Three things stand out for me over the past 7 days. I started a new yoga class, I watched Don Berwick deliver an extraordinary paper at the International Forum on Quality and Safety in Healthcare, 2015 and I started reading Atul Gawande’s book On Being Mortal. What all those things have in common is open-heartedness.
As I lay on my yoga mat on the board floor of a local church hall listening to my new yoga teacher’s thick Dublin accent I set my intention: to keep an open and soft heart. The spirit of Yoga rarely comes easily for me. I engage in a constant pull towards perfection and improvement. While a softer voice reminds me about the value and integrity of each pose.
And so, it was with this start to my week that I encountered Atul Gawande and a day or so later, Don Berwick.
Atul Gawande speaks of the relationship of giving and receiving healthcare as :
A human being coming to another human being with their body or their mind’s troubles and looking for their assistance. And that is the central act of medicine.
According to Gawande we have 30 different organ systems and at latest count we have 60,000 ways they can go awry. It is perhaps the enormity of those numbers that drives us towards the shelter of regulations and policies. But there is no shelter there. We need to embrace fully the at times frightening world of purpose and connection. We must throw ourselves into a way of working and living where we value and revere the commitments that we make to the colleagues we work with and to people we deliver care to. Where we push ourselves to do so much better because there is no other choice. This way of living and working connects us to the joy and the open-hearted sense of purpose and meaning in our work. It sees us celebrating the connections between the people.
Don Berwick so eloquently described the invitation that the harsh world of healthcare is offering to us as leaders:
The world is inviting you to cynicism. The tools that you’ll notice in your hands first in that world are laws and regulations, and compensation systems and budgets, dicta and fear, measurement, standards, measurement, measurement, measurement.
They are seductive. They make you think you can mandate improvement, that you can command knowledge growth, that you can require excellence. They are deceiving you. You cannot. Of course laws matter, regulations matter, compensation, budgets, policies, they all matter. Standards can help. Measurement can help. Control can help. But only in proper proportion and only if they don’t harm. Only if they avoid waste in time and ideas and spirit . Only if they maintain deep respect for how complex the real work is and how good at heart the real people are.
Thirty years in the vineyards of improvement have taught me how impoverished, how blunt, how inaccurate, yes abusive, the tools of inspection and incentives are without deep understanding and respectful action regarding the nature and the sources of interdependent human achievement. (Don Berwick) International Forum on Quality and Safety in Healthcare, 2015.
We need to decline, at every offer, the invitation to cynicism and renew our commitment to open-heartedness. I’m going to renew this commitment on the yoga mat again this week.
