Thursday, April 21, 2011

YOU Can Redesign Our Systems and Create Positive Change

I've talked about empowering our employees to make positive changes and why it's so important not to "check your brain at the door," but I thought it was especially appropriate to revisit this topic after a rather interesting employee lunch session I had this week. On a regular basis I hold these employee sessions where about seven or eight staff members are invited to an open discussion. These sessions are a great way for me to narrow the gap between the front office and the front lines. It's important for me to know what the people actually doing the work believe, and it's important for them to hear what I believe as well.

This past Tuesday was a particularly good session where one of our employees raised the issue of hospital acquired infections and our ability to protect the patients. The employee demonstrated how there is always room for improvement in any department, explaining that when patients come to radiology for a study, for example, they often come in on a stretcher with their belongings (often jewelry) laying on top of them. So, when it's time for the study, the technicians must remove the belongings off of the stretcher and place them on some surface in the radiology area, now potentially contaminating that surface with germs. After the study is completed, they pick the belongings up again and put them back on the patient when they leave, potentially transporting not just the patient, but more germs. This very hard working, caring employee lamented the fact that this was not a process design that would help us reduce hosptial infections. I agreed with her wholeheartedly. 

So why doesn't this employee feel empowered enough to present a solution to this potential problem to his or her manager? This employee and his or her colleagues can redesign the system for transporting patient belongings and they need to feel that they have the wherewithal to devise a solution and put it into action. 

This is the difference between an empowered workforce and one that is not quite there yet. At Toyota, for example, when the workers find a prolem, they resolve to fix it; they're not waiting for a boss to fix it or a supervisor to give them permission to solve the issue. We need to move beyond just identifying the problem to getting in action to prove it, and fix it. If it was your daughter, you wouldn't want her to get an infection. Our staff should feel empowered to make positive changes. 

So, my messagge to all or our employees is this - when you see a potential issue and have a good solution, let your supervisor know. And, my message to all of our line managers is - encourage your staff to bring these types of ideas to you so they feel empowered to enact positive changes in the workplace.

By encouraging an open exchange of ideas by the employees who are actually doing the work and witnessing any issues, we're ultimately moving our organization to a continuous quality improvement model, and this is where we need to be. This model first focuses on the person being served (the patient), then recognizes that you get to oustanding performance by designing systems, then emphasizes measurement, teamwork and finally employee empowerment.

What do you need to feel empowered to make positive change? Do you believe you have the support to bring ideas for improvement to your managers? I welcome your feedback on this very important topic.

Finally, this is a week of religious reflection and celebration and I wish our Jewish and Christian staff members a peaceful and happy Passover and Easter.


  1. In radiology, specifically CT, we try to place items from isolation beds on specified areas that are covered with towels in order to help keep surfaces germ free (we wipe those surfaces down as well). Since this is not a universal practice the lack of consistency becomes an issue.
    A very cost effective, simple solution to this problem would be for all patient belongings to be placed in a patient belongings bag that remains attached to the stretcher, bed or wheelchair during the entire transportation process.
    For example an inpatient coming from the unit would have their chart as well as the emergency box which commonly accompanies them in the bag and the bag would be attached to the bed. There are a few benefits other than decreasing the spread of infection if this process was universal. We would reduce the cost of searching for or replacing misplaced patient property.
    If there is a need for the chart or emergency box there is no time wasted looking around to see if it was set on the floor or counter, every employee, regardless of what department they worked in, would know it was in the bag. The incidence of emergency boxes being left behind would decrease and less time and energy would be wasted on identifying where they came from or how to return them to the proper unit . The units would waste less time tracking their items and calling departments to locate them.
    If the exam requires removal of any personal items such as eyeglasses, hearing aids, clothing etc. Those items would also be placed in the bag attached to the patient stretcher. If we could get the word out to all units to participate with this I think we would see a much smoother more comfortable transportation process for the patient as well as a decrease in lost or missing items and ultimately less likelihood of spreading infections from department to department.
    We already have some patient belonging bags and the only adjustment would possibly be the size needed for some situations. I have researched this subject on the internet and patient bags come in all sizes from Ziploc size to large transport size. I think the expense would be minimal compared to what we spend in replacing missing items or wasted time and energy.
    Ticia C.T.

  2. I've tried to make suggestions and for years the boss has shut them down. He has his idea of how things should be and that's that. He wants someone who comes in and does what he says and doesn't think about it. He also wants you to feed his ego by telling him how great things are in the department. If you want us to have input have less management, there are too many supervisors, managers, directors, VPs who attend too many meetings.


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