Expect more than just nurse strikes in the upcoming days.  Command and control thinking with its cost-cutting mentality is sure to get worse.  Let’s not limit this to just hospitals, but I expect to see strikes in many other industries as workers of all sorts say enough is enough.

It is never good when workers strike . . . especially in hospitals where life and death are decided daily.  The question becomes what are the root causes? They are usually same things with cost cutting being a focal point.  We know that cutting costs always increase costs . . . always.

Unfortunately, command and control managers know little more than how to manage budgets and productivity.  Few hospital administrators spend time in the work understanding their systems.  Time instead is spent over the deteriorating income statements and reports that give them little context of the causes of costs.

A heart-wrenching story about a nurse suicide can be found on YouTube (Melissa’s Story) paints a sad picture.  We have plenty of disciplinary procedures and protocol but few efforts to advance learning and improvement of services.  There is much waste in hospitals and there is a need for administrators, nurses and others to work on the system (structure, technology, work design, technology, policies, etc.).

Why work on the system?  Because 95% of the performance of any organiztion is attributable to the system and only 5% the individual.  Working on the system gives us a huge opportunity to improve.  Working on the individual results in poor outcomes.

The current structure of most hospitals with poor work design and management focused on costs leads to a predictable conflict.  This is neither good management or good patient care. 

Redsigning hospital work requires both management and worker looking together at customer demand and not each other.  Better thinking will prevail as management and worker understand customer purpose and derive new and better customer measures that drive costs down and relationships together.  The old command and control style of worker’s work and manager’s manage with cost cutting does nothing good for management, worker or patient.

We face an era of more strikes or more cooperation, I would suggest that it is more profitable to seek cooperation.  Proper focus on the system and the causes of costs is a great place to begin.

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Make the new decade a profitable and rewarding one, start a new path here.  Download free from www.newsystemsthinking.com “Understanding Your Organization as a System” and gain knowledge of systems thinking or contact us about how to get started at tripp@newsystemsthinking.com.  Reach him on Twitter at www.twitter.com/TriBabbitt or LinkedIn at www.linkedin.com/in/trippbabbitt.