Work Backward to Move Forward
By Michelle Gray-Bernhardt
“Solution-oriented”: have you heard this term? A solution-oriented approach focuses on outcomes over challenges. It works backward – it starts with an ideal situation, and then determines steps necessary to attain the ideal situation. A problem-focused approach analyzes the problem itself in detail before taking action. A solution-oriented approach dwells on solutions; no detailed analysis of the challenge is necessary other than the knowledge that things can improve.
In a traditional approach, be it budget, staffing – really, any common challenge in healthcare – managers often delve into every aspect of a problem, analyzing it from all angles. While such analysis may be prudent for some challenges, what would happen if it were simply acknowledged that improvements could be made? In this model, visualizing the ideal outcome leads the improvement process, without getting mired in details. While it sounds simple, it is a real change in mindset for many people to relegate the problem to the background and the solution to the forefront.
Ask “What would make things better?” around a specific challenge. Visualize the ideal outcome (not always an easy task), and work backward from there to identify steps to bring about the desired outcome. When you are approached to tackle quality improvements, cost savings initiatives, or the implementation of new clinical practices, what will your reaction be? Will you be tempted first to justify the status quo, thinking that new ideas or practices won’t mesh with your hospital culture or your current budget, that your staff won’t react kindly? Might the next reaction be to over-analyze the problem in an attempt to make it go away with minimal change? With this approach, it’s easy to get mired down in the details of a challenge — and the subsequent gathering of data to defend oneself from ultimately addressing that challenge. This mindset discourages innovative solutions.
Try working backward. Strip your challenge to its fundamentals: “What would improved patient satisfaction look like, feel like – what would be different?” A focus solely on improving patient satisfaction scores on an assessment tool in a low-scoring area (room cleanliness, as a random example) might miss the soul of the issue – relationships with people. An ideal outcome might be identified as happier patients, people who feel less vulnerable and more in control of their hospital visit, improving their perception of their care. This is very different than simply focusing on room cleanliness, reminding nurses and housekeeping staff to pick up debris from patient rooms and empty trashcans in a timely manner. While clean rooms are certainly one piece of the puzzle, there is a larger goal to work toward.
With budget adjustments: “What would an ideal budget look like? How much do you have to work with, and how close to the ideal can you be with what you have? Your ideal budget probably contains significantly more dollars for things like additional staff, continuing education/training/certifications, etc. What might it take to make that happen — are there any grants or other outside funding opportunities? Could you partner with local universities/schools to start an internship program? Could hospital volunteers work in a non-traditional capacity to help your unit or department? These ideas may not occur to the person solely seeking to eliminate line items from the budget. Solution-focused problem solving requires a forward-thinking mindset with the ability to visualize an ideal outcome and recognize that this ideal will be reached in steps both large and small.
Want to see what steps others have taken to improve? Check out HMC’s KnowledgeWeb (www.hmccentral.com). We have compiled over 8,000 ideas from your peers to help you move forward!
