Be Prepared

There’s a French cooking term that almost every chef knows: mise en place. The literal meaning is “putting in place.” It refers to the arranging of the set of ingredients one needs to cook a dish--each one chopped, sliced, measured and prepared, and separated into individual containers. A good mise en place is the first (and some would say most important) step in cooking a great meal. Without it, the choreography of cooking is never in time with the beat. If you try to chop or peel or measure as you go, the pan is on the heat too long, and the garlic burns, and the sauce separates, and the pasta gets soggy, and you cut yourself because you’re rushing to catch up. The rhythm of what you’re doing is lost in your haste, and the whole process spins out of control. 

Cooking isn’t the only process that has a mise en place. Painters use a palette, so they don’t have to squeeze out globs of paint as they go. Fishermen rig their lines the night before so they aren’t fiddling with gear when the fish are biting. Carpenters use tool belts so they don’t have to go back to their truck every time they need a framing hammer or a cat’s paw. 

In medicine, we can use a mise en place as well. A few minutes at the beginning of the day, to review our patients, pre-chart some notes and orders, and make a game plan with our teams can have a huge effect on how the day feels. It can keep us dancing on the beat, even when the music is playing double-time.  

The same is true for process improvement. The number one cause of failed initiatives is launching a solution before you’ve taken the time to really understand the problem. 

My friend Lee Fried likes to say that sometimes you have to go slow in order to go fast. Preparation can seem like a waste of time--but when the pans catch fire, and the smoke alarms go off, and you’re digging in the medicine cabinet for a bandaid for your finger, you might have to rethink that.