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Can you expand on top down vs bottom up? Do you literally mean reading from the bottom of the page, or starting with the most granular items and decreasing gran
by insomniacity 9y ago
Can you expand on top down vs bottom up?
Do you literally mean reading from the bottom of the page, or starting with the most granular items and decreasing granularity?
- wpietri 9y agoSorry, I mean in an organizational sense. If managers tell workers "Here are checklists! Now follow them!" then they aren't as effective in improving quality as workers saying, "Let's collaborate to make sure we are doing procedure X well. How about a checklist?" Checklists are an easily observable symptom of an team drive for improvement of outcomes. But you can't reverse that and plop down checklists that are used under threat.
- komali2 9y agoI don't know much about how hospitals work, do doctors even have "managers?" I would figure the doctors would be the ones coming up with and using the checklists.
- nradov 9y agoIt's complicated. Doctors employed by hospitals report to two sets of managers. There are other doctors who serve as medical department heads and the chief of medicine. But those doctors are also accountable to non-physician business managers for administrative and financial issues. And then independent self-employed doctors may have privileges at the hospital and see some patients there but don't have managers in the traditional sense.