At the end of the summer, I had to stay for a very short period in a hospital, that is part of the UK National Health Service. My background as a medical doctor, makes me a very bad patient. Actually, I am a very bad patient, regardless.
When you are stuck in bed for a while, you see a very different world. That happened to me.
The overall care was very good, everybody was very thoughtful and professional. I had no real complains. There were obvious inefficiencies in the way the nurses and medics did things and communicated (or not) with each other. A couple of times, I was tempted to start a conversation about how one could fix these problems. I forgot I was not wearing an organizational consulting uniform. That blue hospital pyjama should have been enough to clarify this for me. Needless to say, I did not succeed in my ‘operational efficiency’ conversation. But, I may write about it!
From the many professional faces, and hands, one person, a young nurse, was remarkably different. For whatever reason she was short with people, not communicative, not very interested, unhelpful and very close to shockingly disrespectful. I remember that nurse. The rest is becoming a vague memory.
One bad apple can have huge impact. When people complain about public services such as the NHS, they sometimes do on the basis of that one bad apple. There is not much praise for the good apples. It is similar in organizations, where one person in a team could easily kill the spirit of the whole team, or give the team a bad reputation. The last person you talked to in a call centre is the person you tend to remember. If that person is not very helpful, or polite, or knowledgeable or even interested in solving your problem, your mind thinks that the entire company is like that.
When I confront my clients with the Bad Apple Problem, I tend to get a rather universal answer: it is virtually impossible to control the statistics; there will always be bad apples, people say.
I have a problem with that. Not with the probably sound statistics, but with how we use them to justify inaction. The conventional wisdom says it is not worth finding those bad apples, they are a tiny minority and the huge majority is what matters. How wrong this is. The statistics do not have anything to do with how your mind works. One Bad Apple is a big (mental) problem, not a small (statistical) problem. We must take care of all individual Apples, not the statistics.
The tyranny of ‘the one’ is perceived every day. Tell the restaurant owner, or the hotel owner, to ignore that One Trip Advisor, dreadful (and, who knows, perhaps deeply unfair) review. The last, perhaps tyrannical, one is the last reputation. Intelligent owners tend to reply now to every single Trip Advisor review in the hope to be seen as engaged, whether grateful or sorry, but never silent. They have understood the potential impact of the Anti-Statistical Bad Apple Theory.
That nurse left me with a bad feeling abut the clinical Unit. Unfair, disproportionate, unfounded, but bad. Public services are often in an even more vulnerable position since our expectations as users are high. Look at the language I have unconsciously used at the beginning. My way of expressing a positive was that ‘I had no complaints’.