Читать книгу The Quality Improvement Challenge - Richard J. Banchs - Страница 56

The formation of a high‐functioning team dedicated to improvement tasks is difficult in healthcare. QI teams face three main challenges:

 Time. Teams in healthcare often struggle with getting off quickly to a productive start and finding the time to carry on their project activities. Patient care is always the priority for clinicians; QI activities are often seen as less important. Resource constraints related to staffing and scheduling requirements limit the availability of key stakeholders to participate regularly on QI project teams. As a result, teams are composed in an indiscriminate way with an underrepresentation of front line clinicians because they cannot be relieved from their patient care responsibilities.

 Silos. The culture of the healthcare environment also makes improvement work difficult. Healthcare silos (doing what is best for me or my department/unit/function instead of what is best for the patient, team, or organization) foster group mentality and functionality rather than team performance. Competing priorities create confusion and adherence to dysfunctional loyalties, making the task of improving difficult.

 Pushback. QI teams in healthcare often struggle with the lack of buy‐in from the front lines; under these conditions, it is difficult to have a successful handoff of their recommendations to the people who “do the work.”