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Blog: The flipside to problems

Primary care
25 June 2018

I’ve been thinking about the saying, ‘Choose a job you love, and you will never have to work a day in your life’. Well you might love your job but no matter what you do, whether a plumber, architect, or health professional, there are ‘every day’ types of problems. For example, the mountain of things on the ‘to-do’ list that require thinking, phoning, typing, filing and hopefully fixing. Solutions here are relatively simple and linear.

But every professional also gets tougher problems to solve. Sometimes they are deja vu issues, when we revisit the same problem over and over again and wish we had the time and thinking space to see things differently and shift this recurrent hurdle once and for all.

In health care we get our own brand of especially thorny problems. These might be a patient complaint, a near miss (the adverse event that nearly happened), being rankled by a performance comparison (how do they do it better than us?) or it might be something that turned up when reviewing a patient file.

There is a flipside to problems.

Most of us feel satisfaction when we tick off something on the to-do list. In fact, I’ve been known to add a task that I’ve just completed to the list so I can scratch it off! Addressing more complex problems is harder. But we all know that wonderful feeling when you’ve actually solved a work problem that has got under your skin, a problem that has your brain on repeat mode, a problem that really matters to you. Now that is a problem worth solving.

I heard about a doctor who found a glitch with laboratory results handling. He and his practice never wanted to relive that ‘oh no’ moment again. The relief and joy of focusing on a problem and improving something that mattered to him and his team far outweighed the effort involved in the many small changes that they put in place. And they felt so good about it that they are now tackling other issues in the same way.

Instead of always dealing with what is happening and fighting fires, the trick to turning thorny problems around might be to allow space and time to think about how, when and why the problem occurs. Using simple or easy to learn quality improvement methods and tools can help us to understand the problem and identify, test and implement solutions.

Need help? Consider applying for the Commission’s Whakakotahi primary care improvement challenge or the Safety in Practice collaborative to walk you through this, contact the PHO quality improvement network or look at the Commission’s primary care website for resources.

Author: Dr Susan Wells is a member of the Commission's primary care expert advisory group and the programme's clinical advisor. Sue's contributions offer insights on the context for primary care quality improvement success. Sue works as an associate professor of health innovation and quality improvement at the School of Population Health, University of Auckland, and before becoming a public health medicine specialist was a GP for 10 years.