November 18, 2011 Leave a comment
By Tom Best
Even if you’re not a football fan, you’ve probably heard phrases like these before:
- Our team just needs to “get a win”, and we’ll turn this program around!
- Let’s prepare for “one game at a time”, and in the long-run we’ll end up on top!
Successful coaches have used such phrases to make seemingly impossible goals feasible. I’ve also found these two phrases helpful in guiding healthcare improvement efforts.
“Get a win”
While many projects require long-term effort to achieve sustained improvements, we sometimes undervalue the benefits of a short-term “win.”
I once worked with a hospital to increase the reliability of their med and lab specimen transportation system. The bulk of items were transported via pneumatic tubes. To the frustration of many, tubes were often unavailable. Hoarding tubes at each care unit only seemed to make matters worse. As a result, many had deemed this problem too difficult to fix.
To start the project, our team decided that I set aside an afternoon to walk from unit to unit, releasing any stockpile of extra tubes back into the system (with help from unit management).
As you might guess, I wasn’t too excited to build a reputation as the tube police. But, you know what? The effort served its purpose. Although the improvements to tube availability were short-lived, a primary goal of our project became crystal clear to unit management after only one afternoon’s work.
To sustain improvement, we implemented an annual education competency for all clinical staff on the proper usage of the tube system. But the initial walkabout was just the “win” we needed to get improvement started. It effectively communicated our long-term improvement goals, and demonstrated that we were going to address this problem directly.
“One game at a time”
Another project aimed to reduce the frequency of mislabeled lab specimens. While the definition of a properly-labeled specimen was practically universal, each care unit had a different set of challenges impeding proper labeling. It was next to impossible to recommend one solution for all units; previous efforts along these lines had not fixed the problems.
Our team decided that labeling procedures throughout the hospital should be addressed sequentially, group by group. We first analyzed data to identify departments with a high percentage of mislabeled specimens. We then started working with one department at a time. We used a standard framework to guide our efforts (i.e. the SEIPS Model) but the details of the approach were dependent on the situational factors, such as the initial level of leadership engagement and the current state of the unit’s labeling process. During these efforts, we shared our progress with the rest of the organization, highlighting the improvements that resulted in the areas we had visited.
There is a word of caution when applying the “one game at a time” mantra. If misinterpreted, it can produce unsustainable improvements. In our context, after moving to the next unit’s specimen labeling procedures, the team still needed to periodically circle-back with previously-visited units to ensure the problems were permanently fixed. Revisiting an area can be done efficiently if standardized data collection and reporting mechanisms are in place.
In closing, “get a win” and “one game at a time” are just two mantras that apply across multiple industries.
What other phrases guide your healthcare improvement work?