Safety and Organization

Published in on Jan 4, 2021

This is another post about lessons we’ve learned from COVID that also apply to acupuncture safety in general.

I wrote in an earlier post: we’ve successfully nerded our way through the pandemic so far, to the point that a lot of our organizational systems are in better shape now than they were before COVID. Another way of putting that is: responding to COVID has helped get our systems into better shape. And so a lesson we learned is that there are major overlaps between safety and organization, as well as safety and leadership.

In order to create safety, you need to have a certain amount of organization. Safety doesn’t thrive in chaotic environments; it likes structure and stability. Part of a culture of safety is building a sort of benign bureaucracy. (In a small business, the business owner often has to do it from scratch with limited resources.) Even for a self-employed solo practitioner, that kind of benign bureaucracy can (and probably should) include safety policies, manuals, communication templates, and plans.

Because we have an acupuncture school, we’ve worked on developing resources to prepare students to start their own small businesses. We’ve noticed that acupuncturists tend to have complicated relationships to organizations; a lot of people in the acupuncture profession describe organizing acupuncturists as “herding cats” . Acupuncturists’ resistance isn’t just about everyone wanting to follow their own ideas, though; it also includes an aversion to paying attention to organizational infrastructure. Maybe it has to do with being a subset of “energy healers”, but it seems that acupuncturists can get very impatient with the mundane details of maintaining structures. They don’t like nuts and bolts.

Whatever the reason, orienting acupuncturists towards safety also requires orienting them towards organization. Some of the most important nuts and bolts of organization are communication and decision-making. (Lots more about that here.) Safety that’s active, participatory, cooperative, relational, and creative -- as opposed to just avoiding mistakes -- needs structures to support communication and decision-making. You can’t count on safety communication and safety decision-making to happen spontaneously, without planning. Especially in a small business, they’ll get lost in the avalanche of day to day tasks.

Safety decision-making can be challenging. Before we could write our COVID safety policies, we first had to decide what to base those policies on. Given that we were dealing with limited, ambiguous, and changing information, the foundational decision we made was that we were going to follow the guidelines issued by the Oregon Health Authority no matter what. Even if we disagreed with them, even if they were inconvenient, even when we suspected that guidelines issued one week might get reversed the next. If we weren’t sure about something, we’d call the OHA and ask. (Which we did, several times.)

That foundational decision was a way of setting a boundary to keep ourselves sane. We said: maybe the public health authorities aren’t handling this perfectly or exactly the way we’d like them to, but we’re going to focus on doing our jobs and letting them do theirs. We’re not going to second-guess them. We’re going to stay in our lane, because there’s a daunting amount of work to do there and it’s all we can handle.

The public health authorities couldn’t promise to keep us safe. However, following their guidelines made us safer -- at the very least because their guidelines were consistent and simple as opposed to chaotic and complicated. And as a result, it allowed us to move on to other safety tasks as opposed to unproductively going around in circles, trying to write policies on an unstable foundation.

As we navigated issues that came up later, that foundational decision periodically encountered resistance from people who DID want to second-guess the guidelines, or who wanted to react impulsively based on emotion. There were moments when the whole process felt like driving on ice, when we had to make sure the organization kept moving forward and didn’t spin out with all the second guessing and the strong feelings. Apparently making and sticking to decisions is a scary thing all by itself, never mind COVID.

The same goes for communication. In my unscientific estimate, organizational management and leadership require about ten times as much communication as people think, and about twenty times as much as they’re inclined to actually do. This also applies to safety. The right amount of communicating for safety purposes is going to feel daunting -- even scary -- to most people.

Which brings us back to the AERD. One of its purposes is to provide some structure for communication around acupuncture safety. The AERD is based on a couple of foundational decisions: first, that collecting safety information is a valuable thing to do, and second, that people communicate better about safety issues when they’re not afraid they’ll be met with punishment and blame. The AERD represents our effort to normalize communicating about safety. Also, this blog. Thank you for reading.