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The Great Pandemic Pause

4 April 2022

At the beginning of the pandemic I wrote a remarkably positive (particularly for me) blog about how I could see that necessity was triggering a miraculous transformation in services.  The University achieved things that I never thought possible, shifting to online teaching overnight, providing flexibility for our students in terms of offering them unprecedented levels of trust via the ability to sit online exams and granting automatic extensions to essays, no questions asked.  In healthcare, video consultations and test result text messages offered the possibility of a more patient centric model of care.

People on Twitter remarked that:

The optimist in me was hopeful for a ‘more lean’ future hopeful that organisations could keep hold of that ‘anything’s possible’ feeling and keep innovating, ‘opening up’ and embracing change.

Steady on Sar, steady on.

The trouble is, whilst it feels like we’re “coming out of the pandemic”, many of our organisations aren’t feeling stronger than ever, they’re feeling a little at sea, destabilised by what has happened and the seismic changes that have occurred. Whilst the pandemic precipitated a certain level of pause, which could be used to try new things out, to regroup and rethink, the reality of the situation is that in many situations, what we’re left with is a backlog of work and an uncertainty about how best to move forward.

In the University, whilst our Executive MBA students were so appreciative of the automatic extensions that were granted, what actually happened was once one extension was granted, you kind of automatically needed another one because having more time for your ‘previous’ assignment ‘ate into’ the time needed for your next assignment.  Suddenly, the University was awash with extension requests making the reassuring rhythm of the academic year almost impossible to navigate as each student’s learning pathway stretched out afore them.

Healthcare organisations too are under unprecedented levels of strain. I just watched the lunchtime news and in February 2020 in England there were 66 women waiting for more than a year for Gynaecological surgery, in January 2022 that number has increased to 24,780.  The picture is similar in Wales unfortunately, huge backlogs for non-urgent operations, that have yet to be dealt with by a completely exhausted workforce.

When teaching lean, I often talk about Repenning and Sterman’s “Improvement Paradox” – the ‘it’ll get worse before it gets better’ part of change.

Repenning, N.P. and Sterman J.D. “Nobody Ever Gets Credit for Fixing Problems that Never Happened”,
California Management Review, Volume 43, No. 4, Summer 2001.

When in class, I share the graphs, point at the depressing ‘work smarter’ dip that occurs after the triggered change (top right graph) and ask everyone:

“WHY? Why does this dip happen?” Sure enough, I’ll get the responses I’m looking for.

“Because it takes time to get used to a new way of doing things?”

“Yes… learning new way of doing things takes time, anything else?” ….

“Because you have to take time out to organise how you are going to change the process?”

“Yes exactly, and what happens when you are taking time out to plan these changes?” …

“Not much!  The emails still come in, the telephone still rings. The work is still there.”

 

The queue builds.

 

Not only does the queue build but the pandemic provides perhaps too perfect an excuse for a lack of progress. For example, is it possible to ring a service based organisation these days AND NOT have some kind of automatic warning that ‘because of the Covid 19 pandemic, waiting times are really high at the moment’ which might be true, but again, you’d hope that after 2 years we might have dealt with these delays by now.  I also think that some organisations have seized the opportunity that the pandemic has afforded to surreptitiously stop some services and ‘take back control’.

So what’s the answer?

As Repenning and Sterman stated, it won’t be ‘working harder’.  I think that we are going to have to take ‘working smarter’ to new levels and think and work in a completely different way.  Busting those healthcare backlogs is going to demand a completely radical approach. We’ll never get on top of those queues practicing healthcare the same way that we did before the pandemic.  In terms of the University, at the moment we are clamping down again on the flexibility that we offered students in the crisis as we just can’t manage the limitless extensions ….  yet we know that students really appreciate them.  This clawback causes me pain because in my heart of hearts I know that increasing flexibility of learning opportunity is the answer, but yet my experience of this flexibility was that it created huge problems.

So I suppose the question is, have we been using our ‘pandemic pause’ wisely enough? Creating a new type of University education or a completely new approach to Healthcare? Or have we just been doing all we can to survive? Have we been focussing on the innovation required to trigger a step change shift from working harder to working smarter? Or now that things are ‘returning to normal’ will our working practices just return to normal too?

The trouble is, I no longer think that normal is possible. The world seems too different and too changed.