Are You Confidently Wrong?

31 Oct 2018

Katie Anthony

Healthcare Leadership, Communication


In any process of change, long-held biases among colleagues can slow down acceptance and adoption. Science knows why: When someone has a long-held belief, they are unlikely to accept information that contradicts that belief. We're all vulnerable to this.


For example, one nursing department routinely used the wrong disinfectant for a surgical procedure, and this was only discovered after many incorrect applications. When asked why they used it, they were confident that they were using the correct disinfectant because, “It’s what’s provided for us.” When the purchasing department was asked why they’d provided the (wrong) disinfectant, their response was, “That’s what the nurses request.”


This was a circular problem in which both parties were so sure of their correctness that neither perceived the possibility of a problem, much less that they had created it.


It’s difficult, but not impossible, to move people beyond their long-held biases. To do so, you must first know that a bias exists. Marching into the boardroom and declaring a brand-new process before knowing everyone’s bias is a sure-fire way to lose at the start. When an opportunity for change presents itself, first take the time to understand who within your organization needs to be on board for success. Then meet with each of these people one-on-one.


At first, don’t attempt to introduce a solution. Instead, take the time to understand each person’s perspective on the issue. Learn what a “personal win” would be for that individual, and when you’re ready to bring your solution, make sure you’ve addressed each person’s bias and personal win within your presentation.



One helpful framework common in healthcare is SBAR: Situation, Background, Assessment, Recommendation. Using SBAR is a simple and standardized way to present an idea and your proposed solution. Here’s an example:


Situation: Patients are complaining about wait times in the emergency department.


Background: The emergency department is temporarily understaffed while two new physicians are being hired.


Assessment: Wait times are indeed up by 10-20 minutes at peak traffic hours of 9 p.m. to midnight.


Recommendation: Train the ED reception staff to set realistic expectations with patients about wait times. Have staff round in the waiting room every 15 minutes to remind patients of their importance and update them about admittance timing.



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