Bureaucratic red tape is delaying patient care. How can you navigate this challenge effectively?

Often, these bureaucracies are for the sake of patient safety. Having completed quality improvement and advocacy projects as the bulk of my scholarly activities, planning and executing changes and ideas absolutely needs some red tape by experienced physicians, nurses, and various key stakeholders to lay the groundwork and prepare. It's when bureaucracy is simply getting the approvals from multiple administrative persons who outrank you who simply need to check a box or who may not be able to help you because too much is already on their plate, that it becomes frustrating. In this latter scenario, needed experimentation of changes can get so delayed they don't even happen.

Nemawashi is a Japanese term and concept that means to lay the foundation. In practice, it is to gather data from all your key stakeholders so you can go into a decision armed with all important information. Communicating clearly means doing all the groundwork so you have a well-formed argument to provide your target audience, speeding up the processes of any negotiation and/or persuasion. Have answers to key questions: What's the current process? What's your proposal? Why is this better? What will it take to implement? Who needs to be involved? How do we measure success? If you don't have the answers, find someone who can help you get them. This is the P for Plan of a PDSA cycle in Quality Improvement. (Plan-Do-Study-Act)

There is truth to the idea that newcomers and the youngest individuals are the most passionate about change. The burden is on them to communicate clearly, to the right people, and with data. However, the newcomers are also burdened by all the other aspects of the job they need to do and learn. In residency, a few months in, the first years have all these ideas, but the seniors are just ready to leave. The seniors are cynical, they don't think change will ever happen, and only a select few maintain the passion they had first year. Key point: Find your biggest advocates in leadership positions. Ones with experience and a healthy level of cynicism, but used to challenge you and help you revise your plans without stopping you.

To navigate bureaucratic red tape delaying patient care, streamline processes by advocating for policy changes and leveraging technology. Collaborate with administrative staff to identify and address bottlenecks. Utilise electronic health records to reduce paperwork and improve information flow. Engage in continuous communication with stakeholders to ensure alignment and expedite approvals. Educate and empower staff on efficient practices and advocate for regulatory reform to prioritise patient care over administrative tasks.