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Truth Drift™ is the loss of meaning as information travels upward. I introduced the term in The Data Trap after seeing the same thing happen in different organizations and different situations. Information would start close to the work with context, explanation, and details that mattered. As it moved through the organization, some of the original meaning disappeared. By the time it reached the people making the decision, they were looking at accurate information and still wer

Consider a nursing unit staff meeting where bedside reporting is back on the agenda. It has been addressed before. There are laminated signs in the patient rooms describing exactly how it should happen. The expectation has been communicated. People know what is supposed to occur at the bedside before the outgoing nurse leaves. And yet the conversation is happening again. Someone suggests retraining. Someone else suggests monitoring compliance more closely. Maybe the expectati

You know within the first sentence of an email whether you want to read it. Sometimes you know before you even open it. The words haven't had a chance to matter yet. The sender already does. You've sat in a room and felt the energy shift when a particular leader starts talking. Nothing dramatic happens. People find somewhere else to look, adjust in their seats, and wait for it to be over. You've heard someone speak to a full group in language that sounds nothing like how they

How fast does your leadership team move from a performance metric to an action plan? I've been thinking about that question ever since sitting through a leadership meeting where staffing performance across several hospital units was being reviewed. Some units were meeting the budgetary standard. Others were not. As happens in most performance reviews, the conversation naturally settled on the units that had missed it. At first, nothing about the meeting struck me as unusual.

A group brought me a project they had been working on for several weeks. They were trying to understand why patients were not showing up for their appointments. The no-show rate had been a persistent problem, and they had done serious work. They had mapped the process, tracked every patient touchpoint, and built out the data to show what the office was doing to address it. The presentation was thorough. They knew how many calls had been made, how many texts had been sent, whi

We were in a meeting talking about potential cost reductions when critical bonus came up. It was expensive and used broadly enough that it was an obvious place to look. During the discussion the CEO wondered out loud what would happen if we stopped offering it. There wasn't much reaction when he said it, but soon after the meeting, the directors were told to stop using critical bonus. They were furious. They knew how stretched the staff already was and how important critical

Consider a healthcare leadership team reviewing a performance measure that has been sitting below an external benchmark. The organization is at 81%. The benchmark is 87%. This isn't the first time the measure has been on the agenda. The team has reviewed the process, made changes, talked with the people responsible for the work, and watched the number improve for a while before leveling off. Now it is back on the screen. Six points below the benchmark. The conversation turns

Most senior leaders I talk to cannot answer that with any precision. They know the reports. They know what came up in the last leadership review. What they cannot tell me is the last time someone on the floor said something that confirmed what the numbers said. A leader I was working with had a patient flow metric that had been declining for weeks. The usual sequence had played out. Additional data was requested, the accountable party had been identified, an initiative was la