Ignorance…Definitely Not HC Bliss

Posted on September 19, 2013

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I take criticism very seriously.  As an architecture student, I was well-prepared by the design studio jury process to field almost any negative attack on my design (or me) regardless of relevance. Perhaps the most biting piece I’ve ever received was this: “You don’t know what you don’t know.”  It is the kind of comment to patiently absorb and mull over before reacting, which is not easy because it is personal.

To me ignorance—a lack of knowledge or information—is acceptable in the short-term as long as a person is willing to overcome it, either by self-education or compensating in other ways, like hiring an expert.   Let’s face it:  everyone is ignorant about something, even within our own professions or specialties.

And in certain circumstances, the quip “Ignorance is bliss” is accurate because not knowing something is a convenient way to weasel out of responsibility.

However, I interpreted the above statement to mean I was ignorant of my ignorance.  True or not, ignorance of ignorance—‘ignorance squared’—is potentially quite dangerous.  It suggests a lack of awareness of the scope or importance of an apparent information gap, an almost cluelessness, and perhaps no plan to bridge the knowledge gap.

So when I heard that same comment again recently, made by a healthcare consultant about hospitals, my ears perked up.

Put in context, I was discussing design for operational efficiency with a rather successful healthcare strategic planning consultant.  For instance, I asked him if he thought there was a singular ideal way to lay out an OR suite for maximum throughput.  He said he wasn’t sure because most hospital department directors do not regularly track their department’s throughput and performance.  What’s more, they do not know what their throughput should be, let alone could be.  They don’t know what they don’t know.

Lucky for hospitals, simulation exists.  Simulation is the singular best tool to help fill in the haziness of departmental performance—from the OR to the ED and elsewhere in between.  It is the ideal liaison between design and operations.  Simulation can target efficiency goals and verify they will be matched based on the way a hospital department goes about its work.  And it can help identify places in the process to improve should the targets fall short.  All of this is done virtually, or more specifically, by allowing a computer to run thousands of scenarios based on a department’s day-to-day operations, and derive averages of those outcomes.  Those data help inform administrative decisions for improved efficiency when compared against external and internal hospital performance benchmarks.

Simulation can reduce uncertainty and ignorance exponentially.  Hospitals may not yet know how to fix a department’s performance, but at least they will know what they are looking for.  In some cases, simulation can do both:  identify where a hospital should be performing, and how to get there.  Simulation can remove at least half of the doubt, and possibly all of it.

Simulation is a powerful tool for sure—one that will get more press—and I am lucky to have access to it here at Haskell.  If only I could have traveled back in time to school…

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