Journal of Healthcare Management - March/April 2014 - (Page 150)

J o u r n al of H ealt H care M anage Ment 59:2 M arcH /a pril 2014 agree that a factor belonged in a particular failure category. In all, focus groups identified more than 20 different factors that participants believed cause hospital organizational change and improvement efforts to fail. Figure 1 contains the 10 most frequently mentioned factors, with corresponding percentages and ranked in order of frequency. The findings in the figure are the basis for the forthcoming discussion and recommendations. FINDINGS In this section, we outline the top 10 key factors that cause hospital improvement and change efforts to fail based on the input of the study participants. We include verbatim quotes when a statement or comment was taken directly from the information provided by the focus groups. In addition, a key leadership lesson from each factor is identified. Key Factor 1: Poor Implementation Planning and Overly Aggressive Timelines According to the participants in the study, change initiatives in healthcare organizations fail to achieve desired outcomes because their implementation is poorly planned and the proposed time frames for implementation are overly aggressive. These two issues were consistently linked by participants and were identified as the single greatest cause for failure. This finding is not surprising given the economic and legislative pressures being brought to bear on hospitals coupled with the depth and breadth of changes sweeping the healthcare industry. Nonetheless, participants made clear that there is no substitute for taking the time to develop an effective plan for the implementation of any organizational change. One major reason for poor implementation planning was that FIGURE 1 Top 10 Barriers to Successful Hospital Change as Identified by Frontline Hospital Leaders* 1. Poor implementation planning and overly aggressive timelines 2. Failing to create buy-in/ownership of the initiative 3. Ineffective leadership and lack of trust in upper management 4. Failing to create a realistic plan or improvement process 5. Ineffective and top-down communications 6. A weak case for change, unclear focus, and unclear desired outcomes 7. Little or no teamwork or cooperation 8. Failing to provide ongoing measurement, feedback, and accountability 9. Unclear roles, goals, and performance expectations 10. Lack of time, resources, and upper-management support 73% 67% 62% 55% 52% 50% 43% 38% 36% 33% *The findings presented in this figure are from a sample of 167 frontline leaders from four Midwest community hospitals who participated in 42 focus groups designed to identify the primary causes of why hospital change initiatives fail to achieve desired outcomes. The percentages represent the number of focus groups, out of 42, that identified a specific factor. 150

Table of Contents for the Digital Edition of Journal of Healthcare Management - March/April 2014

Journal of Healthcare Management - March/April 2014
Contents
Interview With Marna P. Borgstrom, FACHE, President and Chief Executive Officer, Yale New Haven Health System, and Chief Executive Officer, Yale-New Haven Hospital, Connecticut
Specialties: Missing in Our Healthcare Reform Strategies?
Costs and Benefits of Transforming Primary Care Practices: A Qualitative Study of North Carolina’s Improving Performance in Practice
Governing Board, C-suite, and Clinical Management Perceptions of Quality and Safety Structures, Processes, and Priorities in U.S. Hospitals
Use of Electronic Health Record Documentation by Healthcare Workers in an Acute Care Hospital System
Why Hospital Improvement Efforts Fail: A View From the Front Line

Journal of Healthcare Management - March/April 2014