Monday, March 7, 2011


My town is embarking on an opportunity for change. But we have been misled before. So much so, that we aren’t easily swayed. We want change, and we want to work on it now. But underneath and all around us are those damn crevices, towers of great information that are difficult to break down or break through, systems that prevent serendipity. (1)

There is nothing like a really good idea. An idea that makes sense, builds on itself, allows for adaptation. I start with an idea trail. It begins with one thought, and then another. Some link, some don’t. Eventually I apply smart program development criteria. But in the mean time, I talk it up with folks from different paths and places. Then I suggest we have coffee somewhere near where the idea has the greatest meaning. Frankly, here is the secret. With putting the right folks together, a wonderful set of ideas will be created which can become a working concept. Inclusion of all these disparate sectors results in: buy-in, feedback and self-evaluation and, of course, best methods of implementation.

Here is an idea. A pediatric specialist changed positions. She worked at a community based center providing needed and (essentially) free services to children with developmental and orthopedic problems. Now she works in the neo-natal intensive care unit (NICU) literally down the street where all the kids she had been working with started out in life. Right away she was able to share with them what ‘what happens if’ feedback, e.g. prolonged position of the child for feeding and airway protection causes residual impairments. This interaction should be going on without large-scale initiatives.

The idea trail. Given information about the local healthy community initiative, I wondered along with my dear colleague that there might be a connection not only between high risk NICU infants and lifelong disability but societal problems as well. Without hesitation, a list was generated: post-traumatic stress syndrome (PTSD) of the parents, the emotional delays and latent inappropriate teen drug use, severe funding cuts along with a void of strategic education and support for the high risk infants’ ‘first responders’ - their parents. Well, she shared the opportunity with her colleagues and they got inspired and the trailhead is established.

Now let’s apply some creative analytic thinking. What information might help the idea? Discard it, embrace it, or change it? It would be great if we could answer some assumptions, such as, is parental PTSD also related to income and residence or culture? How about the social sequelae of having been in the local NICU? Do most of the kids go to college, or have families of their own? What are the essential needs of the child after discharge, and are these services accessible and affordable, or even used? There are more questions, and questions beget questions. What would families of the children share? Why, the teachers in pre-school! As is turned out, the rehab facility down the road hadn’t shared their insights with their nearby colleagues until happenstance occurred.

This process doesn’t cost much, if anything. It certainly can happen quickly. Many who sit in organizational charts are comforted by lots and lots of detailed data; others just know the problem and need for it to be articulated. But we all suffer from lack of connectedness.

(1) Meyers, Morton A.: Happy Accidents: Serendipity in Modern Medical Breakthroughs, New York: Arcade Pub., Distributed by Hachette Book Group, c2007.

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