Managing Office Staff: What Podiatry Can Learn From The Airline Industry

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Lynn Homisak, PRT

   There is no room for personality clashes in the flight team. There is no lying, “it’s not my job” comments, dysfunctional relationships or emotional breakdowns. They must work together as professionals to do what needs to be done. Given the large numbers of planes in the sky at any given moment, without clear communication, compliance and teamwork, there would be disasters of epic proportions and the flight teams know it. This is no small task and is filled with stress. They understand that a successful outcome occurs through cooperation and there is no room for quarrels, backtalk, disrespect or insubordination. They just do it, not part time and not just when it is convenient.

   Based on my years of experience in healthcare, it is fair to say that communication is the number one issue in the majority of offices. This was evident when I visited a large multi-doctor practice on the East Coast. Part of that consult was to meet with all the staff managers and discuss where they felt efficiency breakdowns occurred. As we worked through issues, one manager asked, “I’m confused. Did our doctors actually fly you across the country to ask us what the problems were so you could tell them what we said? They are here with us every day … Did they consider asking us that question?” If their communication skills were modeled after air traffic control, this practice could have concentrated on improving patient care and efficiency systems, but they could not get past their communication roadblocks.

   Teamwork and communication compliment and feed off each other. Through active listening skills, mutual effort and commitment to a successful outcome, shared responsibilities toward a common purpose/goal, clear accepted procedures, dedication and sacrifice (“taking one for the good of the team”), this combination can increase trust and performance.

Why A Hasty Run-Through Won’t Cut It When Training Staff

Another underutilized tool in the shed of success is proper training. While many jobs at the onset appear daunting, airlines make certain their pilots are fully trained. No shortcuts allowed. The level of training that one receives turns that fear into confidence. It is easy for an employer to criticize an employee for not doing his or her job right, but it is often the result of improper or no training, something employers fail to take responsibility for.

   I had the privilege of sitting in the actual cockpit of a Boeing 737-800 simulator to see and feel firsthand what is involved with flying it. As I took my seat among the hundreds of knobs, handles, dials, buttons and levers in front of, above and below me, I could not help but feel intimidated. I got a quick “run-through” from the pilot, who parked himself in the co-pilot seat and began rattling off what he said I needed to know before takeoff. Pull this, check this, lower that … it seemed his instructions were endless. He basically touched on some key points, like how to start the plane, pull back on the throttle, put it in autopilot and drop the landing gear.

   When he completed his 15-minute tutorial, he asked if I had any questions. Even though I knew I was not prepared, off we went. This was an eye-opening event. Even though I (we) landed the plane (thanks to the co-pilot), we crashed as I taxied to the gate. Had it been a real flight, 162 passengers plus crew would not have made it.

   Needless to say, a hasty “run-through” just did not cut it. Yet this is too often how we train staff in many offices. Circumstances are different but the reasons for failure are the same and while hundreds of lives may not be at stake, reputations are.

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James DiNovis DPMsays: December 19, 2011 at 2:39 pm

Ms. Homisak has only touched on a small portion of what has come out of aerospace engineering. The Crew Resource Manual (CRM) was used as a resource for the writing of Atul Giwandi's The Checklist Manifesto. Many of us are aware of the use of checklists in the OR prior to beginning a surgical case.

The CRM has also been used in developing heuristics and algorithms for anesthesiologists in dealing with OR crises. Doctor Gaba et. al. at Stanford have developed a simulation program (think flight simulation) for anesthesiology residence programs at Stanford and Mass General for instance.

Another resource developed from CRM, Operations Management and In Extremus Psychology is the text, Crisis Management in the Acute Care Setting. It is quite comprehensive and helpful in improving quality of care and patient safety.

Thank you Ms. Homisak for your interesting article.

Jim DiNoivs

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