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Stretch your pinkie toes

By Jeff Terry

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When is the last time you paid much attention to your pinkie toes? I must say that it had been a while for me. Then I started running in "five-finger shoes." These are those strange looking running shoes that separate each toe like a glove separates fingers. Everyone should run in them at least once; squeezing each toe into its slot may be the best possible way to appreciate your pinkie toes.

Five finger shoes force the foot to use dozens of small muscles that are underutilized or even dormant in more typical running shoes. What happens next is amazing. Underutilized muscles and joints start to engage, your stride lengthens, you run faster and easier, and then all of the sudden, you begin to value your pinkie toes. Two once mostly forgotten appendages become essential. Their strength and length enable a transformation to better running.

Like most transformations, unlocking the potential of the pinkie toe begins awkwardly. The guys who fit shoes at running stores know this. That's why they coach, encourage, wait patiently and smile wryly as first-timers struggle into their five-finger shoes. And for first-timers, the pinkie toe is the hardest part. It just doesn't seem possible - like placing a roller board into the overhead of an Embraer or CRJ. Before long of course, it's automatic. My technique is to slide my pinkie finger along the outside of each toe - starting with the big toe - to firmly align it and slot it into place. Stretching and slotting my pinkie toes is the best part.

As we emerge from the 4th and 1st of July Holidays, I'm inspired to find and stretch pinkie toes within health systems. Perhaps more importantly, I'm reminded that transformation requires both excitement and vision. The experience of running in "goofy shoes" immediately captures the runner's attention and quickly makes clear that better, faster, more effective and easier running is possible. Too often, transformations in patient safety, capacity management, culture, care models, etc. just sound like more work and more cost. Maybe that's why I like my five-finger shoes so much... They've not only transformed my running, they also cost less than traditional running shoes.

So, in honor of Independence Days in both Canada and America - days that celebrate two nations stretching those most important pinkie toes of freedom and liberty - here are five pinkie toes that might stretch your organization's performance.

  1. Schedulers. Schedulers are among our most important touch points with our patients and physicians. Have we invested in their training, kept them current on new capabilities, and provided them with simple tools to connect the dots of need, capability and timing?
  2. Tribal knowledge. Every hospital seems to have a core of nurses who have been there since... well, a long time. You know them when you see them. Too often we ask them not to "tell war stories" for fear it will undermine the latest improvement effort. There's logic to that. Then again, unlocking the knowledge of our most experienced and dedicated caregivers may be just the pinkie toe we've overlooked.
  3. Block time in the OR. Most hospitals allocate blocks of OR time to either surgeons or service lines. These allocations always make sense in the moment. But, has our analysis kept up with evolving surgeon habits, OR capabilities and utilization patterns? There are very few hospitals - maybe none - that couldn't improve the pinkie toe of block utilization.
  4. Mobile medical equipment. Could we better manage battery powered life support equipment so we can find them in emergency situations (e.g., power loss)? That's a pinkie toe that isn't needed every day but makes a big difference when we do.
  5. Patient Safety Communities. Patient Safety Organizations, like the GE PSO, are creating virtual patient safety communities within which providers can discuss the nitty gritty reality of patient safety in a protected environment. That includes sharing with both local and global peers. This promises to unlock pinkie toes everywhere.

I'd love to hear about pinkie toes that you and your teams have found and exploited. I'm certain others will benefit from the sharing. Who knows, if we get enough pinkie toes maybe we'll have a contest to celebrate the most impactful discovery and transformation.

Stretch your pinkie toes!

Comments (2)






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  • Bob Francis October 12, 2011 11:55 AM

    This is good stuff Jeff.
    As a ten mile a week jogger, I will try the pinkie shoes
    when next at sports shop.

    For the team benefits, I really do think that exchanges of best practices, as in your number 5 above may be the most important way to improve safety. Sharing, Sharing.

  • Margaret Mary October 12, 2011 12:21 PM

    Of course this article made me think of you! You may or may not be interested in his analogies to Medical Center administration, but I felt compelled to share. I didn't think about the under-used muscles that would be awakened with your shoes. Very cool!