The Solution Compass Blog
Real hospital problems. Practical solutions. Written by people who've lived it.
The Drawer Didn't Come With the Contract
When you buy a practice, you don't just inherit their charts and EHR licenses — you inherit the sticky notes, the whispered workarounds, the binder behind the med room door. If you don't map those, you'll spend the next year undoing what they did right.
The Answer Exists. It's Just in Someone's Head.
The sticky note on the med cart isn’t a workaround — it’s a breadcrumb. And every time someone asks for the protocol and gets a PDF instead of a name, we bury another piece of knowledge under another layer of documentation.
The Unanswered Question Is the System’s Best Diagnostic
Every time someone asks a question that can’t be answered, the system isn’t broken — it’s telling you where the knowledge is missing. That’s not noise. That’s the clearest signal you have.
Patient Access Has the Highest Turnover and the Least Documentation
High rule complexity plus high churn is the profile where oral knowledge transfer fails hardest. It is the best place in a health system to start a knowledge program, and almost nobody does.
Nobody Knows Who to Call, So They Call Everyone
Broadcasting is the rational response to not knowing the route. Routing knowledge decays faster than anything else you own, because reorganizations never feel like documentation events.
How a Workaround Quietly Becomes Your Policy
It starts as a real fix for a real problem, gets taught without its reason, and within two years it is defended as the way it has always been done. Nobody decided this.
Stop Building the Perfect Folder Structure
A tree requires every item to have one parent, and healthcare content is multiply classified by nature. You need classification. You do not need a location hierarchy.
Downtime Procedures Are Useless If They Live in the System That's Down
Nobody designed it this way. The instructions ended up inside the thing the instructions are about, because putting documents in the sanctioned place is what a conscientious person does.
New Graduates Stop Asking Questions Long Before They Stop Having Them
Six questions an hour in week three, one in week eleven. Competence did not increase sixfold. The price of asking got set, and the operational questions went underground first.
Why Your Intranet Search Returns Nothing Useful
The nurse types 'can't chart vitals'. The document is called 'Flowsheet Row Unavailable'. Nothing is broken — your index knows the vocabulary of your authors, and your users are not your authors.
Every Screenshot in Your Documentation Has an Expiry Date
Screenshots feel like proof, which is exactly the problem. On when a picture earns its maintenance cost, and how to write steps that survive a vendor upgrade.
Knowledge-Centered Service Works. Getting Analysts to Do It Doesn't.
KCS is sound methodology with a well-known adoption failure. The cause is not misunderstanding — it is asking people to pay a cost on their scorecard for a benefit on someone else's.
The Most Important Thing an AI Assistant Does Is Say 'I Don't Know'
Every demo shows you the questions the system can answer. Abstention behavior is the property that determines whether you can trust any of the others, and it is the one nobody tests.
Fifteen Places to Look and No Idea Which One Is Current
Counting where a hospital's operational knowledge actually sits, and why consolidating storage is the wrong project. You need one retrieval surface, not one storage location.
What Happens to a Question Asked at 3am
Overnight questions get answered fast, confidently, and by a method nobody would approve of if they watched it. Night shift is where undocumented practice gets invented.
The Cheat Sheet in the Drawer Is Your Best Documentation Audit
Every nurses station has a folded sheet of paper that nobody approved and everybody uses. Banning them does not work, and it was never the point. Read them instead: they are a demand-weighted map of exactly where your official documentation fails.