Tuesday, February 16, 2010

The Art of Making Sustainable Change in Your Hospital Part II

In the last post I discussed the steps involved in identifying problems and breaking them down into their component steps. Today I want to focus on what to do with that information and how to track your progress.

The key to sustainable change is to get as many of the players as you can involved in finding the solution but most importantly, listening to what they have to say when they have a suggestion. So once you have identified the problem area you want to address and you have broken it into components assigning teams to each one. The next step is to get these teams together on a weekly basis to report in front of each other the progress they are making. This does two things. First it gets all aspects of the problem area discussed with everyone to get input from all and facilitate a ordinated solution. Secondly, it provides a sense of friendly competition among teams which improves overall morale and builds a sense of buy in to the change process.

Once you have your teams reporting to each other you need to make sure that they have accurate information to report on. I will say it again; if you can't measure it you can't manage it. Before you start the process you must ensure that you have an accurate baseline from which to measure any improvement, such as ED Customer Service scores at the 6th Percentile. Next you need to set a realistic goal and time frame to get there. Your goal could be to be at the 75th Percentile within 6 months. Now comes the important step of providing timely accurate feedback to the team to measure their progress. Monthly reports from Press-Ganey are not sufficient. In this case you need to set up an in house Customer Service survey that can be given to as many ED patients as possible every day with daily tabulations. Believe me, teams will not want to stand up in front of their peers reporting bad information.

Putting all of these steps together over a prolonged period will indeed produce sustained results.

Mark Brodeur


  1. Monthly reports? We have quarterly reports and can get on eCompass whenever we want to run our patient satisfaction scores. If you think the only thing you can get from Press Ganey is monthly, you need to talk with whatever staff member at your hospital is responsible for patient sat and tell them you need training. I had no idea about eCompass untill I asked.

  2. Thanks for the feedback. You are right, formal Press-Ganey reports are quarterly. Our hospital used eCompass and generated our own monthly reports. I thought that was good enough and I was wrong. Also, even though you can get eCompass updates daily, they are based on patients who were in your ED possibly weeks ago. I suggest an internal daily survey to know if there was a problem or improvement yesterday.


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