Who do you see as responsible for the duration of this task? Why? 2. What fundamental errors do you believe caused this to happen? 3. What should Smith do with his newly acquired information?
The UNNecessary Task
Additional Topics—Authority; Communication; Criticism and Discipline; Motivation
The health information management (HIM) department of Memorial Hospital was considered able to function for a day or two at a time without a manager when neces- sary. However, when Mrs. James, the director of HIM, was hospitalized for several weeks, administration asked Guy Smith, the director of admissions, to look in on HIM on a regular basis. In his previous position with another, smaller hospital, Smith had supervised both HIM and admitting.
About noon one day Smith noticed a completed form entitled “Daily Census Report” on the corner of a clerk’s desk in the medical records department. It caught his eye because in his months at the hospital the only census report he had seen was the computer-generated report he received each morning. He became even more curi- ous when he noticed that the hand-generated report was dated for that day. He asked the clerk who created the report and why.
“I do it,” she said, “but I don’t really know why.” She proceeded to describe the process: Each morning she took the previous day’s record department count of admissions and discharges and merged it with the information obtained from copies of the midnight census report generated by the head nurse in each nursing unit. This took her about an hour and a half each day.
Smith asked, “Who uses this report?” “I don’t think anybody uses it.” “Then let me put it this way,” said Smith, his frustration beginning to show,
“Who receives the report?” “Nobody,” the clerk answered. She went on to explain that some time earlier the
hospital experienced problems with its computer system and certain census informa- tion was being lost. Mrs. Victor, who was her supervisor then, showed her how to do the report and told her where to leave it. For about 4 weeks the report was picked up faithfully at noon every day.
“Why hasn’t it been discontinued?” asked Smith. “It was discontinued, once,” the clerk answered. “By me. And I got into plenty
of trouble over it. It got picked up regularly only for about 4 weeks. After that, before I knew it I had eight or nine on my desk. I tried to ask Mrs. Victor about it but I still
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couldn’t get an answer—you couldn’t get her to stand still for 10 seconds—so I just stopped doing it on my own because I couldn’t see any sense in it. When Mrs. Victor found out I dropped it, she gave me the chewing out of my life and said that I’d better never do anything like that again without a direct order.”
Smith said, “But Mrs. Victor has been gone more than a year. Did you mention this to Mrs. James?”
“Yes, but I’m not sure it ever sank in. She’s just as busy as Mrs. Victor ever was, and the only people who seem able to get her attention for more than a minute at a time are administration and the physicians. She said she’d look into it, but I haven’t heard anything. And I’m not sticking my neck out again.”
Guy Smith spent a few more minutes with the clerk looking over some of the reports. In that time he discovered that the clerk had done neat, accurate work, taking as long as 90 minutes a day, for nearly 25 months. And 23 months’ worth of this work was never seen by anyone other than the clerk herself.
1. Who do you see as responsible for the duration of this task? Why? 2. What fundamental errors do you believe caused this to happen? 3. What should Smith do with his newly acquired information?