![]() “She’ll think we’re all in our silos, not communicating with each other, and we don’t know which breast will be operated on,” she said. Ms Shockney gave the example of a patient being asked 3 times, on the day of her surgery, which breast will be operated on. “Sharing best practices provides comfort,” she said. She suggests streamlining procedures so that data are easily collected once rather than multiple times sharing best practices among facilities, departments, and units and encouraging feedback and involvement in new approaches. In silo systems, patients and their families are angry, anxious, and demanding, but breaking down the silo system allows patients and families to feel like important members of the healthcare team. ![]() Silos promote challenges to communication in the form of ineffective correspondence systems and difficult-to-reach team members rather than the easy exchange of information between facilities, departments, and staff. In a silo system, meetings are run top-down rather than allowing for and encouraging the free exchange of ideas and information. Ms Shockney offered insight into identifying silos at work. “We should try to deliver that experience efficiently and effectively, with good clinical outcomes.”īreaking down silos can be threatening but eventually fosters innovation and leads to increased productivity, as it unlocks the information needed for successful collaboration. “We owe it to the patient to sit down as a team and understand who’s responsible for what and how we can decide on shared goals centered around the patient experience,” she said. There is unclear delineation of responsibilities among clinical oncology nurses, nurse navigators, patient navigators, social workers, schedulers, and office management. “But the one thing everyone should have in common is the patient.” Differences in perception can cause confusion, but avoiding a silo mentality involves asking questions rather than making assumptions.Īccording to Ms Shockney, “silos haphazardly manage the nation’s healthcare,” and exist even in the field of navigation. Don’t assume you know what’s in someone else’s silo,” she said. In the literal sense, silos prevent different grains from mixing. But building a culture of trust can combat this effect. When morale drops, people become “unthinking robots just trying to get through the day,” she said. They can be found in hospital transfers lacking complete documentation, care plan meetings missing key players, and admissions processes in which patients and families are not provided with the information they need to become proactive members of the team. Silos operate at various levels of long-term care. “And for managers, participating is just as important as delegating,” she added. People are prepared to continually attend meetings and make the appropriate comments, but often do little until the next meeting, she noted, underlining the importance of designating assignments at the close of a meeting and checking back on progress. Yet despite the inefficient arrangement in a silo system, change is often resisted. “They expend significant time firefighting, which leaves little time to address the real causes of problems.” “Managers struggle to engage people in collaborating to implement vital changes and complain that it can be like pulling teeth to encourage ownership of collective goals,” Ms Shockney said. Working in silos encourages localized, disconnected decision-making and a culture in which individuals blame others and do not take ownership for their actions, leading to apathy within a team and an increased workload for managers. ![]() “It occurs when people have little interest in understanding their part in the success of the organization as a whole,” she said. Individuals operating in this manner resist sharing information and resources with other people or departments within the organization and conclude that it is not their responsibility to coordinate their activities with peers or other groups. Shockney, RN, BS, MAS, ONN-CG, discussed the warning signs and pitfalls of operating in silos, as well as how to avoid falling into them.Īccording to Ms Shockney, Program Director and Cofounder of AONN+, Administrative Director at the Johns Hopkins Breast Center, and self-described “farm girl,” a silo mentality is an inward-looking mindset that commonly occurs in healthcare organizations. At the 2017 Academy of Oncology Nurse & Patient Navigators (AONN+) West Coast Regional Meeting, Lillie D. Working with a silo mentality can be detrimental to the delivery of high-quality patient care.
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