We compiled a list of the ten key attributes of the ideal healthcare organization. The first concerned organizational mission, vision, ethics and values. The second was that “employees are treated and compensated fairly and receive great benefits.”
The third of these is as follows: “Programs, policies, roles and responsibilities are clearly understood, followed and supported.” This is a common problem area for organizations, but in healthcare it can be literally a matter of life and death.
Healthcare organizations frequently do a lot of things. For one randomly selected hospital we found a list of fifty-nine different medical services provided; it also had eighteen medical departments and fort-six training programs listed. Even that of course omits many other functions. Certainly it is “idealistic” to expect that all hospital employees can understand and promote all of so many endeavors, but the goal should indeed be that every doctor, nurse, administrator, cafeteria worker, janitor, etc. be have such knowledge.
How can organizations inculcate such learning? Obviously training programs are one solution; everyone should be regularly oriented and regularly retrained on what the organization does. An intranet is another good idea, allowing employees access to organizational information and fostering knowledge management.
But perhaps the best way to achieve understanding is to regularly survey employees on their knowledge and opinions. Offering all employees the opportunity to evaluate, give feedback on, and make suggestions about all organizational functions is a sure way to motive their interest in and awareness of these matters.
The Joint Commission mandates a policies and procedures manual; a randomly selected example lists more headings that we could count. Clearly, knowledge management is an important in healthcare, and the ideal organization must be a learning and knowledge sharing organization of the highest order.
Though policies and procedures can and should be codified in way that all employees have access to them (an intranet being the obvious means, though requiring constant vigilance regarding issues such as updating, clarity and obfuscation), obviously no one can be familiar with them all. Yet all employees should be aware of their existence and thoroughly informed about those that apply to them. Naturally, that raises the question of who has to know what, which leads to the critical question of roles and responsibilities.
It has long been understood that lack of clarity and acceptance of roles and responsibilities can be a crucial factor in healthcare. The professionalism of the various actors and the complexity of the system make conflict in this area all too common. The only effective way to resolve such issues is to have all employees motivated, engaged, and participating in ongoing discussions of what they and others do, how it is all done, and how improvements can be made.
Finally, it is important to realize the programs, policies and procedures are not documents. “Following the book” is not a way to guarantee to successful outcomes. Training and learning resources are helpful but not sufficient in themselves. Instead, the principles and details at stake have to be part of the organizational culture.
To ensure that such standards are understood, followed and supported organizations must engage and give a voice to all employees. Codification, education and discipline all have a place, but unless the leadership listens to all employees and provides them with appropriate forums for their views and ideas rules and regulations will have only “paper reality”.
Policies, program and procedures are everyone’s responsibility. If you are a CEO, you might actually want to tear up the book and start over again, giving everyone the chance to become involved and enthusiastic. If you are a manager, you can put particular issues on the agenda for unit meetings. If you are a doctor, nurse, attendant, lab worker, housekeeping, maintenance or other staff involved in maintaining a safe, secure, and clean environment. you can make it your business to learn about them, to offer suggestions to make them better, and to start discussion for that purpose. Even patients may want to study hospital information sources beyond those that they may be handed or see on the walls in the interest of advancing their care, exerting their rights, and fulfilling their responsibilities.
–Jim Murphy has a solo consulting practice called Management 3000, focusing on organizational development and change management. Being semi-retired, Jim is willing to provide very reasonably priced consulting, coaching or project work for organizations aspiring to improvement in organizational culture, effectiveness and employee engagement.
Formerly he led the Massachusetts Bay Organizational Development Learning Group, was Human Resources Director for the City of Boston Assessing Department, and served as a consultant with the Boston Management Consortium. His consulting practice includes management coaching as well as research and writing on employee relationships, leadership, healthcare and collaborative practices. Having produced newsletters for several organizations and being a frequent content writer for the”Confident Voices in Healthcare” blog, he is interested in writing and research opportunities, as we all consulting and coaching.