Clint Maun, CSP

As I have often said, today's healthcare setting is one of opportunity, change and sometimes confusion. With the constant concern over healthcare reform it's no wonder healthcare organizations, and specifically hospitals, appear to be "caught in the middle". This issue of changing healthcare in America ultimately comes down to attitude. Our profession's attitude can be boiled down to one of three perspectives, either healthcare reform, healthcare deform or healthcare perform.

Individuals who are looking toward healthcare reform see the world totally changing with new and better things to happen. People who look at our changing culture as healthcare deform see the way they have been practicing the business of healthcare changing, and usually believe it is not a good change. They believe it's all going downhill and we "might as well turn most of our organizations into compounds, weather the storm, get our guns ready and hold off the enemy."

The third perspective is an attitude of healthcare perform. This is the attitude which interests me most. By understanding there will be change, some good, some not so good, we can then understand the great opportunity to positively effect the end results for our customers and ourselves. This viewpoint for healthcare perform leads us to the need to be proactive rather than retroactive.

It's been my experience that too many times healthcare providers, and specifically institutional based providers, have waited for change or programs to be implemented. This has some merit when you don't have all the pieces of the puzzle, however, we have usually found ourselves scurrying in disarray to try to implement new mandates. I believe if we operate as leaders in our environment and in these changing, uncertain times, we will have opportunities like never before. If we simply try to manage the chaos, changes or hassles, we will find ourselves in a retroactive position.

To produce a health care perform attitude, we must realize there are important concepts to embrace. First it includes the ability as leaders to direct the efforts of the organization toward positive key results. We need leadership throughout the organization from the top down. The department manager and other supervisors must be facilitators, catalysts and coaches. We must move ourselves beyond the role of cop, enforcer, quality assurance inspector and so on. We need to develop the spirit of self-check, self-support and self-measurement for all co-workers.

As leaders we need to embrace the concept of Continuous Quality Improvement. By that I mean, adopting the attitude that there is always the opportunity to improve our efforts. This offers improvement opportunities in revenue enhancements, areas of cost containment and quality of programs and services. When we develop or embrace the concept of Continuous Quality Improvement we understand, as leaders, the need to set the tone for our own healthcare reform or perform.

Continuous Quality Improvement or CQI is a major organizational commitment. A Quality Leadership Council should be formed to develop a master plan for CQI implementation to include all of the training, issues, logistics, concerns and methodologies for success of the program. The master plan will be the guiding document which will move you into proactive change. Quality Action Teams will be developed to work on key issues of improvement. Empowerment will be a major, measurable vehicle to determine if you are moving into leadership versus management.

The overall organization will, through the CQI master plan, have measurable key indicators which will target success. All CQI and leadership efforts will be tied to the results. These key indicators will lead the organization based upon their ability to improve processes, systems and people toward the accomplishment of these key indicators.

I am confident that a CQI effort will create an environment of mutual understanding, commitment, empowerment and team effort toward common targets and goals. Your patients (customers) will receive the rewards and you will have your rewards, if committed to an overall team concept.

It's been my experience that developing organizational success based upon individual or fragmented accomplishment produces management oversight. One of the hassles is, the harder we try to manage all parts, it never seems to totally fulfill the whole organizational need. By looking at the effort from a new perspective, we should be able to do whatever the team needs and have all individuals participating toward that series of end results.

The stories about Continuous Quality Improvement are amazing. The successes are individualized and varied across the country, but one thing is for certain, we are in need of a changing set of goals for our organizational leaders. If we can agree that all leadership is tied to team success, then we have made a major step in understanding the difference between leaders versus managers. I believe you will agree this has true potential for defining our own healthcare reform or perform, and it holds the opportunity to move an already great organization to newer heights.

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