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Did you ever have one of those moments in a project where everything stops, there is a breathless pause, and the world starts to turn in a new direction? I had one yesterday…

I’m running a project where we are building new clinical point-of-care reporting tools. Basically, reports for Nurses to use in making sure their patients were getting known best-practices care. Nothing special in most industries, but pretty radical in Medicine.

The meeting was the first time that real end-users were being introduced to these reports as part of the Beta portion of the project. It is always an exciting moment, in which the users will either react energetically and positively, or sit there dumbly and hope that the project ends soon and they can go back to doing things the old way.

We were well prepared – we had recruited and briefed a customer project sponsor, we had an overview presentation, report mockups (real shots aren’t ready yet), and a workflow development module to help the users figure out when and how to run and use these new clinical care tools.

But still, you never know. We were relieved when initial acceptance was positive. And then, in the course of the discussion, our Clinical Pharmacist touched on an important workflow issue, which was this: who of the multi-professional care team (Nurse, supervisor, intern, pharmacist, nutritionist, etc.) would run and use the report – that is: “own” it? We had discussed this among ourselves, and thought that there were several options depending on the situation.

Unexpectedly, the world stopped. You could see the Supervisors thinking about this suggestion. Clearly, they had not considered this possibility, and had seen these reports as their tools, nursing tools. Data is power. There was a pregnant pause…

Then the world resumed turning, in a slightly different direction. Yes, the supervisors could see that there were several options, and were open to discussion. I could hear the foundations of Health care shift ever so slightly.

Its moments like these that I work toward. I know that big changes start with small but fundamental shifts in momentum. I was started on my search for momentum shifts by a book, one of my favorites growing up, “The Left Hand of Darkness” by Ursula K. LeGuin. In the book, a character is cautioned: ‘When the world turns in your hand, you must be careful what you say.”

I believe that it is true – there are moments when the otherwise static and inert world shifts right in front of you. In these moments, often the best course is to keep silent.

Larry Cone