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Chief Medical Editor's Page | Jan 2019

Failing to Plan is Planning to Fail

At the time of this writing, it is New Year’s Eve here in London—the usual time of year when we all reflect on the year that has gone by and consider the year ahead, wondering what it will bring. In the United Kingdom, many of us are not sure whether we should be bracing ourselves for Brexit and the impact it may or may not have. Will it be like the damp squib that the millennium bug was? Personally, I expect not, but I resolved a long time ago to try not to lose sleep over things over which I did not have control.

Considering where we do have control, I expect that many readers this year will have a variety of plans under consideration, whether they are personal or career-related. For most of us, fun though it may be, our career sadly dominates our lives, and I expect that some of us are planning to change situations or positions, take on a new associate, move to or build a new clinic or surgical center, or adopt a new procedure or technology.

What is interesting, and something I have thought a lot about, is the fact that we call these plans. Have we truly planned many of them in any detail? It is exciting to actually do things and not necessarily plan them, and many of us (myself included) work things out as we go! Sound familiar?

Things often do work out naturally, and we may achieve our goals in the end. But did we do so efficiently, and did we consider the risks in not planning? We must acknowledge that the process of planning is a discipline that requires setting aside time, and it may even cost money—either directly or indirectly because we cannot conduct other activities during that planning time. By not planning, we may achieve savings, but money and time are often spent later in fixing things that might not be going well.

In any venture, no matter how complex or trivial, there does have to be some planning in order to see things through to completion or, in other words, meet expectations. Imagine having to perform a surgical procedure that is perhaps unusual or that you do not do often. We have an expectation of what result is desired. To get there, we need to consider a plan of action and, in the process, understand what instruments, disposables, and devices might be required in advance. Additionally, we have to consider what might occur during the procedure and what the plan of action should be in that case. We also need to consider what assistance we might need from other personnel such as an assistant and/or scrub nurse.

Have you not found that going through the exercise in advance, with clear communication, helps your staff members understand what is needed and what is expected from them, and, in turn, earns their respect and complete cooperation? Just those few minutes of extra planning can make all the difference to make things much more straightforward and less stressful. In doing this, we optimize the chance of success in a problematic case.

Planning in other areas is really no different, except perhaps in the language that is used and the need for it to be written down. As I see it, there are four components:

  • No. 1: Define expectations;
  • No. 2: Establish the process to get there;
  • No. 3: Allocate resources; and
  • No. 4: Be accountable.

Expectations and the overall process to achieve them are best articulated with clear goals or measures. If these are written clearly, preferably with the participation of others who might be involved, there is a higher chance of success. Allocation of resources, specifically people and money, is a vital component of planning. Quantifying this is useful, and it brings to everyone’s attention what work or effort is involved.

In the process of planning and allocating resources, accountability is inevitably structured into the plan, and the importance of meeting deadlines is understood by all. A well-devised plan serves as a road map whereby, if or when milestones are not met, they are identified early enough and revisited to put things back on track, whether it be in terms of time or through the further allocation of resources. A plan with clear expectations (endpoint measures) along with clear allocation of resources and accountability will be respected by those involved, generate enthusiasm, and thus optimize the chances of success.

As they say, “Failing to plan is planning to fail.” So, whatever your plans or expectations are for the year—career or otherwise—here’s wishing you all considerable success and prosperity from all of us at CRST Europe.

Happy New Year!

Sheraz M. Daya, MD, FACP, FACS, FRCS(Ed), FRCOphth
Chief Medical Editor