Thursday 20 August 2009

'House MD' as a Knowledge Manager

I came late to the party, but now I am a confirmed fan of 'House'. For those of you who are not familiar, 'House' is an American television medical drama. The show's central character is Dr. Gregory House (Hugh Laurie), an unconventional medical genius who heads a team of diagnosticians at the fictional Princeton‑Plainsboro Teaching Hospital (PPTH) in New Jersey. The character has similarities to Sherlock Holmes: both are forensic geniuses, musicians, drug users, aloof, and largely friendless. But that's not (necessarily) why I wanted to draw the comparison between House and Knowledge Managers.

For those who aren’t familiar with the character of Dr. Gregory House, he is the cantankerous diagnostician of the eponymous television medical drama. He limps along with a cane and pops Vicoden as if they were Skittles. Each episode features a baffling medical case that endangers the life of the patient. House’s staff wrestle with the problem, proposing and rejecting diagnoses until House, having heard enough, insults them, correctly identifies the malady, prescribes a treatment, and saves the patient’s life.

So what has House to do with KM. Well there are two basic tenets I was introduced to when I was learning about KM that it appears to me are at the heart of each programme.

'None of us are as smart as all of us'. Despite House being 'a genius' and tending to believe that he is always right, the fundamental process at the heart of the series is 'differential diagnosis' involving all members of the team including House where they participate in essentially brainstorming all the possible causes of the malady affecting a patient. Bouncing ideas around the team is seen as fundamental to the diagnosis. In one episode House was seen to reject a possible recruit to his team because he thought too much like House himself and House recognised that the value of the process was having a variety of thought processes (avoiding groupthink)

Learn Before, During and After
Like all good physicians, the characters in House rely on taking a patient history and reading their charts - learning before. As each episode unfolds, they uncover new symptoms and reconvene as a team to review their differential diagnosis before moving on. Learning during.
Where they appear to fall down (or maybe it just doesn't make good television) is on the 'Learning After'. I've yet to see them get together at the end of an episode and say, 'ok, what did we learn. How can we do better next time'. There was even one episode where it was made plain that House had not been updating his patients charts because that was not as interesting to him as moving on to the next case. (Sound familiar?)

So if I were so bold as to offer a suggestion to the script writers it would be that perhaps they should consider having House's team conduct an After Action Review once in a while.

1 comment:

Unknown said...

if you ever get to see an episode where they loose a patient and still dont have a diagnosis, house will become obsessed with trying to find out why they lost the patient, which i think may qualify as "learning after" but i'm not sure.