“We must become the change we want to see.”
Mahatma Gandhi
In a time when healthcare organizations must function as efficiently and securely as possible, the strength of leaders and the effectiveness of systems become paramount to the organization’s success. How close are you to achieving your objectives?
With very few exceptions, our mission and vision statements talk about providing quality of care and sustaining quality of life, dignity, independence, and a host of other desirable objectives that most of us would agree belong in such statements. Unfortunately, when asked what the facility’s mission and vision are, few staff, at any level, is able to say. In fact, most look to the information cards attached to their nametags for the answer. While it’s a good idea to use these resource cards, it would be better if we all internalized what our intentions really are.
So, we return to the original question of “could you live here?” If it is our intent to create an environment that’s livable for residents and patients, we should be able to see ourselves in the environment.
What keeps us from becoming the kind of environment we envision? It has been my observation that there are five primary ways in which facilities are challenged: 1) many administrators and financial officers have never been caregivers, 2) many managers have never had any management training, 3) general education and training are not given the priority they should be given, 4) communication and accountability are poor, and 5) we often don’t respect everyone we work with, and we show it.
This last challenge is, perhaps, the most significant. When talking with workers, I am told that management does not respect them. Examples include not speaking to them when passing in the hallway or coming on to the unit, not including them in discussion on how to make job assignments more practical or efficient, not ensuring that there is a fair and impartial method for resolving grievances, and not helping. Call bells - why is it often only the nursing assistant’s responsibility to respond to call bells?
When you look deeper, however, you find that managers often don’t understand each other or demonstrate respect for each other’s opinions or circumstances. Likewise, peers in the labor force often demonstrate disrespectful behavior toward one another.
Personality conflicts, jealousy, and office politics complicate the respect and communication issues across a broad spectrum. For simplification purposes, one might make the analogy of parents who fight or use profanity in front of their children. If this dysfunction is the example, the whole family will soon be dysfunctional.
Every organization needs to begin their path to lasting change by taking a hard look at how we interact with each other. While confronting interpersonal issues can be difficult, confrontation and healing are the only proven methods to resolution and growth.
Changing the nature of relationships is the best foundation for changing the way the organization achieves its goals. When everyone feels valued and respected, the atmosphere changes. If we can achieve respect and equality among the workforce, we will be more likely to demonstrate respect and inclusion toward residents, patients, and their families.
More than creating a mission and vision statement, facilities must develop standards of behavior that every one is expected to abide by. For example, every department head should meet with his/her staff weekly to identify and address issues that arise in the day-to-day working environment. In doing so, the opportunity for creative problem-solving and collaboration is provided. When staff feels included, morale and pride begin to increase, and communication and accountability improve naturally.
In similar fashion, administrators should meet with managers more frequently to minimize the potential for political or personality issues to fester. Too often, department heads are left to resolve conflict on their own. If we are equal in clout, it is doubtful that we will be able to resolve conflicts without a third party. It is also common for administrators to be in a position to resolve issues related to clinical practice or resource allocation.
If the administrator is not a clinician, his/her ability to resolve the conflict will rely on fair and equal education from the opposing sides. If the relationship between the administrator and one of the parties is stronger, there is a good chance the decision making process will be unfairly influenced. Regular dialogue, equal education, and collaborative problem solving will facilitate the organization’s ability to thrive.
Lastly, education and training need to be a primary focus for all staff, management and labor alike. Education and training is the most effective and efficient way to achieve lasting change. So many times, an understanding of why we are asked to do something in a particular way is lacking. Little digestion can be accomplished in a 15-20 minute inservice. How we educate and whom we include will have all to do with reaching our objectives.
Education should not only focus on the delivery of care and services, but on building relationships and enhancing teamwork. What motivates people to shine for four or five days of inspection? Wouldn’t it be wonderful to have that type of organization, teamwork and camaraderie all the time?
Every organization can improve its environment by looking first at leadership:
- Evaluate communication methods and delivery systems for accountability.
- Create an open dialogue between administrators, managers, and labor.
- Enhance education and training methods, and ensure equal access.
- Develop standards of behavior for all to abide by.
- Eliminate what doesn’t work.
In our next discussion, we will look at making education and training a primary focus in your organization. Knowledge is power. The more powerful your workforce is, the more successful your organization will be. Watch this site for Part 4: “Education and Training: The Foundation for Success.”
Barbara Speedling ©2006
|
