Changing, Transforming How Hospitals Work

Is Change Enough? by Ken Bast

For those of you with extremely short attention spans or an unusually high degree of curiosity, the answer is no - change is not enough. A real transformation is necessary. You already know that, however, since you went to the end of this article to find out.

For my entire career I've been working with hospitals that have leaders who say change is required and in fact to not change is very risky. In spite of that risk very few of them have changed in any fundamental way. They've tinkered and made some incremental changes, but in real terms little is different.

Those small steps are not nearly enough. We have mountains to climb and oceans to cross and hospitals must transform themselves, they must become flexible, customer focused, efficient and resilient. Hospital leaders must get desperate enough to turn to their underutilized, secret weapon: their own employees.

Few other "industries" have the true diversity in staff, from brain surgeons, to technical people to entry-level positions that hospitals have. Yet, despite this true diversity, hospitals too seldom call upon their staff to think of and try out new approaches, to actually design work flows, to interview potential team members, to use their considerable brain power to improve the organization and make patient care safer, more efficient and more effective.

Today's (not tomorrow's) hospitals must consistently produce high quality, low cost, predictable, customer focused encounters. The idea that "we're pretty good" fails on two counts. First, "pretty good" isn't good enough and second, how do you know how good your organization really is? What are your measures? Who are you measuring against? Being better than average is not enough for today and will be laughable tomorrow!

The way to find out for sure if your hospital is good is to identify top facilities by outcomes in your key specialties and then benchmark (not just compare) your results against theirs. You must find out how they get their results, what their work processes are and how your processes differ. Explore and discover what their steps are and how they get consistent, good results. It is not anywhere close to acceptable to only look at outcomes as cost numbers without a detailed review of the process they and you take to get there.

As you might already know, you must ask an additional question after you've addressed the "are we any good?" question... that is: are we getting better? Even world-class providers continue to work on improvements. They understand how they track against past performance from 3 years and 3 months ago, etc.

In the Hospital Focus 5 approach we put five major factors into place to assure desired results:

(1) Both bottom-up, departmental changes and improvements, as well as top-down, strategically targeted changes and improvements are sought. (2) All employees, not just select teams, are involved in a structured way in the improvement process every month. (3) The process itself is guided by trained process facilitators. (4) All improvements are driven by data, by results. (5) Focus is on the customer and their needs and wants.

Of course, like every major management effort, executives must support, champion and lead the effort in order to achieve long lasting success. The effort, when spent is highly rewarding to all. Hospitals must be transformed!