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High Performing Hospitals: Do You Measure Up?
By: Patrice L. Spath
Brown-Spath & Associates
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What causes one hospital to be more successful than another at implementing new patient management initiatives? In my experience it's not just one factor or attribute that differentiates the exceptional organization. The differences are found in the attitudes of people working in the organization. To better understand how the attitudes of people affect overall organizational performance, consider the statements listed below. "We've already tried that and it failed." High performing organizations view failures as opportunities for learning
how to do it better next time. If an organization has never experienced any
failures, it's usually a symptom of a stagnant environment. In these
organizations, mediocrity becomes the norm because staff won't put themselves
in a position of being punished for failures -- causing very few new ideas to
be brought forward or implemented. Consultants can help physicians and staff think outside of their boxes, however organizations must be careful not to become consultant junkies. People working in an organization that constantly relies on outside consultants for new ideas take on the characteristic of "learned helplessness." Organizations that excel in performance improvement use consultants sparingly, knowing that the people who do the work have the best ideas of how to improve it. Consultants, if they are used, merely provide these people with new tools for getting the job done and then they go away. "That's not my job!" Hospital cultures are notorious for having thick barriers between disciplines. Moreover, like the caste system in India, professionals are pigeonholed for life. Organizations that excel at patient care improvements are constantly striving to break down the walls between physicians, managers and staff. People are rewarded for collaboration, not conflict. This ideal is well embedded into the fabric and culture of the organization -- for example, manager and staff performance appraisals are linked to their team behavior and team successes, not individual performance. "If only we weren't so short-staffed, we could provide better services." "If only we had more staff" statements are a symptom of two phenomenon: (1) people are unable to think outside of their traditional habits; and (2) people have not been trained to think outside of their traditional habits. Staff reductions are a reality in all health care organizations, unfortunately only high performing organization combine staff cuts with effective education. Saying, "You've got to learn to work smarter" will fall death ears if staff aren't adequately trained in work redesign techniques. Transforming Attitudes The new challenges confronting today's hospitals require a complete and comprehensive change of leadership styles, cultures, and structures. Some organizations just merely survive in the rapidly evolving, competitive marketplace, while others soar to the top. How do mediocre performers transform themselves into high performers? It starts with leadership. First, they must critically assess what's "out of whack" and then take steps to effect change. In my experience, what needs to change the most in the under-performing organization is the way people are motivated. The heart of the notion of motivation is striving: people wanting to work hard and to do well. Everyone has goals, however the important question is how management and employees agree on goals that are mutually satisfying. When staff participate in the setting of the goal, they are likely to have more of a sense of ownership. In under-performing organizations, it is common to see goals established without any sincere effort to involve employees or physicians. Finally, leaders must give some significant rewards for goal attainment -- either in the form of recognition, money, or time off. Let the employees have some say in selecting their rewards. The second most important change that needs to occur in the under-performing organization is elimination of barriers between disciplines. "Teamwork" is an easy word to say and spell, but transforming this concept into reality in appears to be difficult. When leaders say, "We've got to work as a team," their words must be backed with actions. Does your organization have one combined medical/administrative Quality Council or do physician leaders meet separately from administrative leaders? Does your organization have a nursing practice committee and different committee charged with discussing non-nursing issues? Does one professional group receive more time off for educational endeavors than other group? Have you made scholarship funds available to everyone or just a select group of disciplines? Hospitals have many traditions that, unfortunately, have created thick walls between disciplines and professional/nonprofessional staff. High performing organizations are constantly working to remove these barriers, is yours? Copyright 2000 by Brown-Spath & Associates To Learn More: Patrice L. Spath is available for in-house presentations on this and other health care quality and resource management topics. For further details, visit Brown-Spath & Associates on the web at: http://www.brownspath.com or write to: Brown-Spath & Associates, PO Box 721, Forest Grove, OR 97116. Visit the web site of Brown-Spath & Associates (www.brownspath.com) for the latest information on health care quality and resource management, free up-to-date articles on contemporary performance improvement topics and invaluable training resources. Our web site is updated at least quarterly, so be sure to return often! (07/00) |
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