Oh dear. I fear that management incompetence at Mid Staffordshire NHS Foundation Trust will have done nothing to enhance the reputation of targets. Apparently, the target that all A&E patients must be treated within four hours led to a number of disastrous unintended consequences. The target was met at the expense of patient care.
Targets often get a bad press– but I love them. The existence of a target or deadline spurs me into action. Without targets I’m sure I’d do a fraction of what I do now. Perhaps I’d even grind to a halt.
Targets and deadlines have so many advantages. For example, how could you ever under-promise and over-deliver unless there was a target or deadline to be under or over? How could you know how well you were doing unless there was a target to use as a yardstick? How could you “aim high to hit high” unless there was a target? The whole concept of “high” is meaningless without targets. How could you impress people unless they knew your target and that you had achieved or exceeded it?
How could you review progress towards a target or deadline if there wasn’t one? You’d have to play the “I’ll know it when I see it” game, which is a pathetic way to dodge the whole business of having to predict a desired outcome. There is no perception (ie, learning) without contrast and there can be no contrast without a target. How could you learn to set relevant, realistic targets if you never had any in the first place? Targets, especially missed ones or ones that spawn unintended consequences, generate masses of learning.
Why am I so keen on targets when most people grumble about them? Well, if you are suffering under the yoke of imposed targets, you’ll have spotted it straight away. It is simply because the targets and deadlines I have been eulogising are mine, not the absurd, often irrelevant, often impossible, things imposed by “them” (you’ll have your own “thems”). Not targets that distort priorities and get people to do daft things.
Agreed targets between consenting adults are the obvious antidote to imposed targets. Everyone has the right to be consulted about the targets and deadlines that affect them. Whenever anyone attempts to impose deadlines on me (clients often try this) I remind myself that I have a choice: if I’m happy it is sensible, I can agree, or, if I think it is unreasonable, I can negotiate. All those people who knowingly do silly things to meet imposed deadlines should exercise this choice.