Lessons in Business Intelligence from the ICU
Bells, Whistles, Beeps, and Chaos
Spend any amount of time in an ICU and you are hit with an overwhelming amount of chaos. Now the anxiety of such a visit doesn’t help the situation or often allow for unbiased observation, but then that point can be an ideal lesson. By the way, the cover image above does little to illustrate that chaos.
The real view, and honestly this one is on the more organized side, is far more complicated. Most things are. This one looks a bit more antiquated then the one I am current staring at, but better (or newer) technology does very little to alleviate the chaos.
Colored lights, giant numbers, knobs, dials, bells, whistles — it is a menagerie of chaos. All to support a similar menagerie of doctors, residents, nurses, interns, and perhaps even the janitor. Each specialist locates their consul of choice, focuses on their instrumentation, makes some odd faces (good news, bad news, they all make odd ones…) and then note a few things on their pad or clipboard before leaving.
The hospital knowledge workers have their role down. I doubt many notice the clutter, with the exception of the dedicated nurse who occasionally tidies things up. The patient, while surely not happy about it, spends their time mostly oblivious to the nonsense. Sedated or otherwise, it is all rather surreal.
To the outside observer (the patient’s family), this whole thing is a mass of inefficiency and distraction. For the concerned observer, add anxiety and confusion. Every time something dings, changes, beeps, or flashes — there is a wave of high blood pressure, questions, and stress. Is it any wonder?
To the uninitiated, the thinking goes something like this “Why have and alarm if it isn’t a problem?”. To a quiet observer of the experts, it is quite clear that this logical assertion holds little true significance. Most things just aren’t that important. So why all the fan fare?
There are, of course reasons. How good any are is quite debatable. The chief reason is very analytic — iterative development. If you could go back through the time series of an ICU, you would be able to watch as each separate instrument was added to the array. In other words, all of this was piecemeal, not planned.
Your Business
Businesses often engage in this sort of iterative development, too. The array of lights and whistles (daily emails, dashboards, and reports) create a whirling cacophony of information to the outside observer. But in the business world, the outside observer is a consultant or a new hire. One doesn’t care. The other believes it is just because they are the ‘new guy’ until jading experience teaches them not to care either.
Like the hospital worker, our business employees focus on what is theirs to care about and ignore the rest. So is there any harm?
The Objective Observer & Opportunity Cost
Don’t discount the objective observer. People are quick to note that the experts are being served, that the objective observer lacks context. Perhaps? But again, this array was not constructed with a single goal in mind. Each instrument was added along the way. Each has and had a purpose, but these are additions not components. There was no master design.
The result is a substantial learning curve. Talk to any family who has dealt with a lengthy hospital stay and they will know what each beeping light they can ignore. They too will have become jaded and focused on only those noises or flashing lights that seem to matter. But thankfully, most of us don’t spend that length of time in the hospital.
The second issue is opportunity cost. There is lost potential here. These instruments could work together. They could create incremental value. They could be cleaner, clearer, and more educational. And just because no one has, is little proof that value isn’t there. The time series creation of this array created a sort of friction, there is a cost to change.
Had someone intervened early in the cycle, it would have been less risky to make changes, faster and less complicated. Perhaps the main monitor speaks to this with it’s five major read-outs. An additional challenge may come from the fact that many of the other instruments are a la carte depending on circumstance.
This gets to a final lesson. Who is really in charge? In the hospital, a plethora of specialists are typically involved — so who really has the incentive to push for a more integrated and higher value system. The nurse? You can see where this might challenge things as well. One would like to think that hospital administrators and other leaders would press for higher value, a better experience… but hospital feedback loops are complicated, costly, and open to litigation.
Your business should not be this encumbered. Yes, there are budgets and development cycles — but your business should be able to see past this. The final question — do you have the talent and expertise to improve it?
