How do you create a healthcare organization that continually improves?

In my experience, having a Vision is clearly a first step, however having SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) goals are equally important to support the vision. It’s easier to set expectations on why we do what we do but it’s harder on how to execute on goals. The SMART goals helps to keep the healthcare journey of small & sustainable incremental improvements.

Assuming you’re a Clinical Lead (and as such have no direct decision/power over monetary compensation) don’t forget you have responsibilities, not rights: 1) You’re an umbrella to your team. When trouble rains down from above, it should stop on you, not them. 2) Control your ego. We all have one, but the job is to elevate people to a position higher than yours, not to elevate yourself by standing on top of your team. 3) If you have hiring privileges, make sure you bring in people who are smarter/better than you. Don’t be the type who is afraid of leading people better than yourself. 4) Don’t micromanage people. Your job is to create the vision, foster ideas and put out the fires.

Creating a healthcare organization committed to continuous improvement requires visionary leadership and a culture that thrives on innovation. It goes beyond just delivering care; it's about elevating the healthcare experience for patients, staff, and the broader community.

In my opinion, continuous improvement requires a culture that support’s continuous learning, open culture, fair distribution of work load and evidence based decision making using technology such as Medblaze Digital Quality Management Systems that allows care providers to continually improve patient safety and experience without causing burnt outs

Root cause analysis (RCA) is a problem-solving technique used to identify the underlying causes of an issue. 1. Identify the Problem, define the problem or issue you want to analyze. 2 Gather Data This could include historical records, process documentation, observations and interviews. 3 Brainstorming Utilizing a diverse group of individuals who are familiar with the problem. 4 Ask the “why" question multiple times to drill down to the deeper cause of the problem. 5 Analyze Causes- Consider both immediate and underlying causes. 6 Identify the Root Cause. The root cause is the fundamental reason behind the problem, and it will prevent recurrence. 7 Develop Solutions to the issue. 8 Choose the most suitable solution. AI assist*

Aligning staff with the purpose behind our actions is fundamental. When they understand the "why," it ignites a collective commitment to patient safety, wellness, satisfaction, and equity. Yet, our mission shouldn't end with internal engagement. Patient inclusion is equally vital. They are the ultimate beneficiaries, and their insights are gold. By actively involving patients, we bridge the gap between care providers and care recipients. A deeper patient connection requires more than just surveys; it demands empathy. Immersing ourselves in their experiences helps us grasp their perspectives. What's a day in their shoes like? What hurdles do they face? Addressing these aspects tailors our approach to their real needs.

For continuous improvement, such initiatives need to be co-designed and done in partnership with staff, patients, and family members. Including an appropriate mix of staff members (supervisory and non-supervisory) on teams is essential to engage them in the activities. Also, it is very important to ensure equity when choosing patients to participate in those groups (through the inclusion of vulnerable populations and marginalized groups).

Involve all levels of staff, from frontline healthcare providers to administrative personnel, in the improvement process. Seek input from patients and their families to understand their needs and perspectives. Engaged stakeholders are more likely to contribute valuable insights.

The number one lesson learned from improvement work is to first ensure that the staff fully understand the WHY behind the needed improvements (and preferably embrace them as well). Too often we are viewed as implementing the "flavor of the month" based upon our own viewpoints and opinions of what we believe the staff might perceive...have open dialogue, ask them, and then give tangible reasoning that they can relate to and/or see value in.

Having had the opportunity as an emerging healthcare professional (Staff Nurse to Director) at US Army, US Navy, Department of Veteran Affairs as well as HCA facilities I understand the intricacies of healthcare an it is my opinion that yes a well defined Mission and Vision is paramount but aligning an organization with staff that have a passion for healthcare and ensuring your organization has user friendly technology, adequate staffing, visible/caring management and supplies that are needed will surely result in excellent patient care

Adopt proven methodologies such as Lean, Six Sigma, or the Plan-Do-Study-Act (PDSA) cycle. These methods help identify inefficiencies, reduce waste, and streamline processes. Provide training to staff on these methods and encourage them to apply the tools to their work.

And continue to use these tools to ensure sustainability or the new improvement will most likely be circumvented by resorting back to the more comfortable processes used prior.

In my experience, sticking to the methods and tools that improve outcomes will be sufficient. The best laid plans are as successful if they are executed in timely and efficient manner. One should consider AI automation in reporting out and pushing data to teams to keep close monitoring on trends and measuring impact delivered by changes/action plans.

I completely agree with the importance of implementing improvement methods and tools. While these approaches are incredibly valuable, it's equally critical to ensure that everyone involved understands and embraces them. When utilizing these tools, it's essential to maintain a culture of reflection and a continuous search for opportunities of improvement to perform better.

Stay informed about the latest advancements in healthcare practices by attending conferences, workshops, and seminars. Benchmark your organization against others in the industry to identify areas that need improvement and gain insights into successful strategies.

With a systemic focus on measurement, transparency, staff engagement, and technology, continual improvement becomes an organizational habit. To catch the 'habit,' I would start with a few strategies; *Foster a culture of quality by making it safe to report errors and emphasize learning over blame. Celebrate small improvements from frontline staff. *Establish clear metrics and benchmarks to quantitatively track clinical, ops, and financial progress over time. *Create interdisciplinary improvement teams, including varied stakeholders to design holistic solutions. *Partner through the healthcare organization and with patients and families through data analytics, surveys, advisory councils, and co-design sessions to infuse the patient voice.

I think that establishing a continually improvement mindset starts with implementation of the concept of "learning organization". Building in that concept in the organizational body provokes all staff levels to be in a continuous state of looking forward to excellence in day to day operational as well as the strategic activities followed by going down into proper educational and training needs assessment to prepare for implementation of a well-organized robust education and training plans.

In the pursuit of refining healthcare workflows, an open-minded approach is crucial. Begin by introducing solutions that truly aid day-to-day tasks, avoiding unnecessary additions. Training establishes a strong foundation and set up SOPs. Then, transition to coaching and mentoring, incorporating feedback for agile pivots when required.

Ensuring that value-added recognition programs are implemented and support the dedication exhibited throughout the org. Implementing the Daisy Award when there had been no formal recognition program was the most appreciated step we took to help validate the hard work.

Training equips staff with a deep understanding of the organization and how it contributes to its success. What makes this approach particularly valuable is that it's a two-way street. The organization invests in its employees, showing they are valued and essential. This investment doesn't stop with staff. It extends to management as well, as they actively engage in the learning process. Feedback plays a crucial role in this exchange, acting as the spark that ignites continuous improvement. In the end, culture matters. An environment that not only fosters learning but also embraces mistakes as opportunities to learn.

I agree on sharing the success stories in different forums helps teams learn from each other as well as providing motivation to bring necessary change. Most importantly, sharing those practices helps develop toolkits/repositories which can be applied to different setting easily and avoids unnecessary reinventing the wheel for similar set of problems.

Recognize and celebrate the achievements resulting from your improvement initiatives. Share success stories and lessons learned across the organization to inspire others and promote a culture of learning from both successes and setbacks.

Make improvement part of culture. Reward anyone who attempts improvement, even if the initiative fails. Only then a culture for continuous improvement can be created.

Everything above can be summarized in one word and that is Culture. And culture in health care cannot be anything but centered on people. It's all about putting people first. Never losing sight of our own humanity for the sake of patients, those who provide care, and every stakeholder in between. There can never be true meaningful continuous improvement, without that passion and love for people.

One thing this article doesn't mention is the importance of having solid KPIs or an understanding of the organization's strategic initiatives. Everything stems from that (or should). I think this is still a surprisingly overlooked tool to use as the North Star, still, in healthcare.

In the 1980s, I reasoned that mental and mind-body healthcare methods and models would continually evolve and that computerized health information decision-support tools would increase in use and have to transition accordingly. So, we built software tools that utilized very flexible information systems and collaborative frameworks that continuously adapt to technological and clinical changes.

An organisation's journey of continuous quality improvement stems from its leadership's commitment. Leading by example makes all the difference.