Ebola Drives Home the Importance for Processes That Work

Posted October 22, 2014 | Technology |

Infectious disease experts from the US Centers for Disease Control (CDC) and medical advisors from other US public health agencies have repeatedly stated that the US healthcare system is more than capable of dealing with any incidences of Ebola that occur in the US. Since the outbreak began in West Africa, the press has cited various officials saying that the US -- indeed, the western world in general -- leads in understanding Ebola and how to contain the disease.

It has also been touted repeatedly that many of the practices now standard for fighting Ebola in Africa have resulted from CDC research and experience gained from successfully containing previous outbreaks there. Moreover, it has been reported that information and guidelines developed by the CDC for diagnosing and treating people for possible Ebola infection at US emergency rooms (ERs) was distributed to healthcare facilities, and that healthcare workers were briefed, with some having received training as well.

Yet the first incidence of Ebola to show up unexpectedly in the US was mismanaged from the start. (Ebola patients have been successfully treated at a number of US hospitals; however, these patients were initially diagnosed as suffering from the disease in Africa and were then transported to the US for treatment.) The incident in question involved "patient zero" initially being misdiagnosed and sent home from a hospital in Dallas, Texas, only to be admitted to the same hospital several days later suffering full-blown Ebola. This was followed by two nurses who had been taking care of that patient contracting the disease a few weeks later.

There have been other, secondary issues involved with treating Ebola patients in the US. These include problems with finding firms to handle the disposal of medical waste and the decontamination of facilities and equipment, and difficulties locating housing for quarantining individuals (as covered in the New York Times).

It now appears that American health officials were overly optimistic in their initial assumption that US hospitals were adequately prepared to diagnose and safely treat Ebola patients, and they somehow overlooked the mismatch that can arise when it comes to taking expert advice and practically applying it in a real-world scenario -- in this case the complex environment of the hospital ER.

The goal of this Advisor is not to blame healthcare organizations and medical personnel fighting the Ebola crisis; I salute these brave heroes! Rather, it is to highlight the fact that even well-defined and standardized practices — unless properly implemented and deployed — can go awry. And this certainly applies to enterprise operations, too.

Implementing processes in any complex environment can be difficult, in general, but where problems really tend to be encountered is when it comes to handling exceptions. In the case of Ebola, although US hospitals are well equipped and very experienced with handling all kinds of infectious diseases, the deadly nature of Ebola makes it an exception.

Simply put, treating Ebola victims is exceedingly dangerous (considerably more dangerous than treating patients suffering from any form of hepatitis or even HIV). Just the procedures for putting on and removing gloves, suits, face shields, boots, hazmat suits and other protective clothing are, in themselves, quite complicated. This is evidenced by the fact that the only other case of Ebola transmission to a healthcare worker outside of Africa involves a nurse in Spain who contracted the disease while caring for a patient who had been transported to Madrid for treatment. She believes that she may have accidentally touched her face while removing protective garments. It is suspected that the American nurses in Dallas may have contracted the disease in a similar manner. Thus, the US is not the only country to experience difficulties in implementing safe Ebola treatment procedures.

Due to the dangers for healthcare practitioners treating and managing Ebola patients — and complaints from nurses and other medical personnel that they have not received adequate training or are lacking in suitable equipment —the CDC has been forced to implement new policies and stricter procedures in an effort to contain further infection.

Certainly the treatment of Ebola offers an extreme, and terrifying, reminder of how a lack of well-implemented procedures or processes can severely affect planned operations. That said, examples of how poorly implemented processes can hamper enterprise operations abound, ranging from the frustration often experienced by customers trying to return items bought online to the near chaos that we saw with the launching of the (i.e., US Affordable Care Act) website.

The bottom line is that having a lot of information and expertise available does not readily translate to front-line workers being able to utilize it efficiently. Rather, the transfer of domain-specific information and knowledge to front-line operations requires training and for processes and procedures to be put in place (well in advance!), if there is to be a reasonable expectation that workers will be able to handle exceptional events taking place in complex environments.

Failure to do so is an invitation for trouble. In the enterprise, this can translate to loss of sales and customers due to poor service and support. When it comes to health emergencies, it can mean poor outcomes and loss of confidence in public health services and government assurances in general.

About The Author
Curt Hall
Curt Hall is a Cutter Expert and a member of Arthur D. Little’s AMP open consulting network. He has extensive experience as an IT analyst covering technology and application development trends, markets, software, and services. Mr. Hall's expertise includes artificial intelligence (AI), machine learning (ML), intelligent process automation (IPA), natural language processing (NLP) and conversational computing, blockchain for business, and customer… Read More