I wrote an article in the Harvard Business Review a while back called "The Nut Island Effect: When Good Teams Go Wrong." It was about a group of folks at a sewage treatment plant in Quincy, MA: A team of skilled and dedicated employees became isolated from distracted top managers, resulting in a catastrophic loss of the ability of the team to perform an important mission. The irony was that most people viewing the team would say that it had all the attributes of an ideal working group -- dedication, collaboration, a strong sense of integrity and values, and indefatigable energy with regard to doing the job. It is probably no coincidence that many of the staff members had served in the military, where those virtues were highly valued.
Over the years, many people have noticed the same phenomenon in other industries. Bob Herman, with Becker's Hospital Review, has picked up on that fact, with an article focusing on the presence of this syndrome in hospitals. He cites my experience after entering this field:
[H]e found that the "us versus them" behavior was rampant in healthcare. "We have a team of people that's motivated by the best possible values — physicians, nurses, operating room staff, people in the pathology lab — and they get isolated the same way the guys at Nut Island did," he says. "You can go into any hospital in the world, and I bet if you described this syndrome to five or 10 people, they'd look at each other and say, 'That happens all the time.'"
Bob relates how the use of Lean process improvement in the hospital setting can help reduce the likelihood of this pattern occurring.
Once frontline staff members are trained to report setbacks and managers act on those calls, hospital leadership can map out the processes in question, diagnose the problems and reduce the waste that is bogging down production.... [T]here is a bevy of benefits from this type of systematic hospital improvement based on Lean principles: Employees are not as tired; employees are less likely to make a medication error because they are not as rushed; staff morale improves as more people get to know each other; there is less staff turnover; there is an improvement in overall quality of care; and money is saved as the waste in all processes gets weeded out.
Thanks to Bob for such a clear exposition of these points.