glasser" thinkers look for ways to make things more need-satisfying within an organization. I think its possible to all of these things when you consider that everything we do in an organization is need satisfying for someone... even things which seem assinine.



This is why the article in CNN about the woman dying because she was ignored in the waiting room of Kings County Hospital in New York is so appalling to me. I would like to believe something like this could never happen in my organization. I understand that several of the blamed employees have been fired - which is probably fitting in this case. However, I know enough about systems thinking to tell you that firing those employees isn't going to make things any better at that hospital. They were fired as scapegoats (but perhaps rightly so!).

Scapegoat Firing is a Distraction Tactic
This is not a new strategy. Old school leadership tactics have used scapegoat firing as the mainstay of the leadership diet of fear and power. You fire a few key people and get the media coverage and attention focused on those things, and you point to that as your way to resolve the issue. "I fired the ones who caused this problem, see? Everything will be better now." But the reality is that the system in which the problem was created is still broken - which means the problem still exists!

There is a broken system in place at that hospital and the finger of blame must be pointed at the leadership. Obviously complancency and apathy are a part of the organizational culture, but the question is: how high up does this go? Is it only at the psychicatric unit or does it go higher? And more importantly, how did this culture come to exist, and how do we eliminate it?

[Note: Kings County was named the first level one trauma center in the U.S.! That is quite an accomplishment! How can such a great organization have allowed such a terrible culture? Read more about it at wikipedia]

How Did It Get This Bad? How Does It Get Better?
I don't know how high up the leadership ladder this culture of complancency goes at Kings County because I'm not a part of that organization. But I do know how such cultures come to exist and tend to perpetuate themselves. I also know how we rid ourselves of such things.

To oversimplify it: a culture of complacency exists because it is need satisfying to someone (perhaps many people). It is perpetuated because it is need satisfying to someone. And you won't be rid of it until a newer, better organizational culture is more need satisfying than the current one. If the internal motivation to change is not great enough, external sources of motivation can be found: such as public outcry thanks to media coverage.