What’s the coolest sporting event you’ve ever seen? For me, it was the 4X4 relay in short track speed skating at the Winter Olympics. Maybe it’s my process-focused mind, but this is how I broke down what I was watching:

  • 16 people skating really fast in a confined space,
  • Four people racing at a time,
  • 12 people trying to keep their timing perfect so that as they enter and depart their lap of skating they don’t lose a fraction of a second,
  • Trying not to interfere with any of the other skaters,
  • And positioning themselves and their team to win.

The smallest error could result in disqualification for the entire team.

I remember thinking to myself – there’s a lot of correlation in that race to what occurs every day inside our healthcare organizations. I’ve always thought healthcare was more of a relay race than a marathon. We have handoffs between team members multiple times a day for every patient: lab results, imaging studies, physical therapy, medications, transportation, respiratory. No matter what may have gone well or poorly before, when we grab the baton for our area of expertise, we work as best and as fast as we are able until we reach the next handoff, all while trying not to get in anyone else’s way.

However, in healthcare, we tend to focus on the best execution of our part of the process. We don’t typically step back and work as a team to first understand the best overall delivery method for optimal care. And we may or may not collaborate with those with whom we share a baton.

I was working with a client recently who wanted to enhance their patient throughput. As we talked about their objectives, she made a compelling statement to me along these lines: “We don’t need to waste any time doing an assessment. We know our problems – we live through them every day! We must get to a solution quickly.”

For once, I refrained from stating my bias and agreed to meet with the team of physicians and clinicians assigned to the project.  For an hour, everyone discussed the solutions that they wanted to implement: New technology. More physical space. Additional staff. More assistance from other departments. All the usual solutions. Once all the wish lists were out on the table, we got down to the key question:

“What problem are we trying to solve?”
“Throughput.”
“What about throughput are we trying to enhance?”
“We need more of it.”
“Okay, what’s getting in our way?”
“See all the solutions.”

As so often happens in our complex healthcare organizations, this team had succumbed to what I fondly refer to as Spaghetti Solutions: throw a bunch of good ideas at the wall and some of them are bound to stick and solve something.

However, implementing sustainable change is about building community. The community must share an understanding of the problem to be solved. There must be context for change that is understood and accepted before any improvements can be introduced. Committing the time to create that context through an assessment is the best investment an organization can make if sustainable improvement is your goal. Targeted improvement initiatives created in a context of awareness can be your greatest advantage in building a high performance relay team for your organization.

This week’s blog was written by Laura Archer. Laura, Senior Vice President at Healthcare Performance Partners, is responsible for strategy and services development, as well as providing oversight of all non-Lean Six Sigma consulting engagements. Laura has extensive experience in facilitating performance improvement in health care service delivery. Her career spans twenty five years with experience in academic, for profit and faith based providers. She has extensive experience in engaging executives, medical staffs, and front line employees to drive sustainable improvements. Laura has served as a professional consultant with  Ernst & Young and Deloitte Consulting , served as an internal employed consultant for Parkland Health and Hospital System, Harris Methodist Health System (now Texas Health Resources) and a faith based academic medical center. She has led decision support services and has a strong background in utilizing data to mobilize teams in driving sustainable improvements in work processes. Laura received her undergraduate degree in accounting and organizational administration from Oklahoma State University and her M.B.A. in Healthcare Administration, from Oral Roberts University. Laura is a non-practicing Certified Public Accountant.

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