1. Develop a common vision that is easily understood by everyone, and share it so that all departments can build off it. This type of vision setting should be done on an annual basis. To help focus your efforts, select five areas of focus within the hospital and develop a short statement that summarizes each area and your vision goals. For example, for "morale," a vision statement could look like, "Be the Employer of Choice in the ______ Area." Each department can then determine how it will specifically support that goal in their area.
Most importantly, these goals should be shared broadly with all staff members so they can refer to these goals when planning and prioritizing activities for the year. Pictures can be very useful in reinforcing the goals. For example, if the goal is to reduce waste, a picture of a trash can with an "X" through it and some common types of waste identified around it, such as expired supplies, work great and ensure that all employees can understand the message.
To measure how staff members are contributing to the set visions, poll them and ask them how they are specifically contributing to the goals. You may be surprised. If your staff can't immediately explain how their actions impact the hospital goals, then how can they support them on a daily basis?
2. Use metrics and data, not emotions, to drive your decisions; if you don't currently have the data, start collecting it. Don't assume that your staff knows what measurement expectations are. Ask yourself and your staff these questions:
- How do you know if you are performing at the level that is needed?
- How do you know if you are providing what your customers want, both internally and externally?
- How do you know, as management, if you are providing the correct level of support and mentoring to your staff?
Setting up measurements for your staff around process performance helps remove emotions from the decision-making. Focus your team around data so you can hear the voice of the process clearly and use that data to help improve processes. Examples of measurements that can help place the focus on metrics include: percentage of charts completed accurately; number of instrument sets completed per hour; number of patient falls; level of antibiotic compliance; number of on-time starts in the OR; patient room turnover time; treatment to discharge time; OR delays by reason; and environmental services response time.
3. Set up area performance boards in all departments to focus activities around those issues that are most significant to the area. Measure expected outcomes of the departments in top categories such as quality, safety, delivery cost, and morale. These measurements should be something meaningful and specific to the department. Each individual in the department should be able to review the performance of the department and understand what contribution they made. When there are difficulties maintaining or improving performance of the process, those same individuals should be able to work together to solve the issues preventing excellence from the process. Provide the team with the information, data, training and resources to aid them in problem solving the issues so that they can aid in designing the solution. This will ensure sustainable results.
4. Ensure your leadership team uses the "go look see" management style; don't try to solve issues without going to see the actual problem yourself first. While simple in theory, this is sometimes difficult to maintain without discipline. It requires that the entire leadership team stays connected with staff on a daily basis.
To ensure that problem solving is approached with a true outlook of the current situation, consider the following:
- physically review the point of cause that is driving the problem;
- review the actual situation, not just what was designed as a process solution — look at what is actually being performed on a daily basis; and
- focus the time spent at meetings on resolving the issues instead of talking about them
5. Use visual management techniques to drive expected behaviors and maintain standards. Everyday your staff is spending valuable time that should be spent on patient care looking for items they need. Here are some ways you can make the process of locating necessary materials more efficient so the focus can be patient care:
- have the staff segregate the items they need into those they use daily, those they use weekly and those they use occasionally;
- prioritize the space based on these needs and put those things used most often in the prime "oceanfront property" locations;
- once these priority areas are identified, visually mark them as such so that everyone can aid in maintaining them; and
- Footprints, templates, outlines and flow diagrams posted in the areas will help in outlining expectations and desired behaviors.