What 275 days of intensive care taught me about managing complex projects

Jack Jensen

For 275 days after his birth my son Jack lived in the intensive care units of various London hospitals. A large team of consultants, doctors, nurses and cleaners worked together 24/7 to support Jack’s daily needs whilst solving his long term health problems. Managing complex projects is a large part of my job so being a geek I couldn’t help but analyse the key mindsets and approaches that positively contributed to Jack’s journey. I believe that the concepts below can be applied to managing any complex long term problem and I hope you find them useful.

Set the right long term goal to give context to all decisions

In Jack’s case this was the ability for him to go to a normal school without any assistance. This context provided assistance to making harder short term decisions.

Complex questions rarely have a 100% answer

Doctors are rarely able to give you a 100% answer to complex questions. I have come to appreciate this way of thinking as it avoids setting you up for disappointment. This reflects the reality of the unknown and changable nature of environments.

The more people involved the harder consistent communication becomes

Communication between all of the parties involved in 24/7 care is a constant challenge. This can be helped by writing things down, putting them on walls and doing as much as possible face to face.

Start from the worst case scenario and work backward

Planning for the worst ensures you really think about all options. This is a great mind hack to be happier with outcomes that aren’t the best case scenario.

Capture as much information as possible

Over longer periods of time it is essential to write down decisions and observations so anyone can revisit the context and data around decisions if they weren’t involved in them at the time.

Establishing baselines and thresholds help autonomous decisioning

Every baby is unique and collecting data is a great way to understand their current state compared to their history. Once you have established a baseline it is easier to empower people to act if thresholds are broken. Overall population baselines are also useful over a longer term view.

Monitoring should be visual and constant

All monitors should be highly visible and when something deviates from the established baseline then they should alarm. Alarms should have clear levels between their various states.

Daily stand ups are essential

A daily conversation with all of the people that are going to be involved in the care of the child are essential. This coupled with data enables distributed decision making. Face to face conversation ensures everyone gets the chance to contribute.

Choosing the right option when many are available is difficult

There is a decent amount of trial and error in solving complex problems. There are standard approaches which give you options for the next step but only by trying and measuring will you actually find out how effective they are.

A clear path of escalation is essential

Knowing who to ask if you are blocked or have an emergency is essential. This coupled with having access to people with greater levels of experience can really help move things forward.

The last 8 months have been an incredible journey and I am unbelievably grateful for everyone who has helped us along the way. This process has broadened my approach, understanding and mindset for managing complex projects. I am thankful to the systems that have enabled Jack to have the smile that now warms my heart on a daily basis.

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