The dangers of Formophilia #WILTW

This is the 151st #WILTW

There appears to be a genetic hangover from the evolution of mankind which resists change. Shortly after the invention of the wheel came the invention of the ‘form’ (probably to describe the correct use of the wheel and situations it couldn’t be used). The ‘form’ seems to be embeded in the consciousness of many institutions and its dangers were brilliantly encapsulated by Prof. Davina Allen in a recent editorial.

“Checklists, pathways, algorithms are a tempting way for organisations and healthcare professionals to signal to the outside world that they are making a good faith effort to ensure service quality. Yet the popularity of these everyday tools has not been matched by their systematic and critical analysis, leading to concern about the potential impact of a growing epidemic of ‘polyformacy’ on healthcare systems.” AllenFrom polyformacy to formacology 

Prof. Allen calls for us to take stock of these simple but often very powerful tools and views them as ‘actors’ that do things rather than simple inorganic material. These ‘actors’ also require ‘scripts’ of the necessary information needed to make a tool work. Many assumptions are made about how easy these scripts are to read or enact. The example cited, one that is close to my heart, is the reliance on Early Warning Scores to be used by staff  who must adequately, and appropriately, collect the right vital signs at the right time. If this script isn’t followed correctly, the actor i.e. the score performs poorly.

A mis-understanding of actors and their interaction with scripts makes formophilia a dangerous pre-occupation. In his powerful book, the Seventh Sense, Joshua Ramo highlights the amazing ability for younger generations to develop powerful algorithms that connect the world in ever more intricate ways. But while they are immensely technologically proficient, do they have the context, insight and life experience to know the impact they are having? He quotes Joseph Weizenbaum (a MIT computer scientist) as saying: “Programming appeals most to precisely those who do not yet have sufficient maturity to tolerate long delays between an effort to achieve something and the appearance of concrete evidence of success

In the same way that simple programming is easy to learn, it is a very simple thing to produce a form. It is much more challenging to take time to decide whether the form is even necessary and a whole different endeavour to work out whether it actually works.

What have you learnt this week? #WILTW

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One thought on “The dangers of Formophilia #WILTW”

  1. In the context of the EWS the score is only as useful as the persons ability to interpret it. This is all well and good of the user immediately divulged said score to someone with the knowledge and experience to do just that. Problems with them occur when the user sees the score falls within a “that’s acceptable” category and misses something else that the score is not designed to pick up. Only enhanced knowledge combined with experience (Gestalt) fills that gap.

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