Dropping anchors or raising sails?
By Shelley Burns
(Part one of a two-part blog)
It’s summer and people are sailing. So one thinks of anchors and sails.
Every day, countless managers are charged with implementing “best practices” in their healthcare organizations. Yet, many best practice initiatives are doomed from the start. Managers and administrators have unrealistic expectations about the work necessary and the strategy for successfully implementing “the” best practice for their organization. A best practice initiative is not a substitute for sound management, thoughtful analysis, or well-planned implementation.
Managers become anchored in best practice limbo when they cavalierly dismiss ideas from others; when they use “cut and paste” as an implementation method; and when the best practice search itself becomes the focus of the initiative. Organizations that regularly achieve improvements through best practice initiatives cast away these anchors by gathering wide-ranging ideas, building a customized “best practice,” and emphasizing action and execution, as opposed to endless searches. These are the keys to using best practices as sails, instead of as anchors in the quest for performance improvement.
Anchor number one: my twin, only better
Hospitals are notoriously poor at borrowing ideas from other industries, or even slightly dissimilar healthcare organizations. Anchored managers only consider best practices from acceptable learning partners – and acceptable learning partners are healthcare facilities just like their own. For some managers, there are endless criteria to determine whether it’s worthwhile to even solicit a best practice. These criteria include: same size of facility, services, structure, payer mix, trauma level, average snowfall, number of stairwells, mean temperature, and age of buildings.
And, to top the list off, this exact replica must somehow be a better performer! Does this exact (and better) twin exist? No. Rather than seeking an identical facility, recognize that these differences direct organizations towards innovative improvement opportunities.
Everyone wants to learn from better performers, but how is a better performer defined? Is it based on hospital profitability? Hospital size? Staff experience? Typically, managers focus on this global “better performer” definition and further narrow their idea-gathering opportunities by requiring a learning partner to be broadly exceptional. These managers are thinking too globally, when they should be acting locally. Talking with other healthcare professionals about their best practices is easier once managers determine more specifically the practices they need to improve.
It’s a poor use of a manager’s time to search endlessly for the identical learning partner who has the ideal best practice that you expect to make all the difference. Rather, begin the process with the understanding that there are no quick fixes. Tangible improvement comes from considering many possibilities, and carefully analyzing and adapting the experiences of others to craft a best practice that meshes with your organization. By dismissing potential learning partners, managers cut themselves off from a rich source of ideas.
Shelley Burns is director of knowledge management at HMC.
