Engraining Sustainable Process Changes into Culture

Anyone in the health care industry knows–regulations are always in a state of flux. Health care professionals understand all too well how these regulatory changes impact their operations. They also realize that challenges trickle down to all department team members. This is why it’s vital to continually monitor every department. It is a conclusive way to assess areas of weakness and make the appropriate process improvements in order to remain in (or achieve) compliance while simultaneously optimizing department performance.

There are several methodologies out there to aid you in your approach to process improvements. Some well-known aids are Six Sigma, Lean Management, Lean Six Sigma, Agile Management, Kaizen, and Total Quality Management, but there are others. Many of these methodologies have similar sigma process approaches and goals, so choose the one that best fits your needs and stick with it.

Process Improvement

When starting a process improvement healthcare initiative, there is often an expectation to not only improve departmental performance as a result of that change but also to sustain those newly-established processes over time. Too often organizations attempt process improvement initiatives with initial success but stall out. Over time, the processes regress because they failed to achieve a true culture change. When this happens, departmental performance ultimately begins to erode.

Engrain to sustain! It is critical to engrain the process change into the culture of the organization. This is the best way to sustain those process changes over time. How do you do this?

Three rules to follow:

1. Evaluate the Areas that Require Improvement

The initial step in the assessment phase is to review the policies and procedures related to the process in question. This will determine the established governance. It is possible the policy and procedure are in line with the desired objective. However, in many cases, organizations may also have to revise policies and procedures to reflect more current desired objectives. In the latter case, it is important to include the updating of policies and procedures in the process improvement work plan.

The next step is to measure what your existing performance is based on metrics or key performance indicators (KPIs). These should be compared to available industry averages or best practice measures that are available within the industry. There are many sources of public information available within the industry to identify and compare against current performance.

Once you have reviewed your policies and procedures and measured existing performance, you are ready for the next step. Assess the existing processes. Lay the foundation with a combination of interviews with key stakeholders, management, and line-level employees. Observe and document the workflow and existing staffing levels of each functional area associated with the process(es) in question. When assessing a department, don’t forget these steps. Watch now.

2. Establish Goal Targets and Make Adjustments

The next phase is establishing measurable goals of performance improvement. Begin by identifying a metric or key performance indicator (KPI) related to the process(es) being evaluated. It is important to measure and monitor these established KPIs for continuous improvement and sustainable process changes.

Designate a desired performance improvement goal to strive for that is both achievable and challenging. To sustain process improvement over time, employees should feel a sense of accomplishment associated with hard work achieving the desired result. If the goal is too easily reached, then employees may not gain a sense of accomplishment. This can result in a slide back into the old habits of the previous process. Conversely, if the goal takes too long to achieve, employees may be resistant to future process improvement initiatives. It becomes difficult to maintain the motivation for change when there is little indication of success.

Begin adjusting processes to achieve the desired goals. Once management has identified the process improvement objective and goals, it is critical to identify and implement available technology or work tools to improve automation and workflow efficiency. Not every process improvement initiative will include the implementation of technology and tools. However, the health care business environment continues to experience the exponential impacts of technology. Software applications or technology-based tools provide process automation and/or improve workflow efficiency within the health care business office. It is important to plan for this step—as it can take time to vet potential technology solutions and incorporate the additional costs into the departmental budget.

After leadership has selected and defined the implementation plan of any identified technology solutions, management needs to begin the process of identifying the impact on staffing, processes, and workflow. This should be a collaborative multi-disciplinary approach using guidance from the process improvement methodology selected by your organization.

3. Continually Monitor Process Improvement

Once the changes are implemented, the last step is to continually monitor the progress of improvement based on the metrics or KPIs established in the previous stages. This step is important because it will hold staff accountable for the productivity and quality standards developed. Management should establish a regular cadence for identifying, analyzing, and improving metrics and processes. Daily monitoring of the metric reporting will help determine if implemented changes are improving performance. This way, management can identify issues and work to fix the problem by fine-tuning processes and workflow based on performance comparison to departmental goals.

Factors to keep in mind

Sustainable, organizational change cannot be produced by a single memo or executive edict, but rather must be supported by an overall culture that embraces it. Above all, lay the groundwork for change with clear communication from leadership. Share with staff why and how these changes are being made and procure the buy-in necessary to ensure they not being led by executive motivation alone. Likewise, create opportunities for further staff involvement and idea engagement. When establishing goals, be sure that team members possess the abilities to achieve them and provide the appropriate tools (see step 3), training, and support.

Additional benefits of engraining process changes

Running a health system or any healthcare organization presents its own challenges. Dealing with patients and their families brings a uniquely human side to everyday challenges. It is essential to remember why you and your staff began your careers in healthcare in the first place. Helpfully, process changes such as these provide added benefits outside of the initial stated goals. For example, improved quality improvement process steps and increased automation eliminate waste of resources, decrease human error, and create more time for staff to spend on patient care.

While your healthcare organization is so much more, it is also a business whose success can be measured on outcomes. When it comes to creating and sustaining change, thinking of your healthcare organization as business results in benefits for your patients. For instance, viewing change implementation through the business process management lens can help establish clear process mapping and illuminate needed improvement projects. Support your staff through improved processes and successful workflows using the steps above. Then, your staff can focus on care provision and improve customer (patient) experience, subsequently enhancing star ratings, healthcare’s equivalent to customer satisfaction surveys. Thus, process improvement healthcare measures can improve clinical outcomes and overall success.

Assessing the process, establishing achievable goals, making adjustments to the processes, and monitoring the progress of the performance improvement is crucial to the success of any change in order to maintain the performance over time. By taking these steps, you will engrain the new processes into the culture of an organization and create the most efficient and successful environment possible. Ultimately, your staff and your patients will reap the benefits.