By October 2014, they had reached their goals.
"You do short-term and long-term measures and you try and keep people focused on not dropping the short-term ball," Thompson says, "but knowing that we have a long-term goal because there's always going to be ups and downs."
Don't assume that thing you fixed is still fixed
It's a familiar problem that sometimes leaders tend to focus more on the latest initiatives, and that an area that was already thought to be improved—and supposedly "hardwired"—has slipped, and in the process brought the organization's overall progress back down a notch.
"We fall into this trap," says Kurt Barwis, president and CEO of 154-bed Bristol (Connecticut) Hospital. "We set our goal and whatever it takes, we're going to get it done. We put all these resources to it, and if one person leaves, you become short in that area again. We created a process that works today, but isn't going to work tomorrow, and working tomorrow is the key to sustainability."
Barwis says the solution that has worked for Bristol has been to be intentional and robust about continued reporting. Hardwiring may include, for example, asking the right questions in the clinical record so that leaders will be able to see if the process measures put in place are failing.
Celebrate the wins, and then move on quickly
Part of the problem is in the "triage" culture of healers, says Barwis.
"Healthcare culture has pretty much always been that we love a good crisis," Barwis says. "We feel good at the end of the day when we can say, ‘Oh my God, we dealt with this emergency and this crisis.' It has an appeal. It's an instant response thing, but as leaders, our responsibility is to step back and say, ‘Yeah, that feels good that we solved the problem, but how do we stop the problem from happening again and again and again?' "
Two decades of relentless performance improvement has a real human toll: It's simply wearing teams out.
Jim Molpus is an editor for HealthLeaders.