Observational evidence for the existance of a new fifth state of administration

Dr R. Liang(*) and Dr J. M. Woithe(+)

Abstract

On 2 October 2000 at Westmead Hospital in Sydney an extraordinary event occured within the administration unit. A decision was made which, after careful analysis by unbiased external parties, can only be concluded to be sensible and to show considerable forethought while demonstrating an unique application of common sense by administrative ordinants. This paper reviews the leadup to this unusual event and then analyses the actual event itself which we believe provides a fascinating insight into a previously unknown physical state of administration.

Introduction

In preparation for the 2000 Summer Olympic Games in Sydney, the organising committee had already shown an unusual amount of forethought [1]. The city hospital network was organised in the following way [2]. Three major base hospitals were assigned for the first line treatment of medical emergencies - Concord hospital for athletes, Westmead hospital for staff and spectators, and Prince of Wales hospital for VIPs, since no one wanted the VIPs to have to mix with the riff-raff in order to get medical treatment. In the event of mass casualties (eg terrorist attack, stadium collapse), district hospitals, private emergency clinics and GP surgeries were assigned as second line.

Westmead hospital was expected to bear the brunt of medical emergencies during the Games on account of the large number of spectators expected (many times more than the number of athletes) and the likelihood that spectators were more likely to be in poorer health than athletes. It was estimated that up to 30 cases *in excess* of the usual numbers would present at the emergency department on each day of the Games. The hospital therefore expectantly cancelled all elective surgery for the week preceding, and the two weeks of, the Olympic Games [3].

Much to the disappointment of the doomsday predictors, the number of excess cases attributed to the Games proved to be much less than anticipated; of those, almost all cases were of a minor nature not requiring surgery. The surgical theatres and wards were therefore left empty of patients which was fine for the medical staff but which caused considerable anxiety amongst the administration: the operating theatre was still required to be fully staffed despite the lack of patients. This overestimation was therefore at major cost to Westmead Hospital.

Observations

One month after the Olympic Games, the Paralympic Games were held in Sydney, and the arrangment for management of medical emergencies was the same as for the Olympic Games. Although on a slightly smaller scale than the Olympic Games, Westmead was still planning to cancel elective surgery, at least on a partial basis. Instead of unquestionably charging ahead with this plan the situation that occurred during the Olympic Games was reviewed first, showing great introspection and an uncommon dose of common sense. As a result, it was decided that full elective lists should proceed and that medical emergencies would be dealt with on an ad hoc basis.

This approach proved to be successful; the small number of excess cases kept the hospital tolerably busy, beds were kept full and staff were usefully employed.

Discussion

The foresight demonstrated by this most unusual event is significant in that it demonstrates a number of processes previously thought to be blocked within administrative units. It appears that these processes can occur so long as the forcing is very strong to extreme.

In the first instance it can be seen that two temporally separated events with otherwise similar characteristics can identified as such by administration, despite the natural administrative tendency to ignore anything from the past and to resist the utilisation of experience from past events when planning for the future. It must be noted that in this case the two events of concern were very similar in nature, and therefore the mental power required to resolve them as such was not very large. Thus the ability to make this resolution is not totally absent within adminstration as was previously thought, although it is severely abbreviated. Consequently, events must be very similar in nature before this effect is likely to take place.

Secondly, following the identification of the events' similarity, the administration apparently proceeded to utilise this result. Once again this is an ability which has been assumed absent in administration until the present study. When faced with such a resolution the normal tendancy is for administration to spontaneously drop into one of four states:

  1. deny the existance of the previous event
  2. argue that (contrary to public opinion and common sense), the previous event really was significantly different from the one under current consideration when compared with the "expert" experience of those within the relevant organisation
  3. maintain that the first event was too far in the past to be relevant now
  4. discredit the first event, claiming that its organisation was a mess and its execution atrocious. Once established as public opinion it is easy to claim that the planned event should not follow the same path as the first one.

As for the resolution issue discussed above, the forcing present in the situation under consideration was very strong in that it acted to make all four of the above states unstable, thereby preventing administration from adopting any of them. State 1 was clearly unsustainable due to the scale of the Olypmic Games and the fuss/hype surrounding them. Since the Olympic Games themselves were regarded as a success, state 2 was similarly unsustainable. State 3 would require a serious redefinition of time which no one would believe while state 4 would present the administration with an irreparable public relations nightmare.

It is hypothesised that due to the strong forcing experienced in this special situation, the administration concerned were forced into a fifth state whereby they are forced to utilise the information from the previous event. This is a very high energy state in that it requires more work from administration. Until now no situation has been capable of presenting enough forcing to activate this fifth (previously unknown) state, which further demonstrates the uniqueness of the situation.

Publicly available documentation of this unique incident and the events leading up to it is, sadly, in short supply. This is thought to be caused by the combined action of postulate 8 in the `Special theory of Administrative relativity' [4], and the well-known administrative process of documenting things for either internal use only or shredding (whichever ends up being more convenient to the administration once circumstances have fully developed). The authors have located some relevant documentation which has been referenced as appropriate; however, much of the information comes from direct observation. Readers are encouraged to be vigilant for similar occurances of this fifth state so more might be learned about this exciting new development in our understanding of the internal workings of administration.

Conclusion

The observations detailed herein are significant since they demonstrate the short-lived existance of administrative states which until now had been unknown and unexpected. Further careful observations are required in order to fully characterise the properties of these states, including the important question of state lifetime.

References

[1] see web site at http://www.mja.com.au/public/issues/xmas/stiel/stiel.html, for example.

[2] see web site at http://www.gamesinfo.com.au/yh/he/YHHE10/index.html, for example.

[3] internal memos, August-September 2000, Westmead Hospital Intranet

[4] `A special theory of administrative relativity', R. Liang and J.M. Woithe, admin_rel.html

(*) The Dept of physics and mathematical physics, University of Adelaide, Australia
(+) North Shore Hospital, Auckland, New Zealand

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