“Living Fossils” as Adaptive Clues

In this fascinating radio story, we hear how Mary and Toph set out to modernize communication at their hospital by “liberating it from the pager” - a “living fossil” still used in many hospitals today.

Upgrading to cell phones seemed like an obvious improvement. However, they uncovered adaptive challenges around power dynamics, habits, and professional identity and ultimately failed in their efforts.

Unlike technical problems solved by applying known solutions, adaptive challenges require changing beliefs, values, and mindsets. People may intellectually know improvements are needed, yet struggle with the deep and often unconscious discomfort of change.

Lean practitioners are well versed in rapid cycle improvement for technical problems. This same process expertise can be applied to testing the underlying assumptions that keep systems in place. Assumptions like, “If I cut back on seeking consultations, I’ll be perceived as not thorough enough and put my reputation at risk.” Or, "If I speak up about the deeper challenges in our current workflow, my co-workers will think I'm difficult to work with and that I’m not a team player."

As improvement leaders, we can foster environments where people feel safe leaning into these adaptive challenges. When beliefs shift, behaviors follow. Let's discuss ways we can promote understanding of adaptive challenges in our initiatives.

The full 26-minute story: https://www.npr.org/2023/12/08/1197955913/doctors-pagers-beepers

3-minute summary: https://www.npr.org/2023/12/15/1219737658/why-do-doctors-still-use-pagers

Photo: a close-up of a crocodile, a “living fossil” (like the pager)