A 2016 analysis published in BMJ revealed that medical error is the third-leading cause of death in the United States. This includes process errors, planning errors, and failures to act. Martin Makary, a health policy expert at Johns Hopkins and an author of the analysis, explains that the “complex medical system” in the U.S. “sometimes lacks transparency that results in the wide variation in quality of medical care that is the endemic problem in safety.” Makary also notes that “safety nets are missing and standardization is lacking.”
At the heart of this standardization problem lies outdated technology and confusing systems. Many healthcare providers continue to use lagging systems that don’t efficiently collect or analyze data. Furthermore, a mix of legacy and new systems makes for potential conflicts that add to the confusion and fortify workplace silos. Without the sharing of information, organizations fail to see big-picture strategies and solutions that could help prevent medical errors and increase patient safety.
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Another Groundhog Day has come and gone. Or has it?
In the movie Groundhog Day, weatherman Phil Connors (played by Bill Murray) is forced to relive the same day, over and over again, no matter how he tries to change the outcome. The Environmental, Health and Safety Newsletter recently compared the latest release of the Census of Fatal Occupational Injuries with previous years and observed a similar phenomenon.
The article notes, “The latest census is remarkably consistent with the previous reports. People continue to die in numbers, proportions and circumstances much as they did the year before, and the year before that and the year before that. There are a lot of Groundhog Days in how we’re getting killed on the job.” Even worse is the fact that these factors are no secret. “The same hazards keep killing workers,” the article continues. “What’s most likely to kill someone is not a trick question. It’s an open-book exam.”
If something as critical as lowering workplace deaths can get trapped in an endless cycle of no progress, it shows just how immovable some of these challenges can be. Lack of desire or effort isn’t always to blame.
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When insurance carriers undertake the process of upgrading critical IT systems, project timelines can drag on for years. Such a long project not only is disruptive and daunting, but also poses considerable risks. An analysis of a Gartner survey on the root cause of failed IT projects indicates, “[B]y ensuring that projects are kept small, and as a rule of thumb, not exceeding six months in duration, a much lower failure rate can be achieved.”
What contributes to longer implementations?
While every implementation faces a unique set of challenges, there are several common factors that can push out the go-live date.
A multi-vendor architecture, layered with isolated legacy systems and a patchwork approach to quick fixes, breeds a complex environment where any change may be difficult. The Cognizant white paper Reducing IT Complexity to Accelerate Digital Business notes, “IT complexity has become a critical imperative — requiring businesses to fundamentally rewire and simplify their IT estate.”
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We all want reassurance that the work we do matters—that we’re contributing in a way that matters. Author, consultant, and speaker Norman Marks, in a blog post titled Internal audit needs to perform in a way that matters to the board and top management, puts forth a series of questions that prompt those guiding internal audit to consider whether their efforts actually support leadership’s ability to set and achieve organizational objectives.
“Internal audit can help leaders with assurance that their people, systems, and processes are able to deliver the desired results – and advice and insight on how to improve them further,” Marks writes. “But do we?”
Contributing greater value to the board and top management by serving as a knowledgeable and respected advisor may require a shift in thinking about the role that internal audit plays within the organization. It is also likely to necessitate a change in audit planning and practices. Audits themselves must be seen as a critical component of a more holistic and continuous approach to identifying and analyzing risk, evaluating the effectiveness of controls, and proactively addressing areas of weakness.
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Standing atop Mount Everest is an extraordinarily rare feat. Since the first reported ascent in 1953, only 5,000 people have reached the mountain’s 29,029-foot peak. Over the same span of time, nearly 300 have died attempting to do so. And while making it to the top of Everest is tough, having the fortitude to turn back when the summit is within reach can be even more difficult.
The costs of climbing Everest are significant. In addition to spending roughly $100,000 for a single attempt, the time climbers put into planning and training for the venture is typically measured in years. Given these investments of time, energy, and money, many climbers not surprisingly push on in the face of extreme weather, oxygen depletion, and increasingly bleak odds. Unfortunately, the drive to make the investment “pay off” costs some their lives.
In a season 1 episode of the podcast Choiceology with Dan Heath, Michael Roberto of the Harvard Business School refers to this phenomenon as a sunk cost trap. In a sunk cost trap, Roberto explains that the human mind obscures rational thought because of emotional attachments already ‘sunk’ into achieving a goal. We all experience sunk cost traps in our daily lives: holding on too long to a bad investment, staying in a bad relationship, or refusing to walk out of a bad movie on your first night out in months.
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