Nicole, a Director at a large Oregon midvalley hospital, reported:

"Monday morning, when the hospital operations report comes out, I read it religiously. It outlines most of the operations activities going on at the hospital. This week the report mentioned that the network firewall was being updated between 2 and 4 am on Wednesday (just two days later) meaning any internet traffic going in and out of the hospital during that time could be disrupted.

I'm sure IT wanted to do the right thing by making the update at that time, hoping it would disrupt the fewest number of people. I realized immediately that this would adversely affect our ability to have radiographs read during that time because we transmit the radiographs to an outside service from 11 pm to 6 am. We do upwards of 20 CT's and radiographs an hour at night, so this could harm our ability to provide care during these times.

I knew a radiologist would have to be in at the hospital to provide coverage. So I called the on- call radiologist to see if they knew about this "event" -- they didn't. I called the head of radiology and he totally exploded on me, "The hospital administration never contacted me on this, nor for similar events in the past." He went on to say that he was frustrated by what he perceived as a lack of concern or understanding about his department’s reliance on digital transmission of data, that they could choose on a whim when to take systems down without ever involving his department in the decisions.

I let him vent, apologized for the administration, and said I would look into the issue. Of course he then said the usual -- that "nothing

will ever change, there's not much you can do." I contacted the interim head of IT (who didn't know about the system going down either) who then immediately contacted the head of radiology and rescheduled the down time to an evening period where radiology was not reliant on internet transmission.

The next day I got a wonderful email from the head of radiology (with a cc to my boss, the Chief Medical Officer) stating how much he appreciated the rapid response from the hospital and my involvement.

The real kicker came when I spoke with one of the curmudgeonly older radiologists that evening on another matter, who at the end of the conversation spontaneously thanked me profusely for my intervention. He said it was the first time he felt the hospital had ever seriously paid attention, and dealt with in such a timely fashion, an issue involving his department.

I gained a lot of currency with the radiologists over such a small matter by just getting the right person to understand how important little details like this can be to physician groups. My involvement was probably no more than 10 minutes. It continues to fascinate me how departments within the hospital fail to look at their actions globally.

The lesson I learned from this experience is that when I take the initiative to solve problems, even outside my own area, I can make an even bigger difference than I expect.

The action I call on you to take is, when you see a problem about to unfold, don't wait for someone else to act ---- jump in and fix it. The benefit you will gain is an increased sense of teamwork, happier coworkers, and greater trust."