Journal of Healthcare Management - March/April 2014 - (Page 152)

J o u r n al of H ealt H care M anage Ment 59:2 M arcH /a pril 2014 Study participants noted that in hospital/healthcare environments, leaders can ill afford to be viewed as, in their words, "bureaucrats," "leading from behind," "sycophants," "politicos," or "butt-kissers." According to these participants, ineffective leadership becomes even more counterproductive in periods of rapid change that demand increased performance. Leadership lesson: To achieve maximum performance improvement from any change initiative, leaders must demonstrate competence and character, and they must lead by example. Key Factor 4: Failing to Create a Realistic Plan or Improvement Process It is interesting to note that two of the first four factors that drive failure clearly fall into the category of leaders being ineffective in laying out a plan of action that will lead to a desired outcome. It is commonly stated that "failing to plan is planning to fail," and the study participants clearly agree. With hospitals under increasing pressure to make rapid changes and improvements to their operations, their senior leaders are quick to move forward with plans that were described by participants as frequently "unrealistic," "incomplete," "overly optimistic," "half-baked," "unworkable," "impractical," and even "naïve." When leaders do not take the time to create effective action plans or processes for desired changes, they often lose on several counts, according to study participants. First, they waste precious time and resources in pursuing change using plans that have not been thoroughly and realistically thought out. Second, the outcomes associated with the activity are almost always negative or, at a minimum, are less than optimal. Third, the credibility, common sense, and trustworthiness of senior leaders are quickly called into question at a time when they need all the support that they can get to move their organizations forward. It has been said that any change worth making is worth making right. Our study's participants indicated that to make change right requires an effective, realistic plan and an improvement process that has been thoroughly considered and vetted prior to implementation. Leadership lesson: When leaders ask members of their organization to implement a change initiative, it is imperative that sufficient effort, time, input, and resources have gone into the planning process. Key Factor 5: Ineffective and TopDown Communication Communication is frequently a challenge in any large organization, but this is particularly true in periods of rapid change, as affirmed by study participants. Participants stated that a lack of effective two-way communication surrounding any change or improvement initiative causes significant problems for numerous reasons. When a change is being introduced, extensive and intense two-way communication is necessary among all parties involved. One of the primary reasons that employees frequently fail to buy into or take ownership of a change initiative is that they "do not fully understand either the reason for the change or the process" that will be used to improve performance. 152

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