Читать книгу The Quality Improvement Challenge - Richard J. Banchs - Страница 58

“Who should be sitting at the table”? Make sure your QI team has the right professionals from the front lines. It is important to include the people that “do the work” from all levels of the value stream. Improvement teams often have too many supervisors, managers, and directors, but not enough front line stakeholders who have the “know‐how” of the process that needs to be improved. Without first‐hand knowledge of the process, improvement ideas are usually inadequate, too broad, or too restrictive. These ideas are seen as out‐of‐touch with the reality of the daily work because they have been developed by a QI team lacking the technical expertise or process knowledge of the intimate details of how work is actually done. Without first‐hand knowledge of the process, improvement suggestions are usually not supported by the people who actually “do the work.” How do you feel when regulatory agencies and administrators tell you how to “improve” your clinical practice?

In general, a QI team should have a mixture of stakeholders, supervisors, and leaders with stakeholders > supervisors > leaders, in that order.

 Stakeholders are the people who do the work. They are the front line. Make sure the stakeholders who will have to implement the changes are part of the team.

 Supervisors are the people responsible for the work. They are the nurse managers, division chiefs, directors, and other responsible parties.

 Leaders are hospital or departmental level leaders who support the project. A leadership position in the organization is not by itself a good selection criterion to become a member of a QI team.

 Some teams may need additional members, such as subject‐matter experts, project facilitators, and consultants.

Selecting the people that you get along with is not the best strategy to create a high‐functioning team. Because we usually get along with like‐minded people, filling a team with the people we get along with will probably result in group thinking. To create an effective team, choose front line professionals who bring the appropriate mix of skills. Choose a good mix of “experts, “doers,” and “schmoozers.” These people have the following attributes:

 Process knowledge. Teams must have at least one person who knows the process.

 Organization. Every team needs members who have the ability to organize and get things done.

 Creativity. Creatives know how to work though problems and find solutions.

 Good interpersonal skills. Effective communicators can explain the team’s message and reach the front line professionals.