Who does what…

When we are in the planning stages of any business change we often do a RACI – who is responsible, accountable, consulted or informed throughout the change.raci-matrix-responsible-accountable

Needless to say, in the corporate land I inhabit, this is often not observed and it’s often one of the most frustrating things about what I do.

Everyone, of course, is a communications expert and everyone has experienced some kind of change in their lives.  So naturally, people at work think nothing of critiquing or meddling or redoing my work to suit their personal tastes.  I would say 50% of my working life is sorting out the mess that senior executives create when they ‘get involved’.

guilty-dogAnd I am not without blame here either.  I often do a bit of learning & development or recruitment or commercial negotiation with agencies etc. on the side, as these are skills I have from my past roles which I don’t want to lose. Sometimes I forget about the impact this has on my colleagues who already perform these roles in the working environment.

So imagine what would happen if you applied this degree of ‘scope creep’ in a hospital environment?  If the anaesthetist wakes up and says, “I’ve seen the consultant surgeon do this operation 100 times, I’d like a go”.

Thankfully it would never happen!

The RACI in the hospital environment is very well observed.  The consultant surgeon is accountable for removing the cancer, his surgical team are responsible for helping him make this happen, maintaining my health and well-being at all times.  The dietitians are accountable for ensuring I have enough nutrition to heal in the days after the operation, the nurses are responsible for ensuring the feeding tube is in place.  The speech therapists are accountable for providing me with speech and mouth exercises and responsible for making sure I can swallow safely before I’m given water to drink or food to play with! The nursing team are accountable for my health after the operation and responsible for my care in the following days.  Even the receptionist is accountable for making sure I have follow-up sessions scheduled.  You get the general idea.

What this does is create a very efficient system.  Everyone knows their role and everyone is an expert specialist in performing in that role.

But, for me, the most impressive aspect of all is that the leader – the consultant surgeon – seeks others’ ideas and opinions about my treatment, and he listens to what these opinions are before making a decision. He does not  believe he has all the answers.  He seeks the collective knowledge of his team to assess and debate alternatives.

And this collective wisdom means that today I write in recovery – with the cancer all removed and no radiotherapy required.  The decision to remove my lymph glands and nodes means that those 2 sneaky cancer cells, hidden from MRI and other tests, went when they took the lymph glands away.

In change terms – the RACI and associated governance works.  We have ’embedded the change’.

 

 

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