The Institute of Medicine’s (IOM) Six Aims for Improvement state that healthcare delivery should be Safe, Timely, Effective, Equitable, Efficient, and Patient-Centered. In addition, The American Hospital Association (AHA) has a new and permanent activity called “Hospitals in Pursuit of Excellence.” This portfolio of resources is available to help hospital leaders, clinicians, and staff accelerate the transformation of care and processes to the IOM Six Aims for Improvement (www.ahaqualitycenter.org).
As you read through the summary of the Six Aims and core principles of the AHA’s Hospitals in Pursuit of Excellence (HPOE) program, there are several themes that come through very strongly. From a leadership standpoint, the need for measurement is essential. Not only do you need to know your baselines, but you also have to know the benchmarks, establish goals -- and more importantly -- decide upon and implement the initiatives which are going to move the meter on the prioritized, leading measures.
Three of the core principles of HPOE describe the reduction of variability, removal of process variation, and the removal of inefficiency. Managing these endeavors requires organizing a portfolio of projects and initiatives. Of course, all that may actually be the “easy” part. The biggest challenge for many organizations is building the culture that supports and accelerates a pursuit of excellence. One of my favorite lines regarding culture is that “culture eats strategy for lunch every day.” Not making individual accountability a central theme of any large scale initiative only sets you up to get your lunch eaten by that cultural challenge.
So how can you go about providing a framework to build, manage, monitor and drive successful change? One way is to use Balanced Scorecards. Scorecards and tools that facilitate and promote accountability not only can help provide strong building blocks for cultural shifts, but they can also lead to organizational accountability. My colleague, Jeff Bunting, has written about this in an earlier blog:
“Ensuring that leaders and employees are accountable for business results is not primarily a technology issue. However, both the Strategy Execution methodology and related software must be designed to help nurture and facilitate personal and organizational accountability for real change to occur.” (The Glue: Blog, 08/25/09 Jeff Bunting).
Scorecard software that is effective in facilitating a higher level of accountability will include initiatives (with tasks and milestones) with assigned owners. Providing a status report on predetermined dates, and having the review of the initiatives “real time” in a business setting set the stage for communicating expectations. The questions, dialogue, and action items that come from these exchanges bring true value to the organization.
How are you organizing your efforts for the IOM Six Aims or the HPOE programs? Does your approach facilitate accountability and present an audit trail of status reports, milestones, and level of achievement? Let me know what you see as a “recommended practice” for these pursuits.