Friday 23 January 2015

Managing a clinical pathway with an undisciplined multitude is most dangerous

Maneuvering with an army is advantageous; with an undisciplined multitude, most dangerous.

If you set a fully equipped army in march in order to snatch an advantage, the chances are that you will be too late. On the other hand, to detach a flying column for the purpose involves the sacrifice of its baggage and stores.

Thus, if you order your men to roll up their buff-coats, and make forced marches without halting day or night, covering double the usual distance at a stretch, doing a hundred LI in order to wrest an advantage, the leaders of all your three divisions will fall into the hands of the enemy.

The stronger men will be in front, the jaded ones will fall behind, and on this plan only one-tenth of your army will reach its destination.

If you march fifty LI in order to outmaneuver the enemy, you will lose the leader of your first division, and only half your force will reach the goal.

If you march thirty LI with the same object, two-thirds of your army will arrive.

We may take it then that an army without its baggage-train is lost; without provisions it is lost; without bases of supply it is lost.


From "Sun Tzu on the Art of War - The Oldest Military Treatise in the World"
Translated from the Chinese By Lionel Giles, M.A. (1910)

Discussion:

A physician does not have full authority to hospital staff but has it for the orders made by the physician. So the army of soldiers are translated into the army of orders.

Translation:

Managing a clinical pathway with an army of observations and interventions is advantageous; with an undisciplined multitude, most dangerous.

If you set a fully specified army of orders in every detail in order to snatch an advantage, the chances are that you will be too late. On the other hand, to detach an ongoing column of an active pathway for the purpose involves the sacrifice of its already dispensed solution bags and supplies.

Thus, if you order your observations and interventions to roll over their cutoffs, and make forced STATs without halting day or night, covering double the usual stint at a stretch, doing a hundred rounds in order to wrest an advantage, the leaders of all your three divisions will fall into the hands of the illness.

The stronger staffs will be in front, the jaded ones will fall behind, and on this care plan only one-tenth of your army of orders will reach their outcomes.

If you march fifty rounds in order to outperform the clinical indicators, you will lose the leader of your first division, and only half your staff will reach the goal.

If you march thirty rounds with the same object, two-thirds of your army of orders will be achieved.

We may take it then that an army of orders without sufficient nursing carts is lost; without provisions it is lost; without bases of supply it is lost.

Ray Murakami