Coloring Between the Lines

Children love coloring. Half the joy comes because when you are a child you can scribble how ever you like. Purple tigers and a green sky are beautiful and it doesn't matter if you make it between the lines.

Then people tell you that tigers aren't purple. You ask yourself why and no one can really give you a good answer. Your creativity starts to wither and die and you begin to perform based on what people tell you is correct.

The health care industry has for so long been doing everything between the lines and never asking why it must be that way.

Word of Mouth

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Revamping Your Hospital's Mission Statement

Who am I? Why am I here?

Oh the questions of human existence. They should also be the questions of your hospital's existence. Mission statements can be for the organization as a whole, but also for each part of the organization that feeds into the larger mission. Whether your mission is for the organization or for the med/surg first floor, your mission should have the same characteristics:

1. Missions should be broad in scope but specific in action - You don't want your mission statement to put your organization in a box. "We will treat elderly women who have breast cancer." That may be a great mission for a department, but it doesn't allow innovation and creativity in the services your organization offers.

2. Mission statements aren't meant to change with the newest fad - Mission statements are meant to last the test of time. Your mission statement in the 90's may have been to develop an organization to meet the needs of managed care. However, we have seen managed care decline dramatically, and that would not be an appropriate mission for today.

3. Your mission statement should specifically identify the market that you serve - This is the who, what, when, and where of your statement. Some hospitals may serve a town, some may serve at state, and some may serve a special group (think the VA).

4. Your mission statement should convey the special qualities of your organization - This is about how your differentiate yourself in the marketplace. It helps you to distinguish your hospital from the one in the town 10 miles away. As we talked about in earlier posts, service quality can be a great way to differentiate yourself from your competitor.

Customer Focus

I don't think I have ever heard the work "customer" uttered at a hospital, in my classes at the Bloomberg School of Public Health, or in any publication. Many of the problems that health care industry finds itself in can be attributed to a lack of consumer focus.

A hospital administrator must start reading publications that help them to have a customer focus. Some of the good ones include:

The Church of the Customer Blog
Seth Godin's Blog

The customer focus world is coming. Medicare has begun to get involved and it's only a matter of time before someone finds a way of disseminating this information to the public.

Examples of Quality Through Strategy

There are three great examples of hospitals and clinics that have differentiated themselves on the quality of their services.

The Johns Hopkins Hospital
The Cleveland Clinic
The Mayo Clinic

If you read the mission statements of each of these hospitals, the common theme of all of them is patient care comes first. By focusing on the quality of the patient experience, these hospitals will never have to worry about having patients in their hospital. Patients will seek them out and the bottom line of the institution will be better for it.

Strategy to Quality

The next installment of this series will address the strategic aspects of achieving quality. Strategy can be defined as the path an organization takes from how they are today to how they would like to be in the future. Some call that future the vision of the organization. In this case the vision of the future has to be to run a hospital that cures everyone of their sickness and never makes a mistake. Sounds easy enough...

As an organization we can conceptually see where we want to be. We want to be free of errors that can be prevented. But before we can attempt to devise a strategy to get there we must do two things. We must do an analysis of the external environment that may be contributing to quality problems, but we must also to an internal environment analysis to see where we currently are.

You may have heard the phrase, "what you can measure, you can manage." Focusing internally on the organization would be the first step I would take. Start to find ways to improve the detection and reporting errors. Begin to establish a culture that sees errors as a way to improve and not a fear of reprimand. When you begin to understand the situation you are in, then we can begin to devise a strategy to remedy it.

Quality and Leadership

As we explore the concept of quality at your hospitals we will further dissect the role of leadership in improving quality.

In order to instill quality at our hospitals there are four ways of thinking that we must change to.

1. Quality is not a mistake, it can be measured and it can be managed - In medicine, many people say that outcomes are too unpredictable and therefore there is no way that one can manage and improve it. This is not a mentality of quality leadership. While there may not be a way of measuring something presently, a quality organization will find a to start measuring something and continually tweak it until it is a good measurement.

2. We ultimately serve our patients - Hospitals get very confused as to who their customers are as a business. Are the customers the physicians, the patients, or the community? The patients are the reason for a hospital to be. Improve the quality by focusing on the patient experience and the physicians and community will fall in line.

3. Go long - In order to improve quality in your organization, you have to take a long term approach. If quality is thought in a short term, it will not be accepted by your stakeholders. Changes in quality are expensive and inconvient. Thinking long term puts this in perspective.

4. Tap your inner creativity - Health care workers are not especially known for their creativity, but they may be the most creative and abstract thinkers in the world. Use that creativity to try solutions that you may not think will work. Give your employees the ability to try things and fail. Failure and learning from the failure is what give the world some of its greatest innovations.