David Milner EAD 801 Final Project Guwandes argument seems to focus around the fact that it ta es a colla!

orative effort to ma e "ositive changes in the world# Also$ he ta es the stand"oint that through diligence and "ersistence$ changes can !e made# %&"icall&$ those colla!orative changes come from a centrali'ed leader# %hat leader would need to !e not onl& nowledgea!le !ut also "ersistent when it comes to their wor # (owever$ the a!ilit& for that leader to esta!lish the change and delegate the res"onsi!ilities to the e& "la&ers in the field determines the success of the change# )ts no sur"rise that Guwande feels this is the case when given his "rofession# *urgeons are re+uired to "erform at their !est all the time when its just not humanl& "ossi!le# As doctors$ the& are also e,"ected to do their !est for the "atient regardless of the "otential outcome# (e recogni'es that it ta es a colla!orative effort to ensure that when he is inca"a!le of "erforming at that level$ there are others who can hel"# At the same time$ his "ersistence and vigilance towards fi,ing the "ro!lems needs to !e trans"osed to the "eo"le he is delegating wor to# %he issues that "resent themselves are the fact that delegation limits the amount of leadershi" one can have# %he more &ou delegate$ the less "ower one "erson can actuall& have over a change# Also$ when delegating wor $ the "eo"le who are !eing handed the wor ma& not feel the same wa& &ou do towards a s"ecific "ro!lem# %he& ma& !e wor ing !ecause the& have to$ not !ecause the& want to# (owever$ when considering the ends rather than the means$ leadershi" ma& not !e the most im"ortant factor when it comes to ma ing a change- vigilance and "ersistence ma& !e# .sing a colla!orative method to change the +ualit& of life is one of Guwandes main "oints# A factor to !etter the +ualit& of life in the hos"ital as it "ertains to disease

is hand washing# Guwande highlights the fact that hand washing is one of the sim"lest methods to "revent the transmission of disease and is also one of the most difficult things to change in a hos"ital setting# /& following a few hos"ital em"lo&ees$ he highlights the fact that doctors dont alwa&s have the time and sometimes sim"l& forget# )n the first cha"ter$ the& note that !& giving the "ower to the em"lo&ees of the hos"ital$ the& ta e ownershi" over the "ro!lem# %his in turn made things !etter in hos"itals as far as hand washing goes# *till$ it wasnt enough# )m"roving hand washing from 001 to 201 wasnt going to slow down the s"read of disease amongst the hos"ital# %he doctors and nurses needed to !e more vigilant when it came to their desire to eradicate the s"read of disease in the hos"ital# %his is a feature doctors need to !e successful according to Guwande# Doctors need to have the desire to ee" "ushing no matter how !lea the outcome# (e highlights a few cases where his "atients were loo ing !ad and regardless of what is !eing said$ the doctors ee" "ushing on# )n some cases$ those "atients were a!le to recover and live normal lives# )n one s"ecificall&$ he even states that the famil& of the "atient had given u" ho"e !ut the doctors didnt# *ome were not so luc & and unfortunatel& "assed# (e mentions though that its im"ortant to ee" tr&ing no matter how slim the chances are for the "erson to live a normal life# 3ou can also ma e a "oint a!out his vigilance when loo ing at his tri" overseas to Africa# (e was wor ing in an overcrowded hos"ital with inade+uate su""lies and horri!le conditions# 4ne of the !iggest lessons he seemed to learn while there is doctors can ma e onl& so much of a difference# Persistence is e& to ma ing the most of what &ou have !ut in the end$ &ou are still limited to the scenario &ou are "ut in# (e stated the fact that a "atient "assed awa& who would have never had major com"lications in an

American hos"ital# %he hos"ital didnt have even some of the most !asic su""lies which were needed to save the mans life# Guwandes "ers"ectives are somewhat e,"ected and offer +uite a few valid "oints# Persistence and vigilance are two characteristics man& great leaders "osses# Also$ it ta es a great leader to now when their vision is too much to handle alone and delegate res"onsi!ilit& accordingl&# )n the field of medicine$ these factors can ma e the difference !etween a "atient who lives and a "atient who dies# Doctors need to maintain that sense of vigilance throughout their entire careers# Also$ "racticing medicine would !e much more difficult without a su""orting cast of nurses$ residents$ and other various hel"ers to ee" the !uilding running# %he downfall of Guwandes "ers"ective is sim"l& the fact that he trusts all sources of information# From the "ers"ective of !eing a doctor$ its "ossi!le to do so given that research has to !e done with strict guidelines# 5linical trials are ver& difficult to s ew$ and changes in the medical world dont come without e,tensive research and "lanning# )n the field of education things can !e a !it different# 6here vigilance and a sense of delegation are im"ortant$ ironicall& a sense of s e"ticism is also im"ortant# )n the medical field$ research is t&"icall& done inde"endentl& and doctors are given u" to date information a!out the latest tactics on how to treat illnesses and diseases# %he& get accurate data on how certain "rocedures im"rove +ualit& of life# )n most cases the world of education has "lent& of "eo"le who do the research for &ou as well# /ut the sources tend to !e less clear# Furthermore$ the data which is "resented ma& !e inaccurate or "erha"s even wrong# %here are countless studies which all contradict each other# 7eaders in the educational field need to ee" these facts in mind when the& are "ushing for a new change# )n man& cases$ a new "rogram could come out or !e mar eted to

schools which is designed loosel& to im"rove the +ualit& of education and more to ma e mone&# *chools with "oor leaders will s"end a lot of time and mone& changing "olicies which ma& not need to !e changed due to a good mar eting techni+ue# %his is not to sa& the jo!s of educational leaders are more com"licated$ the& just need to have that third factor of !eing a!le to +uestion the motives of certain studies as the& "ertain to their own student "o"ulations# 7eaders in education are alwa&s "resented with new and "rogressive curriculums and have a ver& difficult jo! of reading through the h&"e to ma e a decision for the majorit&# Educational leaders need to sim"l& as them selves$ will this hel" m& students8 *chool "o"ulations var& widel& !etween regional areas and even schools# *ome schools within the same district ma& have different norms and standards for the students# %herefore a new s&stem ma& wor for one grou" and not for another# Educational leaders are faced with a daunting tas # %he& need to see things the wa& Guwande does to a certain e,tent# )ts im"ortant to maintain a "ersistent effort to reform education in our schools- as well as delegating res"onsi!ilit& so it all doesnt fall on our shoulders# Also$ leaders in education need to delegate the wor of reform in order to achieve success# (owever$ good school leaders dont just jum" on the ne,t great thing# 9esearch shows whatever the "eo"le selling the new curriculum want it to# %he difference !etween a good administrator and a great one is their a!ilit& to +uestion not onl& the research$ !ut whether its necessar& or not to im"lement a new "rogram in their school# %hen$ once a decision is made$ "ro"erl& training the wor ers in the school to utili'e the new "roduct or s&stem needs to !e done to ensure success# )n the end$ Guwandes "ers"ective offers a variet& of valid "oints# 7eaders need to "ossess the +ualities in which Guwande descri!es# :igilance$ "ersistence$ and an

a!ilit& to delegate to create a colla!orative effort are needed to ensure the +ualit& of life in the medical field# %here also needs to !e a certain level of desire amongst the "eo"le who "ower is delegated to# )n the field of education all those things are needed as well# For a change to !e made in education$ it ta es all "la&ers# %eachers$ administrators$ co; educators$ coaches and all other "eo"le who wor with ids are needed to ma e a "ositive change# %he difference as stated a!ove is that !efore a change needs to !e made$ it ta es a leader within the school to evaluate the ramifications of the change !efore its "ut in "lace# %he a!ilit& to ee" !oth short term and long term "ers"ective determines how the change will affect the school# %hen$ if necessar&$ the decision is made to delegate the change to the "la&ers mentioned a!ove# Finall&$ once the change is in "lace$ its u" to the vigilance and desire of ever&one involved to ma e the change "ossi!le#