Organizational Results: Demand Process Improvement

Feb 21, 2010

Kendall L. Stewart, M.D.

One of the evidence-based ways to achieve the results you want is to design and deploy a process that produces those results. But once we adapt to a certain process, we keep following it even if it no longer works—or never did. People don’t like change. It’s true that change occurs naturally, but the pace of natural change is glacial. Successful competitors rarely wait for change to occur naturally.

1. Focus relentlessly on results. The best case you can make that a process must be improved is the fact that it is not producing the desired results.

2. Identify a small group of passionate process owners. If you expect everyone in the group to leap at the opportunity to improve key organizational processes, you have lost your grip on reality. Only a small number of people care enough to make the necessary changes. Find them. Feed them. Empower them.

3. Make the case for change. If you just announce that the process has changed and everyone will just have to deal with it, a fair number of your colleagues will sabotage your recommended changes on principle. Explain yourself.

4. Force compliance. When you’ve accomplished as much as you can with effective persuasion, employ brute force to make the change stick. Audit the players’ compliance. Post their individual results publicly. Public embarrassment works. Attach unpleasant consequences to the failure to comply.

How to you achieve process improvement in your work environment?

9 Comments

6 Comments

Vicki Noel • Feb 21, 2010 @6:24 pm

Implementing a completely new process is challenging at best. We have just done this with Room Service. Change is hard and there is an inevitable learning and compliance curve both from a staff and customer end that makes process improvement frustrating. This process has also reminded me that keeping your direct and indirect customers informed is very important. In order to organize and keep track of all of the process improvements we have already made and potential next improvements, our leadership team developed a PI grid that categorizes and describes the OFIs, lists the attempted and proposed improvements, who owns the improvements, what goal we are striving for and what our current performance is, and the priority of the improvement. We plan on using this to communicate to the employees of the department as a “I heard you and here is what we have done” document as well as sharing with nursing our improvement progress. Stay tuned if this works.
Kendall L. Stewart • Feb 21, 2010 @6:34 pm

Vicki, I like your feedback process.
People are often frustrated when they feel that their suggestions are ignored.
Unfortunately, many suggestions do not make sense and this notification hurts feelings too.
But saying no is better than saying nothing at all.
Leeann Sammons • Feb 22, 2010 @10:15 am

Regular meetings allow the leaders to review key measures, create action plans, and discuss what is and isn’t working. I recently found that one of my departments wasn’t meeting the desired result for a key measure of regulatory compliance. It wasn’t clear if this was because of a bad process or because we just weren’t performing the tasks. I clarified my expectation that the tasks must be performed and THEN it could be evaluated to see if changes need to made. Holding leaders and staff accountable is crucial to improving processes.
stonej • Feb 22, 2010 @12:02 pm

Just when I think a change has been made successfully, I see a behavior or old habit in place. Bedside shift reporting is a major example. If no one is watching then it is so easy to just give report the old way. I have come to the conclusion that it is daily staff reminding and letting them see their behavior it is being observed. How long will this take for staff compliance? I don’t know, but much longer than I had anticipated. It’s not even a major or complicated process, but do staff ever resist. I am going to use staff rounding to be sure each RN has heard the expectation again.
I want my staff to understand that no matter what their job function is, change is a part of our daily enviroment and part of their job responsibility.
Kendall L. Stewart • Feb 22, 2010 @10:53 pm

Leeann, I agree that leaders must set the priorities.
Otherwise, we will all do what we want to do, what is most comfortable or nothing.
Of course, leaders face exactly the same temptations.
Surrounding oneself with challenging colleagues is the only way to avoid falling into this rut.
Kendall L. Stewart • Feb 22, 2010 @10:55 pm

Jone, thank you for making this critical point.
Leaders cannot just clarify their expectations once.
And we cannot assume that people will change easily.
Ongoing clarification, inspection and confrontation are essential strategies for producing lasting change.