A Tale of Two Operating Rooms

  • May 16, 2020


Two Operating Rooms: though next door to one another, they were two totally different worlds. In one, a high functioning team operated in flow. In the other, a surgeon’s choices around how, when, and to whom to express a legitimate dissatisfaction radically compromised patient safety and the wellbeing of staff. The video above describes the event and its visible impact degrading the collective capacity of the team.


Rather than focus on bad behavior, we look upstream to the environment that allows it to exist. Our First Principles of High Performance act as a lens to identify what basic elements might be missing in culture.


We quickly saw the root cause behind these symptoms: an environment lacking in standards and in understanding performance. Recognizing these elements allowed a starting point for our partners’ vision for a performance-focused future, and the ability to reverse-engineer solutions from there. They began with a staff-led creation of standards to uphold mutual respect and honesty in communication, as well as timing considerations.

Not only do standards root teams to mission in mastery, in this case they now serve to protect the sanctity of operational performance from factors that erode what must be the teams’ singular focus: masterful performance.