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Hospitals Work on Processes, Elements of Change Management

 |  By mphillion@hcpro.com  
   March 19, 2010

Hospitals are sick and need our help. That is the message process improvement concepts like Lean and Six Sigma hope to address as they become more commonly used in healthcare.

Like any sick patient, there is a process to help make hospitals better, David Marshall, a Lean Six Sigma healthcare consultant with Magari Consulting Services, said during the recent audio conference "Healthcare and Lean Six Sigma: Implement Process Improvements and Maximize Resources."

That process is:

  • Assess

  • Diagnose

  • Treat

  • Prevent

The symptoms, like waste and blame, pile on like any human illness.

"Blame is like a virus," said Marshall. "But there are no bad people, only bad processes."

As for waste, people adjust to it and get used to it. It takes "new eyes"—another common concept in Lean and Six Sigma—to spot waste that hospitals may have become so used to living with that they no longer even notice it.

Without change management, Marshall said, lasting change can't happen.

Key elements to change management include:

  • Leadership buy-in, active participation, and long-term thinking

  • Regular communication with key stakeholders (via e-mail, reports, and meetings)

  • Employee motivation through incentives (such as recognition, promotion, and burning platform)

  • System of checks and balances (e.g., project reviews and scorecards)

  • Action plans at both the project and program levels that are updated on a regular basis

"Something as simple as an action plan can be incredibly effective—very simple and very powerful," said Marshall.

Change management can certainly be done wrong, however. Poor change management can have many variations of negative results:

  • Confusion

  • Anxiety

  • Anger

  • False starts

  • Chaos

  • Resentment

  • Burnout

A major component of making change management work is meeting management. Leaner processes involve fewer meetings, but meetings are still necessary—so do them right, said Marshall.

The following are tips for effective meeting management:

  • Communicate the agenda at the beginning of the meeting

  • Develop and enforce meeting rules

Prevent interrupting when someone else is talking, and maintain a level of respect among participants as well.

Roles are important. Know who is:

  • Leader

  • Facilitator

  • Timekeeper

  • Note taker

And know how precious time is. End every meeting five to 10 minutes early to allow people time to get to their next meeting, Marshall said.

Matt Phillion, CSHA, is senior managing editor of Briefings on The Joint Commission and senior editorial advisor for the Association for Healthcare Accreditation Professionals (AHAP).

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