Close the Door–I’m in a hurry

Admit it, we’ve all done it. I certainly have, and I suspect most of you take the time or have the interest to read my blogs are guilty of the same action. Frequently, as I rush into an elevator, whether to get to my office or an “important” meeting, I push the destination floor button, and then patiently wait for the door to close.

But I’m not patient, and within a short time, even less time than physicians allow a patient to talk before we interrupt them, I find my finger moving to the “close door” button and push it—speeding up the door closing process. And then just to ensure the elevator was aware of my intention, I often push it once again, or perhaps even twice. Admit it, we’ve all done it.

In our rush to reach a destination, make a deadline, get to a meeting on time, we take an action to accelerate the process. It makes us feel we’ve done something, been an instigator, made a difference.

But I have a theory, and I’m quite sure Otis Elevator is quaking in their boots with what I’m about to suggest. I’m here to suggest that in reality that button, the one we seek out to accelerate the door closing, often has no direct connection to the mechanism which instigates the closure of the door. What if it’s there as a “dummy” button, not a reference to my mental capacity, but itself non-functional in all regards except to create in us a sense that we’ve made a difference, and accelerated the closure.

Really, think about it, and in true quality improvement methodology, try an experiment. I know you’ve got more important things to do with your life, but my hypothesis is that irrespective of when or how often, or even IF you push that “close door” button, the difference in “closure time” (an outcomes measure if ever I saw one) is statistically insignificant. In fact, the more likely intervention affecting door closure which you’ll see have an impact is someone rushing up and stuffing their arm, leg or head between the closing doors—disrupting my PDSA cycle, and also slowing down the process.

Why does my mind conjure up such trivial ideas on which to ponder? Perhaps in our efforts in life, and including my work as a physician and quality improvement leader, we’re often pushing the “close door” button, by adding a new role, putting in a step in a process, introducing a technology that we think will accelerate our improvement efforts. We want the proverbial “elevator door” to close quicker, give us a result which we can celebrate, allow us to claim success.

I constantly hear the need to “move to action” and to accelerate the rate of improvement. But I often wonder, as I begin to understand more and more about the vagaries of human behavior, and the challenges we face in trying to change the status quo, whether we’re at times pushing proverbial “close door” buttons, which give us the illusion we’ve speeded up the process, when in reality, if we’d waited just a tad bit longer, the process initially triggered (whatever that first button we’re pushing identified) would have been as successful without an added “close door” effort.

A silly analogy, a foolish comparison, but I just can’t stop wondering how often I push the “close door” button, think I’m making a difference, when in reality, I’m just satisfying my need to feel I’ve accelerated a process over which I’ve got very little control. Hmmm, seems a bit like life at times, but excuse me, this door seems not to be responding to my initial effort. Where’s that darn button???

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