Flashlights and hammers

 What counts matters, but not everything that matters gets counted. Just ask any United Methodist pastor these days. That denomination is under storm warnings after losing roughly 1,000 members a week for 43 years (I am not making that up). Even though there are still 7 or 8 million United Methodists on the rolls, that steady decline matters. But what exactly would you count if you wanted to map the opposite of decline? What would you measure if you were interested, not in pathology, but  vitality? What is the arithmetic of life?

Counting can feel like a flashlight or a hammer depending on who is counting and whether they are trusted. If you are a pastor and the your are asked by a  Bishop, Board or big deal committee, the counting can feel like a hammer, with you being a nail. This is exactly what is happening today in the denomination. The the ones wanting the numbers are not trusted by the pastors because the clergy don’t think the people on the committee understand the parish reality enough to understand the numbers. The numbers are more likely to hide reality, than disclose it. They like to say that a parish is not like a corporation, so one can’t count in the same way. But a parish is not the only organized entity where complex intimacy is the norm. Hospitals are, too.

We count many many things in hospitals every day, with greater and lesser usefulness. Mostly we count process markers so we can good quality from bad quality. And we count money pretty carefully. And we know that the things that matter most occur in the intimate human spaces where metrics are crude by comparison to the complex wonders that take place. Healing actions and saving behaviors cannot be compelled with anything like a hammer. But it is possible to hold a flashlight to help see whether the good intentions actually do result in good work. That’s what matters. 

Pastors, nurses, physicians, teachers all tends to be suspicious of data, trusting the high bandwidth of stories instead. The human mind is tuned that way. One of my senior colleagues’ mom is in the hospital right now and he has noticed that even with the vastly detailed electronic medical record the staff still seem to lose track of what is actually going on with her–her real story.

Until a leader sees a pattern, they are powerless to do anything but react out of fantasy or fear. Their action is arbitrary or random. Even success is dangerous because it will result from action that is disconnected from reality.  They can kill the ducks and grind the gears.

Good data helps sensitive leaders find the true patterns in the stories. Good stories help sensitive leaders find the true story in the data.

I used to work as a carpenter and had a toolbox filled with all sorts of tools. Sometimes in a hurry I’d grab anything I could reach and use it to pound something into place. Even a flashlight can be a hammer, if you hit hard enough. Bishops and executives do that, too.

Don’t make the metaphor do all the work here. Member and patients are far more complicated, confounding and nuanced than a gaggle of french ducks. And any denomination or hospital is a far more intricate mesh of moving parts than any mechanical gear. Grab a flashlight, turn it on and pay attention.

 

About garygunderson

Vice President, Faith Health, Wake Forest Baptist Medical Center in Winston-Salem, NC. Author, Leading Causes of Life, Deeply Woven Roots, Boundary Leaders and Religion and the Heath of the Public. Secretary, Stakeholder Health (Health Systems Learning Group).
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