Frontiers of Health Services Management - Spring 2013 - (Page 45)

1. What is working well today? 2. is there anyone i should recognize for doing great work? 3. are there any systems or processes that need improvement today? 4. Do you have the tools, equipment, and information you need to do your job today? 5. is there anything i can help with right now? Besides driving constant improvement, this tactic goes a long way toward building the relationship between leaders and employees. it reduces turnover. and because happy employees lead to happy physicians and patients, it might be the best action you can take to create a positive healthcare environment. compare leader rounding to lean’s gemba walks, as described by toussaint: My perception of going to gemba changed when I realized I was not there to walk around but to help. . . . The reason leaders go to gemba is to help staff improve value for patients. Just as frontline staff and physicians are adding value each day, the leader must add value, too—and not just by meeting community leaders, monitoring insurance reimbursement rates, and considering mergers. I learned that my primary job was to remove barriers for frontline staff so they could get their work done. Here is another example, this time involving staff members. teaching staff to round hourly on patients and implementing post–patient visit phone calls both satisfy the “pull” or “single piece flow” tactics so central to lean. Hourly rounding allows organizations to alleviate pain, regularly assist patients to the restroom so falls can be prevented, and so forth. Post-visit calls, made to patients after they are discharged from the hospital, allow us to minimize the risk of medication errors, for example. Both tactics allow the organization to proactively address individual patient needs one at a time, and quickly—rather than allowing them to “batch.” of course, teaching people to practice lean-compatible behaviors is only part of the picture. leaders also need to make sure all staff members are practicing the prescribed tactics and performing at a high level. it is crucial to hold regular conversations with employees aimed at re-recruiting high and middle performers and moving low performers up within—or out of—the organization. low performers can pose a serious problem to behavior standardization. not Quint St ude r • 45 c o m m e n t A r y an organization in which all nurse leaders practice the same sequence of behaviors in order to establish a consistent rounding discipline is not easy. Healthcare organizations standardize many aspects of their operations, from the brand of tissues purchased to the temperature at which food is served. But they tend to balk at standardizing behaviors. as toussaint says in his article, “i have rarely seen evidence of a formal management system that truly supports improvement. Most managers are accustomed to doing what they want with little oversight.” in my work i have found that certain leader and staff member behaviors, when hardwired across an organization, are deeply compatible with lean practices. for example, many successful organizations operationalize the practice of having leaders round on staff members to ask a series of specific, one-on-one questions aimed at obtaining actionable information:

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Spring 2013

Frontiers of Health Services Management - Spring 2013
Contents
Frontiers of Health Services Management - Spring 2013
A Management, Leadership, and Board Road Map to Transforming Care for Patients
Pursuing the Perfect Patient Experience
Adapting to the New Healthcare Market
High Reliability: Truly Achieving Healthcare Quality and Safety
Making Lean Progress Last: Why Sustaining Excellence Requires the Right Leadership Framework

Frontiers of Health Services Management - Spring 2013