‘Silo mentality’ is a phrase used in corporate training. It’s derived from a row of tall grain silos where what’s happening in one silo is of no relevance to what’s happening in the next. That image can be useful for bosses who are frustrated over poor internal communication. In effect, the various divisions within their enterprises have become silos so what the people in one division are doing has become irrelevant to those in the next. The problem is that the bosses WANT each division to know what the other is doing so they can weave a seamless integration allowing smooth operation. In a company, it doesn’t help if sales people are selling faster than production can create the goods. Imagine what it would be like if marketing had a really successful campaign and logistics weren’t ready to deliver the goods to all the new customers.

Hospitals are often very large enterprises with specialist divisions. Even in niche centres like an eye hospital, there must be distinctions between surgery and prescriptions. Ideally they work together but only one cuts patients.

In all organisations there are certain topics which transcend all divisions. Stress is an example, as that can impact negatively across divisions. When the people in one ‘silo’ fail to communicate, it rarely causes laughter in the adjacent ‘silo’. It’s more likely to cause stress and that transmits easily back and forth between silos. Larger enterprises have psychologists who work across the whole organisation. When silo mentality is active, those psychologists are helping stressed workers. When silo mentality is overcome, the psychologists become wellbeing advisers. In both situations they are important and useful people, yet what they will be doing on a particular day is governed by how senior management operate the enterprise.

That analogy fits well with hospital infections, doesn’t it? A seemingly insignificant event in one specialist area can allow dangerous bacteria in and the infection erupts several days later when the patient is in another specialist area. MRSA bacteria introduced during a minor wound care task in outpatients can lead to a patient with potentially lethal septicaemia being treated in intensive care several days later. The healthcare worker in outpatients may not even know what stress they have caused for the intensive care staff.

It’s infection control professionals who get to weave integration between the departments. When the hospital senior management are allowing silo mentality to prevail, the infection control team are busy handling infections. When silo mentality is absent, those same professionals spend their time guiding healthcare workers in safe practices.

Take a moment to think about a hospital near you. Is that organisation known for infections? If so, you’re likely to find good examples of silo mentality between the departments. Who’s to blame? Senior management. Who can fix it? Senior management. When a patient dies from infection under those circumstances, who’s to blame?  I have my view and I’d appreciate knowing yours.

Dr Harley Farmer PhD BVSc(hons) BVBiol(path) MRCVS

CEO NewGenn, published author, campaigner against infections, public speaker.


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