I’ve been thinking about a village, a tribe, and A League of Their Own.

The Rest of the (Thankful for an MRI?) Story

The MRI, if not the nightly pain, prompted me to sign up for the rotator-cuff repair, a 70-minute procedure that was successfully completed on Tuesday afternoon (12/13). It was difficult to keep count, but before I went completely under, I recall being touched by nearly a dozen caregivers (e.g., nurses, technicians, anesthesiologists, and surgeons), to say nothing of the behind-the-scenes cast from pharmacy, housekeeping, engineering, admitting, administration, billing, parking, and security. Hospitals are villages.

During preop, two docs, with yen-and-yang precision, maneuvered a catheter into my neck. The portable pump on the other end took over where surgery left off—dripping Ropivacaine, a nerve-blocking agent, into to my beleaguered arm for the next 72 hours. A day, then two after surgery, nurses called for pain scales. They were pleased that all my answers were zero out of ten. I was elated.

After confirming my consent, the anesthesia started working its magic. But not before I heard someone call the team to order and walk them through a process I recognized from my reading. I said, “Atul Gawande!” to which one physician expressed pleasant surprise that I understood and appreciated what they were doing.

For a moment, I feared he might suspend the anesthesia to tell me how he and his colleagues had worked with Dan Boorman, the now famous Boeing engineer who helps other industries apply aviation-tested checklists to improve safety and accuracy—well before Brigham and Women’s surgeon Atul Gawande’s Checklist Manifesto became a New York Times best-seller two Decembers ago.

So, I’m a week out. The pain pump is gone but with Ibuprofen and a bit of Percocet, the pain is manageable. The trick is learning to live without my left arm for a few months. Anyone remember Jim Abbott, the one-handed pitcher? It was amazing to behold his windup. Jim would put his glove pocket-down atop his right arm, pitch the ball, and place his left hand into the glove, hopefully before the batter hit the ball his direction. When he caught the ball (fielding or, much more commonly, getting the toss back from the catcher), he’d move the glove under his right arm, quickly extract his hand, grab the ball out of the glove, and make his throw or get ready for the next pitch.

NPR interviewed a handball champion a few years ago who had only one hand. The reporter asked what I thought was a stupid question. “Do you find having just one hand a disadvantage?” To my surprise, he said he found it to be an advantage. “Each play, my opponent has to decide which hand he will use. I’ve already decided.”

Regardless of our stations in life, they say we all put our trousers on one leg at a time. But I’ve discovered a new slant to that playing field. Even though I’ve decided which arm I will use when getting dressed (which happens to be on my strong side), it’s far south of amazing. I’ll spare you the details. Enough to say that I hadn’t realized how important both hands were to even the little things in life. Though we admire the heroics of a Jim Abbott, I’d wager even he would say that two are better than one. The handball guy is definitely an outlier.

A few thousand years ago, Paul, an apostle of Christ, used the human body as a metaphor for the church. I think it works just as well for a hospital. He argued that each person/part is needed and that the less attractive parts may be the most important. “The eye cannot say to the hand, “I don’t need you!” And the head cannot say to the feet, “I don’t need you!” On the contrary, those parts of the body that seem to be weaker [for me my left shoulder, arm, hand] are indispensable.”[1]

It’s obvious that the staff at my hospital not only play their roles, but they also work at understanding, appreciating, and honoring their colleagues’ roles regardless of gender, age, or degrees. They call it Virginia Mason Team Medicine.

As we prepare for the seventh unSUMMIT for Bedside Barcoding, I’m thinking about the unique members of our excellent team and their essential roles.[2] Then, there are our enthusiastic alliance and media partners and, of course, your hospital peers who are not only doing a quality job of bar coding at the point of care (BPOC) in their hospitals, but also are willing to give their time to share what they are learning with others.

But wait, there’s more. Hospitals cannot say to technology providers, “I have no need for you.” Nor visa versa. Have you ever heard one hand clapping? Hospitals could not scan at the bedside were it not for the legion of good products and supportive services. Similarly, software companies can’t say what they provide is any more important than what the printer, cart, or scanner companies provide. Each plays a critical role, even if some are tempted to deem their offerings more important than others. A million-dollar electronic medication administration system cannot accomplish its objectives if the lowly bar codes on patient wristbands are unreadable.

And how about the journals and magazines that publish the BPOC literature, print the case studies, and run the ads for required products and services?

BPOC requires a tribe.

Finally, part of the “un” in unSUMMIT is the unconventional (we think ingenious) path we committed to take at our inception, namely that caregivers and vendors would sit shoulder to shoulder in our educational sessions. And, that nurses and pharmacists, safety, risk, and information managers would blend in one conference (rare) to learn from each other.

This team approach has resulted in better products from the vendors and better processes from the end users.

Wherever your role in the enterprise, I hope you will get to experience the team approach to BPOC with us this May 2-4 in Anaheim.

I love the scene in A League of Their Own, when the Rockville Peaches’ Coach Dugan (Tom Hanks) is awakened on the team bus. When they told him the bus wasn’t moving, he barked a question for which the pretty little left fielder, Betty ‘Spaghetti’ Horn, has the answer:

Dugan: Why are we stopped?

Horne: Lou quit.

Dugan: Who’s Lou?

Horne: (Pointing to the steering wheel) The driver.

Grateful for the part you play in BPOC’s league of its own.

Mark