Simplexity

In our quest to improve the quality of health care and social services, we shouldn’t play with a win-or-lose mindset. That’s among the key messages in a new book, The Infinite Game: How to Lead in the 21^st Century, by one of my preferred authors, Simon Sinek.

As Mr. Sinek sees it, we’re all players—whether we realize it or not—in two kinds of games: finite and infinite. The former has a clear set of agreed-upon rules, involving two or more competing individuals, teams or groups. Soccer, football and hockey are all examples of finite games that have a rule book, and a clear beginning and end.

Infinite games are the opposite, since there is no outright winner or loser. Instead, the goal is simply to stay in the game, and play as well as possible. Public-sector institutions and politics—and yes, even marriage!—can be considered types of infinite games, where the aim isn’t to vanquish those around you (regardless of what your spouse may say). Rather, the goal is to evolve and adapt, so that the game can continue to be played.

Much the same is true for health care. As providers of this service, we must resist the impulse to see ourselves as participating in some sort of competition—unless, of course, we see illness, suffering and death as our opponents. If we adopt the point of view that we’re locked in some sort of struggle, we risk diverting our attention from our primary objective: user-centred care. The real point of our infinite game is to change—or hold strong—as the circumstances dictate.

For this reason, whenever I speak about the changes in health care that confront us today, and when I advocate for taking greater advantage of digital technology, it isn’t because I’m looking to “win” at the game of health care. As CEO, I’m determined to ensure that we have the capacity to find better ways of providing personalized care—at the right time and in the right place—to those who need it.

With this in mind, I brought together a group of 30 knowledgeable individuals from in and around our CIUSSS in late January to discuss the future of health care and to explore ways of adapting and transforming, as best we can, to meet the challenges that await us in the short and long term.

Below, I’ve shared my opening remarks from that day, which I hope you’ll take the time to watch.

Since our game has no end, we’re always in the process of recruiting new players, developing innovative strategies and preparing ourselves to score the next goal.  The game itself may never be won, but it does have its champions—not the least of which are the brave patients and other healthcare users who fight their way through physical, mental and emotional adversity, while relying upon us for our ongoing support.

Nearly 35 years ago, in one of the most remote regions of Canada, I looked down at an 11-year old girl and realized she was probably going to die.

A few months earlier, as my surgical residency came to an end, a colleague had suggested that I take a trip to Iqaluit—then known as Frobisher Bay, over 2,000 kilometres north of Montreal—because he thought it would be a good place for me to get away and study for my Royal College exams. At the same time, I could handle whatever surgical cases came up.

When I agreed, I didn’t realize this trip would shape my impending career as a doctor, and would end up affecting my entire life and future relationships.

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I’ve said it before, and I’ll say it again, “You’re only as good as your word.”

Our standing pledge at CIUSSS West-Central Montreal is that we will never stop looking for new ways to safeguard the well-being of those who rely on us for health care and social services. Now I’m happy to tell you how we’re, once again, putting promises into practice.

In my April 2017 blog post, I described a recent trip to Yale New Haven Health, where I learned about the organization’s daily patient safety report. Five days a week, managers from numerous sites come together to trade information, insights and opinions about major quality and safety occurrences, such as accidents and similar incidents, that had taken place during the previous 24 hours.

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A few years ago, I renovated my kitchen—and not without a certain amount of trepidation. If you’ve ever been through the process (or something comparable), you’ve felt the nervousness that comes in dealing with the dust, the disorder, the displacement and an array of logistical headaches. Can the job be put off yet again? Yes, but there comes a time when you just have to face the music. My own kitchen had seen many years of use (it was after all, the original 60 year old kitchen), which is why the paint had started to fade, the appliances weren’t working as well, and the configuration that had once seemed so perfectly designed now felt flawed.

The same goes for the healthcare and social services facilities in our CIUSSS. Of course, there’s a big difference in scale, but there’s no escaping the fact that our institutions, like our homes, become dated. Actually, in most cases, the CIUSSS’s facilities age much more quickly, given the constant flow of people into and out of these buildings.

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