I just finished reading Procrastinate on Purpose, by Rory Vaden. In an effort to organize my thoughts and determine how to apply the lessons to healthcare IT, here's this post.
The main points of the book are "work double-time part-time now, in order to have full-time free time later"; and the Focus Funnel (source):
The focus funnel goes hand-in-hand with the Eisenhower Decision Matrix (ugent vs important--"what is urgent is seldom important, and what is important is seldom urgent"). Vaden adds a Z-axis to the decision matrix for Significance. If Urgent asks "how soon does this matter," and Important asks "How much does this matter," then Significance asks "How long will this matter."
The Focus Funnel then asks the user to eliminate those tasks of no significance, automate any repeatable tasks, and delegate tasks that don't require the user's particular set of skills. If the task makes it through to the bottom of the funnel, then a decision needs to be made: Is this task the most significant thing I should be working on right now? If yes, do it. If not, put it back at the top of the funnel.
I grok at a visceral level how effective this is for those in control of their own task list. What I don't understand is how to apply it to my situation, where my workload is partially at my own discretion, but primarily driven by management--and the managers historically don't appreciate automation or delegation, and never eliminate anything. Healthcare IT is also plagued by IT-style busywork, compliance CYA, and patient care criticality. In addition to my actual work, I have to track it for data-driven bean counters, wrap it up in red tape to protect from malpractice suits, and do it all right now because lives are at stake.
I can apply Vaden's method to those tasks where I'm in full control, but I have limited empowerment to delegate. Let's say I'm assigned a task that can be done by anyone on the team, including fresh new hires. By assigning that work to me, it takes away time that I can spend on tasks where I have unique expertise.
Automating is similarly difficult. A task that costs an hour a day, every day, may require 40 hours to automate a permanent fix. The daily maintenance is urgent, as most things in health care IT are, so it still has to be performed alongside the permanent fix.
Eliminating tasks is easy. Managers have even less time than the grunts, so unless the managers are specifically measuring a task, eliminating the pointless stuff will most likely go completely unnoticed. (That only works if the task is truly without benefit.) Managers have limited insight into how one actually prioritizes, so the Concentrate/Procrastinate portion of the funnel is entirely up to me.
The problem then, is with the middle portion of the funnel--that takes a team. And I can't control my team. Without buy-in from the entire team and from management, delegation is unworkable. Without informed prioritization, getting permission to spend time on automation is difficult, but not impossible--I guess this is where the "work double time part time" comes in--if one 80-hour week saves an hour a day forever, that's an extra 250 hours a year that were just freed for more significant things. It also makes me look awesome in the eyes of management.
I encouraged my immediate supervisor to read it, and he might. Maybe change will happen from middle management outward. In the meantime, I work on the things that I can control, and prioritize based on a task's significance to my workload.