‘SOAP’ for BRAC

Let’s face it – everyone’s a critic in one way or another. There is no question about that. The question, then, is one of objectivity vs. subjectivity in a place where being subjective is the objective. This post explores the significance of recognizing information based on facts versus opinions. Thinking critically about the “subjective/objective” distinction can enable us to identify the nature of information we absorb, eliminate unnecessary biases and reasons for underrepresentation.

Last week, my colleague and I from the Social Innovation Lab visited some of BRAC’s core programs that run in Manikgonj. While the primary objective of our trip was to observe the processes and the ways in which the programs deal with their clients, we constantly explored scope for innovation and development. It was great talking to the DBR and POs who shared their experiences, and discussed many aspects of their program that all seem very important from an organization’s point of view. However, I couldn’t help but notice our inclination towards addressing one issue over another, not because that’s necessarily the most important or interesting problem, but because it’s the ones we made an effort to think in a very serious way about. Subjectivity in this sense seems inevitable. On the contrary, can subjectivism hinder the way we assess and streamline information? What is objective information and why should we consider maintaining a balance between the two? These are essential questions to explore, especially for an organization as diverse and extensive as BRAC.

First, let’s define the two; simply put, subjective information is one person’s opinion. This information is generally seen through the eyes of the person collecting and presenting it. For example, student research papers are usually subjective, in that the student formulates a thesis statement and backs it up with research sources that support his/her views. On the other hand, objective information reviews many points of view (even if it’s different from one’s own belief). It is intended to be unbiased. News reporters are supposed to be objective when reporting the facts of an event. Encyclopedias and other reference material are objective in nature. As a general rule, many scholars believe that measurability and repeatability of objective information makes it better for decision making in continuous improvement efforts. Emotions influence thoughts and our mood can change the facts for us. We overuse patterns with the assumption that because something happened before, it will again. Objective facts are more likely to have an absolute ‘right’ or ‘wrong’ than subjective opinions. However, opinions are necessary, especially in interpersonal communications. So how can we follow a balanced approach?

The ‘SOAP note’ can be a useful example to understand this process. The SOAP note, (an acronym for subjective, objective, assessment and plan) is a method of documentation employed by health care providers to write out notes in a patient’s chart. Documenting a patient’s encounters in a medical record is an integral part of practice workflow in a hospital. The subjective component includes the history or state of experienced symptoms, which are recorded in the patient’s own words. Details such as duration, pertinent medical history, family and social history, are also recorded. The objective component includes vital signs and measurements, findings from physical examinations, including basic symptoms of cardiac and respiratory, pertinent findings and abnormalities, results from laboratory etc. Next, a mid-level practitioner performs a medical diagnosis and presents a quick assessment of the patient’s main symptoms/diagnosis, usually in the order of most likely to least likely. Finally, the plan is what the health care provider formulates to treat the patient’s concerns – such as ordering further labs, referrals given, procedures performed, medications given, etc. A note of what was discussed with the patient is also documented or follow-ups are generally included.

How can we apply the ‘SOAP note’ example to our own decision making process at BRAC? Can understanding the subjective/objective distinction produce high quality information? Something to think about!

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