“Put it down, Tyler,” I say many times a day to our two-and-a-half year old, to which the boy often responds with a stare.
“I’m serious,” I say, hoping that will drive the point home.
As any viewer of Nanny 911 will tell you, consistency is the key to effective parenting — say what you mean, then initiate the consequences you warned your child about in a calm but firm manner. My problem — and I’m trying to get better at it — is, for example, demanding that Tyler put something down which I really don’t mind him having. Perhaps I would just prefer he put it down but, faced with the usual intransigence and subsequent need to follow through on the consequences (i.e. get up), I choose to just forget the whole thing. The problem here, of course, is that such inconsistency means the boy has no idea when I really mean it and when I don’t. My credibility has been shot.
I got to thinking about the importance of consistency, and the credibility that comes with it, when the government recently pulled the rug out from under all CIOs who’d been fighting the ICD-10 fight. Now, before we get too into bashing the government, what it did was the right thing to do. The wrong thing, the ridiculous thing, was that nobody apparently white-boarded all the federal initiatives to reveal a Katrina-like satellite image. I have to believe John Halamka, M.D., — probably the most outspoken (and influential) critic of the transition’s timing — had a lot to do with shunting this runaway train to some regulatory side track. Kudos, Dr. H.
But this righted folly is not without its short- and long-term fallout. Let’s get back to you, the aforementioned CIOs left to pick up the pieces of your credibility and budgets. Have you heard this one at the water cooler yet?
“I told you they were going to postpone it, and they’ll probably do it again. Man, you went on and on about this.”
For those CIOs who’d been taking the government at its word, trying to be good soldiers and get their organization’s up to snuff, many of you will now have to rework the budgets and put that ICD-10 transition money back into discretionary mode, where it will promptly disappear before you can use it. This leaves you in the difficult position of defending those big ICD-10-focused vendor and consulting contracts that you’ve just signed, and leaves you with little defense against those who said you were making much ado about nothing.
A few years from now, you’ll have to do it all over again — educate the organization, foster commitment and, yes, get transition funding. Thanks to this delay it will, of course, be that much harder. Again you’ll hear from those who claim, “This didn’t stick last time, and it isn’t going to stick this time.” This time, it will be that much harder to break through the day-to-day operational noise and marshal the necessary resources. This time, the government’s set-in-stone deadline will seem as concrete as a line in the sand.
To healthcare organizations, and especially to you, their CIOs, the government will continue to promulgate lots of initiatives with lots of deadlines. Now, however, when those commands are returned with stares rather than action, we’ll all know who’s to blame.