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Sharing the Work and the Wins: How to Ensure Improvement Is Everyone’s Responsibility


Health care leaders walk a tightrope every day. With responsibilities both vast and critical — staff and patient safety, employee engagement, patient satisfaction, staff retention, change management — leaders must balance the everyday needs of their teams and facilities with the industry’s intrinsic push for continuous improvement. Throw in a pandemic that has overridden the predictable flow of our days and there is no question: Leaders need support. 

As leaders help their organizations continuously navigate the COVID-19 pandemic while caring for patients’ chronic and ongoing needs, the demands on their time have only grown. In a recent Joint Commission survey of health care professionals, 2 out of 3 (66%) said they are managing increased communications with staff; 1 in 2 (50%) have grappled with plan changes due to staffing shortages.

With this much extra on their shoulders, it can be easy to decide quality improvement work must simmer on the back burner until calmer times. “I’m barely keeping my head above water just managing the teams and patients we have,” leaders may think. “We don’t have time to take on new initiatives right now.” Yet paradoxically, this same work that gets deprioritized in favor of the day-to-day needs can transform those day-to-day needs — and better equip teams to manage their workflows. 

Successful change initiatives have key elements in common. A strong, active, visible leader is vital — but so is an engaged team. In fact, leaders pushing for improvement will find their biggest momentum comes when they champion the teams around them as both active participants and drivers of this work. It’s not about delegating; it’s about empowering teams and creating a culture where improvement is everyone’s responsibility. 

Building a culture of improvement, of constantly seeking the next level of quality, starts at the top — and can be easily halted at the top. Effective leaders must know the importance of their role in this work. Sustained change only happens in cultures where every member feels ownership and accountability of the shared goals of their organization and team.

Culture is one of the most common barriers to effective change — and one we discuss at length in our Leaders Facilitating Change workshops. Leaders know all too well that culture can make or break improvement efforts. A culture where people feel safe and respected is a culture where improvement thrives. At the same time, cultures where people don’t feel comfortable sharing their observations or ideas without fear of retaliation or negativity can quickly wilt even the most robust change efforts and may contribute to high turnover and unstable team rosters. 

Fortunately, culture is a living organism, and it can be transformed with the right tools, committed leaders and empowered teams. There are practical tools to help leaders facilitate effective change — and most importantly, sustain those gains of improvement. We’re seeing support for these resources, as the Joint Commission’s recent survey found over 3 out of 4 (76%) thought change management training and tools were important. 

As leaders continue guiding their teams through this challenging moment, having a shared sense of ownership — and pride — in improvement work is key to creating a health care system where everyone is moving in the same direction. 

Dawn Allbee is Executive Director of Customer Engagement at the Joint Commission Center for Transforming Healthcare.