The down-lights were all turned on and illuminating the island in the middle of our kitchen when my wife turned the corner and saw me immersed in a creative moment. The red wire had just been inserted into the sausage when she stopped in her tracks; hands firmly planted on her hips with that this-better-be-good look on her face; and she let fly, “What the heck are you doing?”
My reply only provoked my bride, “Making a point!”
“Right…with a sausage.”
“Not just a sausage, babe, an IES!”
I knew she did not want to get sucked into what was happening, but she rose to the bait. “What the [bleep] is an IES?”
“An improvised explosive sausage…an IES!”
The most meaningful part of her response was non-verbal; the words that accompanied only served to validate the slow, disbelieving wag of her head, “You are a very disturbed puppy, my friend!”
“Hey, before you judge me, ask yourself how many days of your life will pass before the image of this chorizo sausage wired to an old wind-up alarm clock is wiped from your memory?”
“Probably never!” she replied with no hesitation whatsoever.
“And that is the point I’m making…a shocking…hard to forget…point!”
“Okay, so…you have two wires running from a freaking sausage to…”
I interrupted. “A red wire and a blue wire.”
“Whatever! What point are you trying to make with a sausage wired to…”
I interrupted again. “A chorizo sausage.”
“Don’t make me hurt you with that chorizo sausage, boy! Pray tell…what point are you trying to make?”
“My point is simply this…and it is a shockingly simple point…and it is a point that is extremely hard to make…and most of all, it is a point that…once made…cannot be dismissed as irrelevant,” I began.
“This is about making the right decision to DO something…to do something right when the stakes are high…and failure is not an option…to enable a worker to make a decision as simple as cutting the red wire or the blue wire. This whole bizarre image I’m creating is intended to make the point that deciding which wire to cut is something we have to do every single day of our work lives…and the best results are when we cut the right one…and what can be done to ensure only the right wire is cut every time…and more importantly, the proven fact that Training ain’t gonna get us to that point!”
“She rolled her eyes and said, “I’ve never had to disarm a freaking sausage…excuse me…a chorizo sausage in my entire life.”
“And I agree with that…and would venture a guess that you probably never will. But…how many times do your nurses at the hospital confront an issue with a critically ill patient where their decision holds patient safety and positive outcomes in the balance? Under what critical circumstances are they under the gun to make a judgment call where they have to survive a red wire/blue wire decision moment?”
She became a little defensive to my line of questioning and said, “We train our nurses for situations like that.”
“Certainly you do, but mistakes do happen don’t they?”
“Well sure, rarely, but then nobody is perfect.”
“Exactly…but they were perfect enough to get through their excellent training though weren’t they?”
She knew I was making a point, and those are rare moments indeed, so I pressed onward while I had the momentum.
“And that’s my point. The best training cannot guarantee the right color wire gets cut because training includes so much additional good information that no human being can remember it all. Don’t we wish it were as simple as red wire or blue wire? But it’s not, and it’s getting worse. More systems. More complexity. More change. Greater velocity of demand.”
Then she started to warm up, but not in a good way. “Okay genius, what do you recommend?”
“There are five moments of need. [See figure #1] The first two are where your nurses learn new things and dig deeper through additional training to learn more or to enhance their knowledge, and you guys do a really good job of that today.
Moment #3 – the moment of APPLY – is where training is now complete, and your nurses are at the bedside, at the point of work, and they have a red wire/blue wire moment of need. What happens when they cannot remember? What happens if they make the wrong decision?”
“They ask the charge nurse,” she said.
“Exactly, and if the charge nurse is engaged with another nurse and cannot respond…and the “clock” is ticking…[and I patted the old wind up alarm clock to make my point]…they ask another nurse, right…they rely upon tribal knowledge…or worse…they guess, am I right?”
She did not answer. The wheels were turning.
“Training can only address the first two moments of need. The other three moments happen after training, and to make matters worse, even during those first two moments, the ability to remember long enough to accurately apply what they’ve learned begins to degrade as soon as they leave training, and at a very rapid pace.
What we need to do is supplement the ability to remember…and equip your nurses with that capability to remember…at their individual moment of need at the bedside…do I cut the red wire or the blue wire? Training cannot go to the bedside, but there is nothing preventing us from supplementing the knowledge that gets lost. We just need to be intentional about what we want those nurses to remember when it comes time to cut the right color wire. We have to be intentional about designing the support necessary to address their needs at moments 3 thru 5 because they all manifest at the point of work.”
She turned on her heel and reached into the pantry and pulled out a can of black beans and placed it on the island next to the ticking chorizo with some authority. “I hear what you’re saying, sweetie, and I agree with you, but I have only one request. After you’ve disarmed that sau…that chorizo sausage…fix us something to eat. Your point has made me hungry.”
The Point of Failure
Ridiculous? Yeah, maybe a little…maybe a lot to some of you, assuming you got this far in the post.
I was on a Performance Support Community call early in the week with Dr. Conrad Gottfredson and several other Leadership Council members and we were discussing topics for the upcoming Performance Support Symposium in Austin, TX this coming June 2015. We were discussing how the conversation needed to advance around performance support…and that we were moving beyond the basics like the five moments of need Conrad developed a few years ago. I was in agreement, but at the same time, the five moments of need…especially the moment of APPLY…represent the greatest potential for the failure of Training. I’ve said this before…the moment of APPLY is ground zero. The moment of APPLY is the point of work, and if we are going to avoid failure of hard-earning training efforts, we’re going to have to shift our thinking…to the point of work.
My point in this ridiculous graphic is to send a shocking message that the moment of APPLY is where we must act to avoid the point of failure, and if we are serious about adopting an Embedded Performance Support [EPS] discipline, we are going to have to break through long-held paradigms that we’ve all touted with the promise that “Training Drives Performance”. I’m here to stir the pot and say it DOES NOT. Training does NOT drive performance…it drives POTENTIAL…and we can prove that we have created potential [transferred knowledge effectively] all day long with evaluations at levels one and two.
<RANT> BUT…I have never met ANYONE on the operational side of the business who is satisfied with “potential”. No one on the operational side of the business gets compensated for “potential”. They don’t want a training graduate who knows that they need to use a shovel to dig a hole…they want somebody coming out of training who can dig a freaking hole…and more perfect the hole, the better.
Digging the hole happens at the POINT OF WORK not in the classroom or in some on-line blend. Sure I can simulate digging…sort of…in Captivate during training…and I can answer questions that demonstrate I KNOW how to dig a hole…but can I really DIG one?
Digging the hole happens at the point of work and that is where EPS bridges the gap between the “knowing how” that moments 1 & 2 support and being at the point of work with a shovel in hand at the moment of APPLY and digging the perfect hole…or cutting the right color wire…or making the right decision to administer the right drug…or choosing the right resolution to save a key account…or close a major new business deal…or avoid the creation of material waste…or divert a significant business liability…or…or…or….</RANT>
The point of work is where Training fails our workforce. Training alone is not enough to sustain capability. The point of work is out of scope. The point of work is not covered in the training charter. The point of work is not part of the training paradigm.
The point of work IS part of a Performance Paradigm and that has implications on how we [Training] step out to discover, design, develop and deliver the appropriate blend of assets to cover all five moments of need.
The point of work is where we drive results using performance support solutions, and I’ll be at Learning Solutions 2015 March 25 thru 27 speaking on this exact topic. If you’re in Orlando for the conference, drop into the session Friday morning. I can assure you that no sausages will be harmed during this breakout session.