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There is a Japanese management technique, I can't remember its name. When you sit and watch your unit for a day, just sit and watch, no questions and no reports. Having just sat in an Intensive Care Unit for the last few days I can really see the value of this, all the big things, processes technology and levels of care are FANTASTIC but watching nurses ask for the 23rd time in 48 hours who has got the keys is but one example of a whole range of little things that would help them do their job . Just sit just watch patterns emerge..
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