Sunday, March 27, 2011

WWDD?

WWJD poses a worthy question. “What would Jesus do?” effectively gets to the heart of “the big issues”: poverty, justice, conflict, and other major social and moral questions that face us individually and collectively. The answer we come to when we ask “What would Jesus do?” may not be a comfortable one, but it is likely to be morally sound, wise, and kind.

However, not all the questions we face in life are carry moral weight or social importance. They are not questions of “What is right?” but rather “What is effective?” How do I get the fine cat hair out of my rug? How can I be sure everyone is doing this calculation the correct way? Where in cyberspace should this document “live.” To answer such questions, a better acronym might be WWDD: “What would Dyson do?”

Our cat, Caesar, has a very fine undercoat which he is constantly shedding. These fine fibers interweave and trap themselves in our rugs, are difficult to dislodge by ordinary means. That all changed when we got this Dyson vacuum cleaner. It pulled the white cat hair out of the black rug so thoroughly, the rug changed color. My wife and I were sold.

What would Dyson do? In the commercials, James Dyson speaks of “solving the obvious problems.” But there’s more to it than that. You also look at all the “moving parts” involved in the solution, and carefully reason through how to make them work best. But how does this work in everyday problem solving?

One feature of Dyson vacuums is that they are bagless. After all, you never knew quite a bag got full, changing the bag was always a hassle, and you had to keep a supply on hand. A clear, bagless container solved these problems. Where I work, we occasionally have to use a complex formula to measure how well someone’s heart is pumping. It was all written out in standard mathematical format, and people would have to sit down with calculators to come up with a value that provided critical clinical information. What could possibly go wrong?

The obvious solution? All the computer workstations had Microsoft Excel installed. I created a spreadsheet that allowed the nurse to plug in the appropriate values, and presto, the cardiac output would be calculated, consistently and error-free. It is now available on all the cardiac ICU workstations.

The choice of a clear, bagless collection chamber creates its own issues. How do you empty it, as easily and comfortably as possible? The solution involves two buttons. The first releases the chamber from the vacuum. The second, accessible only after the chamber is released, opens the trap-door bottom to empty the chamber. No contact required. I do this directly in the garbage can outside.

Recently, I got to sit in on a meeting concerning paperwork flow. A hospital's (not where I currently work) Ethics Committee is occasionally consulted about "therapeutic interruption of pregnancy" (aborting a non-viable fetus) and must approve the procedure before before the patient is actually even a patient. While this avoids the regulatory hoops and political stigma of becoming an abortion clinic, it created other problems. How do we track the information in the hospital's electronic medical record system? After all, the patient might have the procedure done elsewhere, or not do it at all.


There was talk of creating a “ghost chart” to contain information, to be "resurrected" when the patient was admitted. But in that the patient wasn't even a patient of the hospital, and might never be, they could end up with a number of these "ghosts" haunting them. These situations were also relatively rare: maybe a dozen a year. Creating a "ghost chart" seemed a cumbersome way to address the issue.

Then, they remembered the patient already has a chart, back at the referring doctor’s office. The Ethics Committee’s decision would be sent back to the referring doctor, and “live” in that chart. If the patient is admitted, the chart from the doctor’s office, including the Ethics Committee decision, would follow the patient over. No virtual chart needed. All the moving parts fit together, and do the job elegantly and effectively. It’s what Dyson would do.

Patient care has a lot of "moving parts," and not all of them (and sometime frustratingly few of them) mesh well. What would Jesus do in approaching these challenges? Aside from approaching the challenge with humility and faith, I find it difficult to come up with a useful answer. What would Dyson do? Identify the problems and solve them. Look critically at the moving parts, and thoughtfully arrange them to best effect.

When trying to do what’s right, it would be difficult to better than ask, “What would Jesus do?” Not all questions are about what’s right, some are about what works. In such cases, the more salient question may be, “What would Dyson do?”

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