The truth, the whole truth and nothing but the truth

Often said . . . rarely practiced

We do not know the author of the oath or expression, “The truth, the whole truth and nothing but the truth.” There is a consensus that it developed in English law courts sometime between 1189 and before the end of the thirteenth century. What is clear is how rarely it is applied to our everyday lives.

In over forty years of gainful employment and thirty-five years of healthcare administration, I can only remember a handful of occasions when someone obviously lied to me. Most people utter the truth and fear not telling the truth.

On the other hand, the whole truth is not a treasured component of our culture. In organizational life, people use filters when sharing information both up and down the chain of command. Ironically, it is probably the CEO and the housekeeper most insulated from a complete view of the state of affairs of the hospital they serve; i.e., the specific hospital’s strengths, weaknesses, opportunities and threats. As I look back over my career I am now aware of numerous examples of truth that oozed out of the organization and to my attention in the most stumblebum manner. Sometimes the truth hurts and people are hesitant to be candid (another component of truth) when dealing with a reporting official. Recently, there has been a growing concern about the accuracy of reporting medical errors and hospital-acquired infections. The impulse to turn away from the truth in these circumstances is understandable on some level.

Similarly, a maxim of human resources management is to disclose to all employees as much organizational information as possible to avoid distrust within the organization and short circuit malicious rumor mongering. Notwithstanding, it is difficult to determine when and how much information to disseminate. I can remember the emergence of the Balanced Budget Act and the management debate of what to share with the employees and how to share it so that it could be effectively understood. Do you insult healthcare staff when the information is too watered down, or do you use provisions from the Federal Register that would make a Philadelphia lawyer dizzy with detail? This can be a daunting challenge.

In our consulting practice, we see hospital management teams that tell the truth to each other but fail to tell each other the whole truth. These are normally good people trying to be polite and, unwittingly, prevent the organization from achieving maximum effectiveness. I know it is easy to pontificate from Mount Olympus. On the other hand, it is so delightful to see the effects of hospital organizations where “the truth, the whole truth and nothing but the truth” is exchanged freely and at the same time strike a balance with civility and good manners.

This may all seem like a lot of nuance or nonsense. It is not. Today’s American hospital is like driving a hospital through a driving rainstorm. Truth can be seen through the windshield of the organization, the “whole truth” is represented by the windshield wipers at full speed. It makes a difference. Find a way to turn on the organizational windshield wipers at all levels, and the roadway to success will be clearer.

Jan Jennings

Republished with permission from the Hospital News Group