Dr. Jake Taylor Jacobs

Now, you know why.

You've been optimizing downstream while the constraint sits upstream blind.

SPD is limiting what's possible in the OR, but nobody's measuring that connection.

You're trying to make cars go faster while the factory can't produce enough engines.

If you're a CNO, you've been watching quality metrics that concern you near misses incidents that trace back to instrument issues, a baseline of risk that won't improve no matter how many corrective actions you implement.

Now you know why.

The quality data you're seeing is the tip of the iceberg.

Underneath are all of the catches, the workarounds, the problems solved before they become incidents.

SPD can't see that iceberg any more than you can.

If you are the SPD director, you've been working harder than anyone knows, putting out fires, managing crisis, hitting your metrics and still getting criticized, still feeling like nothing you do is ever enough.

Now you know why.

You've been managing what the system shows you, but the system doesn't show you what matters to the organization.

You've been succeeding by the measures you have while failing by the measures others use.

If you're a VP of periop, surgical services, you're stuck in the middle.

You see both sides.

You hear the OR's frustration, you hear the SPD's explanations, and you can't reconcile them because the visibility doesn't exist that will show you the truth.

Now you have a framework.

You're not dealing with people conflict.

You're dealing with a visibility gap, a system issue.

Fix the visibility, restructure the system, or implement a new one, and the conflict resolves itself.