Cold shouldered

There’s something wrong with my left shoulder at the moment, so I’ve had to embark upon one of my very rare engagements with the medical profession.

I had thought to write one of those blow-by-blow accounts of what a useless, energy-sapping, time-wasting fiasco the experience has been so far, but on reflection I’ve come to the conclusion that a) writing it all down would take hours and just make me feel furious and miserable, and b) reading it all would just make you feel very bored.

While I was at it, I could have added a few similar paragraphs around the experience of trying a new workshop to service and MoT my old car. Again I won’t try my temper or your patience with a blow-by-blow, although I’ve actually got plenty of time to do so since my service manager has now disappeared on a fortnight’s holiday and no-one else is briefed on what to say to me in his absence.

But even without lapsing into self-indulgent and overly detailed ranting, I can still make the point I want to make – which is, of course, that it’s not just financial services that are rubbish. Everything is rubbish, and particularly everything which involves co-ordination more than two organisations, teams or departments. (The medical experience is mainly rubbish because it involves co-ordination between my GP, the health insurance company, the consultant and the MRI scan people. The old car experience only involves my service manager, the two “halves” of the workshop, mechanical and bodywork, and the spares department of Aston Martin, but that’s more than enough.)

Years ago, I saw an unexpectedly brilliant conference presentation from the then-COO of Pearl Assurance (that tells you how many years ago). He had been investigating a mysterious phenomenon to do with the firm’s back-office error rates. Objectively, the error rates were terrible. But when you researched back office staff and asked them how many mistakes they thought they made, the answer was a tiny fraction of the real figure. How so, the COO wondered. Were the staff just lying? Or fooling themselves?

On close examination, he found the answer. The huge majority of the errors arose in one particular situation: at the point where one person was passing a job on to another person. Time after time transmission errors would occur, the passer failing to tell the passee something essential about what had to be done. As a result, the passee would screw up and the error would occur. But, more often than not, neither passer nor passee had any awareness that an error had occurred. Both felt quite sure that they’d done exactly what they were supposed to do.

The COO of Pearl Assurance told us that having once identified this problem, his company was able to achieve astonishing improvements in its error rates simply by concentrating its training efforts on how to achieve an effective handover process. (I have to say that these improvements clearly weren’t enough to save the company, which was sold and closed to new business not long afterwards, but still.)

Anyway, if the COO of Pearl Assurance is still out there somewhere and still has his presentation slides, I wish he’d show them to the Kentish Town Health Centre, Wellington Hospital and North One Aston Martin. At the moment, their error rates make the bad old days of Pearl Assurance look like paradise.

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