Find opportunities for improvement
Another way to get feedback on how your organization is doing is to simply ask the people who work for you. When Penrose became president and CEO of St. Jude, he rejuvenated a tradition that the organization’s previous leader began: the employee forum. Under Penrose, the forum became a quarterly meeting in which every one of St. Jude’s employees is invited to hear him speak about the hospital’s goals and ask him any questions that may be on their minds. Encouraging two-way communication can help give you a different perspective.
“This is a big organization,” he says. “We have almost 3,000 employees working for this hospital. Trying to communicate a single vision to that many people is not easy.”
Penrose usually speaks for the first 20 minutes of the one-hour session; the remaining 40 minutes is a town-hall format.
When you find opportunities for improvement, you need to have a plan in place to deal with them. At St. Jude, Penrose pulled a team of people together to identify any potential barriers to perfect performance.
The outcomes department is composed of members of St. Jude’s quality department, and it is responsible for finding and closing any gaps between St. Jude’s actual performance level and its goal of perfect care.
Whenever the organization notices a particular area that could use improvement, this team is called in to investigate. Penrose staffed it with employees who are skilled at determining the cause of a problem and developing solutions.
“If they see a failure on our part, they will do a root-cause analysis to identify the cause,” he says. “Then, they’ll try to understand if it was a one-time event or do we have exposure for this failure to occur again.”
“If it is an isolated type of cause, they may be able to put a simple fix in place. If it is more systemic, then they’ll probably pull a process improvement team together to address the cause and find a remedy and implement that remedy.”
That process improvement team needs to include several employees who are familiar with the work that needs improvement. If the system itself needs to be fixed, the first thing that needs to be done is determining what Penrose calls “standard work.”
“On the road to perfect, we have a much higher probability of reaching perfect if we are doing standard work — if we are approaching our work the same, every time, with every patient,” he says.
“We understand that every patient is unique and has unique needs, but a lot of what we do is process-oriented. The more we can standardize around those processes, the more likely we are to get it right every time.”
To determine which processes should be standardized, the team assigned to the problem researches that system’s metrics and patient outcomes. The root-cause analysis begins where the gaps in performance occur and trends are identified. The volume and frequency of failures as recorded in the metrics and as shown in the trends leads to the trouble spots upon which the organization must focus.
