Productivity: What We Can Learn From Wartime Medicine

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World War I was one of the bloodiest conflicts in human history. Millions died, and it fundamentally changed the way Westerners thought of war. But from the ashes came several medical breakthroughs, as doctors innovated new techniques to save lives.

One of those innovations was triage, a simple but powerful decision-making framework doctors used to determine the order in which they’d treat wounded soldiers. The stakes were huge—literally life and death—and the doctors wanted to save as many people as possible. So they took a utilitarian approach:

Soldier condition Priority of treatment
Could live if given immediate care First
Unlikely to live regardless of care Second
Likely to live regardless of care Last

Triage is all about maximizing impact. Rather than treating the patients with the worst injuries first, or going by rank or socioeconomic class, these doctors looked at all their patients, considered their possible outcomes—life, death, permanent injury—and gave priority to soldiers whose outcome could improve the most with quick treatment.

It speaks to the grisly tragedy of war that doctors were forced to make those decisions. But years later, we can look back at the strategy their grim situation necessitated and apply it to our own lives. While it would be ludicrous to compare an office to a battlefield, the science of triage does provide valuable insight to how we can work more efficiently.

Triage focuses all of one’s energy on achieving the best possible results in any situation. That’s the attitude you need for productivity. Every item on your to-do list represents a specific outcome you want to achieve. By prioritizing important items where immediate action will make a big difference, you ensure that you’re always working toward the best possible outcome. Here are the three triage categories for your to-do list:

Type of task Distinguishing characteristics Priority
Vital Very important, and requires immediate action to get the best possible outcome First
Non-vital Very important but can be scheduled. Rarely pressing Second
Non-essential Needs to get done but not time-sensitive Last

Here’s how to handle each type of task, from highest to lowest priority.

Knock out vital tasks ASAP

In the days of Apple’s infancy, Steve Jobs toured Xerox’s Palo Alto research facility and saw the future: scientists moving a cursor across a screen, opening windows, and clicking icons with a curious device called a “mouse.” He raced back to Apple HQ, demanded his engineers duplicate what he’d seen, and started work on what would become the Macintosh computer.

Apple Mousesource

Call it genius or call it crazy. I call it a man who knows a vital task when he sees one. When Jobs saw that mouse in action, he knew that if he acted fast enough he could achieve something incredible. His results validate that intuition. That’s the essence of a vital to-do list item—anything high-stakes where your immediate action will be the difference between success and failure.

You don’t necessarily know when those vital items will pop up. You might even have one or two sitting on your to-do list right now. But know this—they’re the reason you get up in the morning. Nothing makes you more effective than your ability to identify and knock out vital tasks.

HOW TO RECOGNIZE THE VITAL TASKS

Vital tasks come in all shapes and sizes, so there’s no definitive guide on how to complete them. But here’s how to recognize them when they come up.

  • BOLO (Be On the Look Out). Steve Jobs probably wasn’t expecting to see anything revolutionary when he toured Xerox. But when he saw it, he was ready to pounce. Always be looking out for that next vital task.
  • Figure out the deadlines. The key distinguishing factor for vital tasks is that they need attention right now. Again, it comes back to outcomes. Ask yourself how much better your results will be if you knock this task out now, an hour from now, a day from now, etc.
  • Vital tasks fit your skill set. Vital tasks will always be something in your area of expertise—something only you can do perfectly. Case in point: Jobs was a marketing and design whiz. When he saw something well-designed that he could market, he knew he had to act.

Identifying vital tasks isn’t just half the battle—it’s the half that 99% of people screw up. That’s why so many people spend their day putting out fires, sitting through pointless meetings, and running like a hamster on a wheel—losing energy but not making progress. But that’ll never happen to you if you can pinpoint the urgent tasks and ruthlessly prioritize them.

Schedule non-vitals

Think every uber-successful startup founder moves into an opulent mansion when they hit it big? Not Zappos CEO Tony Hsieh. He lives in a trailer park. With two pet llamas. Even more unconventional is the fact that he makes his daily schedule visible to the public on Evernote.

One thing that jumps out right away is how many emails he receives—at least 379 a day. Tony attacks that seemingly insurmountable number using a technique called yesterbox. He devotes time every day to chipping away at the messages he got the previous day, instead of scrambling to field emails as they come in.

Managing email is a good example of a non-vital task because most emails don’t need a response right away. However, email contains crucial information—new ideas, decisions that need your input, documents to look over—so you need to check it every day. But dropping everything to respond to each message the second it arrives will pull you away from tasks that needs immediate attention.

That’s the beauty of Tony Hsieh’s system. He doesn’t try and give every email attention right when it comes in—as he puts it, that would be like a “never-ending treadmill.” But he sets a schedule to check his email, diligently sticks to it, and makes sure that important messages get the response they need without distracting him from more urgent tasks.

HOW TO MAKE EMAIL EFFICIENT

Under triage, non-vitals, like emails, take a back seat to time-sensitive items. But you can’t write them off. Here’s how to make sure your emails are getting the attention they deserve without pulling you away from more important stuff.

  • Set a schedule. Find an email schedule that works for you. Some people prefer yesterbox, some prefer to check email twice a day—the point is that you nail down a recurring timeline so nothing falls through the cracks.
  • Know what to delete. Former Google CEO Eric Schmidt has written that one of the most valuable email skills is being able to quickly recognize which messages you don’t have to read. Deleting unnecessary emails saves you lots of time.
  • Create response templates. Having a few canned responses saved is a great way to save time if you have to periodically send certain types of emails like, say, responses to job applicants.

These strategies empower you to efficiently deal with email on your own terms.

Squeeze in your non-essentials

Recently passed Silicon Valley legend, Andy Grove, grew Intel into the computer parts juggernaut it is today. In his book High Output Management, he instructs readers that to get maximum productivity out of their calendars, they need to “fill the holes between time-critical events with non-time-critical though necessary activities.”

Andrew_Grove

source

In other words, Grove triaged his calendar so that non-essential tasks took a back seat to ones that required immediate attention.

You need to do the same thing. For example, let’s say one of your goals is to refine your company’s process for its weekly all-hands-on-deck meeting. That’s important, but it’s non-essential because doing it next week versus right now gets you roughly the same outcome. It can’t take priority over something more urgent, like completing a client project on time.

Make no mistake though—you still need to get it done. Someone could look at triage and conclude that they should never do any task that isn’t pressing since, theoretically, there’s always something more important to do. For example, doctors know they need to find time for continuing education each year. But at any given time, there’s probably, say, a surgery to prepare for instead. Problem is, if they never do their education, they’ll lose their license.

Non-essentials still have a key outcome attached to them—if not, then they shouldn’t be on your to-do list in the first place. You just need to be disciplined about finding time for non-essentials when you’re not taking out vital and non-vital items.

HOW TO BUDGET FOR THE NON-ESSENTIALS

Here’s how to figure out which tasks are non-essentials and make sure none of them slip through the cracks.

  • Know the outcomes. Take the process improvement example from above. Enhancing your company’s weekly meeting is important, but in the grand scheme of things, it won’t make a huge difference if you do it now or if you do it in a month.
  • Don’t be afraid to say “no.” If you’re working on vital tasks and someone asks you to drop it for a non-essential, be tactful but make it clear you can’t do it. As productivity expert Rory Vaden writes, when you agree to too many tasks, you suffer from “priority dilution” and can’t focus on the tasks that really matter.
  • Batch non-essentials. Find a chunk of time to knock out a bunch of similar, tedious non-essential tasks like, say, filling out expense reports. It’ll take less time overall because you’ll get in the zone and not have to multitask.

Each of these strategies ensures your non-essentials get done without interfering with the important stuff.

Triage is a work in progress

Like the rest of the medical field, triage systems are advancing every day. While those pioneering WWI doctors were eyeballing injuries and going off past experience, today’s triage systems use statistics and algorithms to learn from past mistakes and adapt to any situation.

Over time, you’ll also fine-tune your triage system and get better at discerning which tasks are which. The key is to constantly ask yourself about outcomes. What do you want to achieve, and how will speed help you do it? If you do that consistently, you thrive even in the most chaotic conditions.

(Cover image source: https://www.flickr.com/photos/99129398@N00, National Museum of Health and Medicine)

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