Meetings are a Virus
By James Hanson, MD
Director, Lean Health Care Practice
Moss Adams
Original Publish Date: February 11, 2020
As I see so many people struggling this winter with bad colds and flu, I have made a clinical observation: The signs and symptoms of a highly contagious virus are similar to what I’m seeing in the current epidemic of meeting overload that is running rampant throughout our health care delivery sites. The meeting virus is spread through both direct contact and through electronic communication, especially e-mail. As a result of its virulence and means of transmission, hospital leaders are highly susceptible.
Everywhere I find the same signs and symptoms. The signs are:
- Nobody can find enough time to do what they know they should and want to do
- Strategic targets are not met
- Collective blood pressure and heart rate and respiratory rate are elevated
- There is little free time in calendars—from the C-suite to managers and directors, frontline physicians, and care providers
The symptoms for infected individuals are:
- Fatigue
- Anxiety
- Frustration
- Burnout
- Taking work home
- Expertise in providing excuses for not getting results
Unless we work towards quarantine, a vaccine, and the development of herd immunity, I’m not sure we can stop this current epidemic. So we need to take immediate measures to contain the virus.
- One way to quarantine the meeting virus is to put a limit on the time allowed for scheduling meetings. “No meeting zones”—blocking several hours of the day for everyone in the organization—can help. After all, most meetings seem to end with “OK, so we’ll meet again on this next week!”
- We can also limit the spread of the meeting virus through crafting robust agendas that are action-focused. When the needed outputs are defined and all preparatory materials delivered in advance (and the expectation is that folks come prepared), the agenda can usually move along efficiently without the usual significant amount of time getting the group ready to work on the needed outcomes.
- If we cut out the informational parts of meetings and focus on what we want to do to help our organization help its patients, we can reduce the time spent in meetings. Often the output of one meeting waits weeks before it is used, and much of it becomes obsolete or forgotten.
- Assure that meetings are set up so the work product of one meeting flows directly into the meeting needing that input.
- Combine similar meetings that have a lot of overlap (Quality and Patient Safety, for example). One 90-minute meeting could replace two 60-minute meetings. How many meetings are you having simply because we have set an expectation for a regular (weekly, monthly, quarterly…) meeting?
- Since the virus thrives in meeting areas, consider avoiding the meeting room altogether, and join the key stakeholders in the workplace where the issues you hope to solve are happening. Then you can work from direct observation and data, not just conjecture and memory.
As we work toward prevention, we must also strive to relieve the symptoms:
- Ensure that everyone has enough time to get from one meeting to the next so meetings can start on time and that people have the time they need to tend to their human needs and collect their thoughts to focus on the work at hand. Hour-long meetings back-to-back result in people being late and often tend to fracture focus.
- We can also invite people only for the sub-part of the meeting for which their input is needed. Many leaders waste valuable time waiting for their five minutes on the agenda.
- People often work and think better when they are not sitting. Try getting up and doing things other than talking. Ask people to purposely speak from different perspectives. Draw possibilities on the white board. Act things out.
- Let people send delegates they trust when they feel over-burdened.
I have not yet invented a good vaccine to prevent meeting virus, but I am working on it. As a lean consultant, I am a strong advocate of and witness to the power of cultural transformation. Early research suggests that we can succeed in limiting the spread by implementing and supporting a culture that uses meetings as a last resort. We can also see dramatic results in an organizational setting that does most of its problem-solving where the actual work is done: Leading work on the “gemba” (the shop room floor where value is added) is generally far more effective than in meeting rooms because attendees hear from people who do the work; by testing solutions that come directly from the front line, leaders can markedly increase buy-in for the changes you want to implement.
Consider serving as a public health spokesperson within your organization about the perils of the meeting virus:
- Make a serious commitment to reducing the meeting virus burden on you and your organization.
- Remind your colleagues when they default to “let’s have a meeting” that perhaps there is a better way.
- Work with your administrative staff to default to shorter times for the meetings you have.
- Create the expectation that the few meetings you do have will start and stop on time, and use time-keepers to keep the team on time.
- Allow people to write down their ideas and questions to hand to the presenter rather than stopping the presentation mid-stream. By eliminating these interruptions, we can allow for the completion of the entire presentation and for any remaining time to be spent on the clarifying questions and action ideas the team wrote down during the presentation.
If you falter or give in to old habits, remember that any time spent in a meeting is time we are not actually caring for patients. That ought to spur you on to greater vigilance.
I wish you great success fighting the meeting virus and expect many of you will let me know when you have reduced your time in meetings by more than 25%. Aim for 50% less time in meetings. What will you do with all that time?
James Hanson, MD, FAAP, Consulting Director, Moss Adams LLP. Dr. Hanson is a respected physician who has practiced as a pediatric intensivist in the PICU at UCSF Benioff Children’s Hospital since 1988, and is a clinical professor of pediatrics at UCSF. He has held progressive management responsibility for quality and performance improvement, medical staff affairs, clinical education, electronic health records implementation, and medical group operations. He has a strong clinical background with expertise in patient safety, Toyota Management System, telehealth, and clinical outcomes management.