Healthcare workers are generally very skilled and proficient at making things work. This is highly valued when working in systems of all kinds that don't always cooperate, especially when a life is on the line. Kudos to those so skilled in using their ingenuity to make a deficient or faulty system or process function well enough to get the task completed. But I'd like to point out a flaw that needs serious and widespread attention. Behavior such as this, works around the problem and does not truly solve it. This perniciously creates a situation of dependency; a kind of addiction to the heroics of in-the-moment problem solving. Until the problem is solved, it will resurface for another workaround by the same or other ingenious person.

This can be examined in light of a systems archetype called "shifting the burden". The pattern is familiar and I've drawn out the causal loop diagram. The symptoms of an immediate problems are resolved quickly - the workaround enables the work to proceed in an oftentimes incomplete or risky manner. Usually there is fundamental corrective action that needs to be taken; requiring investigation, observation, devising and testing changes and measurement - in other words, improvement. All this requires time, and many people who work IN healthcare processes are stretched to the limit just DOING work that often requires ingenious workarounds. And the vicious cycle continues - back around to working around the problem.

The heroic workaround will live on until the pattern is broken, and this can require a significant commitment of time and money. Some organizations are making this investment, but many remain addicted to the pernicious workaround.