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It's Time to Get Smart and Remove the Cone of Silence

July 15, 2010
by Gwen Darling
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Late last week, I flew up to Boston to have dinner and a meeting with a potential business partner. The flight up was uneventful – Tulsa >Newark>Manchester. If you’ve not yet experienced the ease of flying into Manchester, NH’s cozy little airport instead of into Boston Logan, I highly recommend it. Rented a car, drove to my hotel, and was picked up and whisked away into the city for a fantastic night of brainstorming and amazing Italian food. All was great – and I even got to see Paul Revere’s house, which somehow I’d missed on all my previous trips to the city.

The meeting the next day was exciting and very productive, and I arrived at the airport in plenty of time to make the flight home. This trip was heading toward a storybook ending, without a doubt! And then. . . a slight flight delay. Then another one. And then? Another one. To make a very long story a bit shorter, by the time we got to Newark I had missed the last flight out to Tulsa and was rebooked for the following morning - Newark >Houston>Tulsa. So. . . one AirTrain and Sheraton Shuttle ride later, I was enjoying room service and a really nice glass of Cabernet and thinking that this turn of events wasn’t really so awful (although it was expensive and Continental should really think about the message they sent by not manning up and providing hotel vouchers).

So why am I telling you all this (other than to find an excuse to show off my iPhone camera prowess)? Because of a conversation I had with a stranger in the airport as we waited for our next delay. “Terri,” a NICU nurse from a “major” medical center in the Boston area (she didn’t mention which one), was traveling to visit her parents for a long weekend, and we struck up a friendly conversation. She had been working in the NICU for five years, she tried not to get attached to the babies but of course she loved each and every one of them, and she couldn’t imagine herself doing anything else. After having just read the results of a study that found that nearly half of hospital employees are “discontent” in their work, this news was wonderful to hear. Upon hearing what I did for a living, however, her mood immediately changed.

“They don’t tell us anything,” she said. “Who?” I asked. “The IT people. We know there are deadlines for the IT changes and that our work is going to be significantly different, but that’s all we know. They don’t tell us anything.” “Well, the new rules for Meaningful Use are going to be published soon, and then they’ll have a better idea of what they’re up against,” I offered. “That’s another thing,” she said. “We’ve heard about Meaningful Use but no one really understands what it means.”

Okay. I totally feel Terri’s pain. The whole “Meaningful Use” concept has been confusing, and until earlier this week had an unsettling nebulous feel to it, likely by design. But now the documents are here, in all their almost 1000-page glory, and it’s time to talk about it. Not just amongst yourselves in Board Meetings, and upper-management retreats, and vendor strategy sessions. No, now’s the time to rally the troops – from the cafeteria staff to the marketing department to the NICU nurses (especially the NICU nurses), to talk about the plan of attack. Blog about it, take advantage of the employee newsletter, invite someone from each department to a “Lunch and Learn” (with lunch on you!) Explain what “Meaningful Use” really is and what it means for them personally, what it means for the hospital, and what it means for the patient community. Unless you’re one of the lucky few early adopter hospital systems, you’ve got a long and challenging road ahead of you, which will require the buy-in and support of each and every team member in order to fully be successful. Don’t keep it a secret - remove the cone of silence!

NOTE: Looking for an “in plain English” explanation of what’s occurred and what’s to come? Here it is.



Thanks for sharing your story. Both the fun-with-business travel and the employee-engagement-requires-communication themes.

There's clearly a lost management concept here. Information Flow. In organizations that have an adequately designed management process, information flows through people, in a deliberate fashion.

When I leave a well-run, executive team meeting, we've already discussed the communication plan related to what we've discussed. There's a clear expectation regarding the message to our subordinates and when that communication is going to happen. It's usually within four business hours if its critical, otherwise within a day or two, and never more than the week. Those subordinates with directs who are receiving the message have a similar, explicit obligation.

The Cone of Silence breeds paranoia. Failure of a manager to maintain this basic communication responsibility is just sloppy.

Terri (through you, Gwen) brings out a serious flaw in many management teams: They forget to involve everyone.

Maybe they are simply moving in a different sphere. Or maybe they don't think others need or want to know. Or maybe they don't think anyone else cares. Or maybe ther are just plain ignorant of the value of ground-level support.

Pity. They lose more than they can imagine.