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Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts

Sunday, 25 February 2018

My bias declared publicly. Could you declare yours?



For quite sometime I have been active in quality improvement, leadership, patient safety, human factors and related areas. My interest includes discrimination in general but healthcare in particular and especially doctors. This relates to discrimination in the western world particularly in the UK. We know bias plays a part in this discrimination. Government and organisations have taken efforts in dealing with discrimination, this takes the form of law, training in equality and diversity and monitoring selected data. We are told how to deal with discrimination and how to avoid discrimination.

We were never asked to assess, quantify and declare our bias.

Bias is a part of life. For better or worse our history, legacy and as humans our capacity to pattern match means that bias gets in. We could even argue that bias is a normal part of life. However when bias affects the career, livelihood, reputation and freedom of certain segments of the population, it ceases to be normal. While bias could be accepted as normal, the positive or negative effects of bias that affects segments of population repeatedly can never be accepted as normal.

How do we prevent bias from affecting others?

In my opinion unless we assess our bias by a common method and then declare it publicly we cannot begin to tackle discrimination.

Once our bias is published publicly, then we can start having methods to take that into account in our decision making by appropriate counterbalances, algorithms, adjustments etc.

I cannot ask others to publicly declare their bias unless I have done so myself.

Currently, the Harvard Implicit Association Tests are a good (but not totally proven) method to assess our bias. https://implicit.harvard.edu/implicit/takeatest.html

I have taken the test that relates to race and I am posting the results by screenshot here.


I am aware that this test relates better to the USA and refers to the black-white races. I also took this test thrice; twice the same result came up that I had a moderate automatic preference for white people and once the test showed no preference between white and black people; on the occasion that the test showed no preference, I had deliberately slowed down to take the test.



So does that make me a racist? I do not think so. Does that make me biased? May be it does, but since I have known this for sometime now, I make deliberate conscious effort to overcome my Harvard IAT data based moderate automatic preference for white people. I think very deeply on how my actions are impacting. I take extra effort to review decisions before implementing them with the awareness of my bias to ensure that my actions do not affect black and minority ethnic people adversely.

If I was an examiner, investigator, police, judge, etc I would want my decisions to be counterbalanced by a formal algorithm to prevent my bias from hurting BME people.

I am not in an unusual category as far as my bias is concerned; I am part of the largest category of persons who have taken this test. How does this affect the society?

We need to start somewhere.

I encourage you to take the test and post it publicly. I am happy to add your test result to this blog if you send it to me. Let us make a change. Let us reduce bias. Let us take the first real step by publicly acknowledging our own bias.

Here is the list of persons who have agreed to go public with their bias tests. My sincere thanks for permitting me to add their names:

Dr Kim Holt: 'slight automatic preference to black people over white people'

Dr Joe Karthikapallil (Ophthalmologist) : 'moderate automatic preference to white people over black people'.

Dr Joydeep Grover: 'no automatic preference between African Americans and European Americans'

Dr Vivek Chhabra (ED): 'no automatic preference between black people and white people'

Mr Bhavik Patel (Financial Sector) - ' slight bias towards white individuals compared to black individuals'



©M HEMADRI


Follow me M HEMADRI on Twitter @HemadriTweets

M Hemadri’s mini e-book 'Standardised Management Conversation' is available - click http://www.amazon.co.uk/Standardised-Management-Conversation-Hemadri-ebook/dp/B018AWBJTU 

Saturday, 25 March 2017

Busting Myths in Healthcare Management



Busting myths in healthcare management
A dozen at a time

Myth 1

Quality can be measured
No

(But, Quality Improvement can be measured)

Myth 2

Publications and guidelines (national) are a good source of evidence (for QI)
No

(Often published evidence is invalid, not robust enough or gets outdated soon. Guidelines are rarely tried in their totality before being recommended)

Myth 3

Increasing Quality Increases Cost
No

(Improving Quality Decreases Cost)

Myth 4

Improving Quality Improves Safety
Often No

(Improving Quality Improves Quality, Improving Safety Improves Safety. According to definitions they are two different things.)

Myth 5

Management by Objectives/Targets are good (for QI)
No

(Targets especially mandatory ones are prone to scamming)

Myth 6

Above Average is a Good Indicator of Quality
No

(Averages are flawed. Averages are not real)

Myth 7

A high percentages of good things and a low percentages of bad things are good indicators of quality improvement
May be but not really

(Percentages could be misleading. Percentages are not real numbers)

Myth 8

Culture Can Be Changed
No

(Processes can be changed and that may change culture)


Myth 9

All Directors in the Board of Directors are Leaders
No

(Leaders are follower defined not position defined)


Myth 10

Management Principles are the same for Healthcare as in any other field
No

(The frontline in healthcare is unique and very different)

Myth 11

Errors can be eliminated (in healthcare)
No

(Errors can be reduced but cannot be eliminated. But harm can be eliminated.)


Myth 12

Human Factors is about Changing Behaviour
No

(Human Factors is about changing Design)

 You can learn more about these from many sources (eg. University of Hull http://successinhealthcare.blogspot.co.uk/2015/06/msc-in-healthcare-improvement-leadership.html or enquire about a bespoke course http://www.successatmedicalinterviews.co.uk/Courses.aspx )



©M HEMADRI


Follow me M HEMADRI on Twitter @HemadriTweets

M Hemadri’s mini e-book 'Standardised Management Conversation' is available - click http://www.amazon.co.uk/Standardised-Management-Conversation-Hemadri-ebook/dp/B018AWBJTU