Don’t throw the baby out with the bathwater in system improvement.
Across all sectors of government, especially the changes that I have seen in health, we often want to move with the latest and greatest improvements. In both Australia and New Zealand we tend to look towards the NHS for trends and ideas as to how we should redesign our healthcare and community organisations. This is often at a great cost with renaming, rebranding, reorganisation and change fatigue with staff. Changes are undertaken before we have the understanding or data in place to be able to see if this is successful or that it derives benefits to those that we are serving (patients and the community).
We are renowned for setting up lofty change projects without first knowing where we truly are at within our organisations. Often jumping to solutions before we truly interrogate what needs changing and what we are doing well. We are trained to be fixers and want to come up with solutions and waiting for data to be analysed and systems mapped goes against the grain and can be viewed as wasteful. Hence, we can rush to “throw the bath out with the bathwater” and can overlook what is positive within organisations, and not completely understand where the real issues are.
As Managers and Executives we are under continual pressure to find improvements in efficiencies, due to the increased pressure on our healthcare system, due to the multitude of the ever-increasing demands of ageing, technology and chronic disease management. But evolution is more important than revolution when we are making changes; any changes. Often the issue with revolution is that it destroys the positives, this can include, but not limited to, corporate knowledge, cultural understanding, clinical system excellence and staff buy-in to any change process.
Staff should be empowered by their leaders to run ongoing efficiency improvement projects that are driven from the ground floor. Leaders need to equip staff with the understanding of the quality cycle and how they can run micro changes and measure these to show quick improvements or where the system needs to be realigned. This gives the ownership of efficiency improvements to the clinical and administrative staff who are working with inefficiencies daily. My experience is that these are where the most meaningful and sustainable improvements in the organisation come from.
So how realistic is this within a busy organisation that is already overstretched? How much can we expect from the staff? It is imperative that unless we can empower each and every staff member through leadership support and buy-in along with appropriate training to see that service improvement is their job, that what we are going to be in a continual cycle of large new projects that are not sustainable and that continue to “throw the baby out with the bath water”.
© WCH Group 2018.