engaging front-line staff to improve quality and safety in hospitals peter lazes, cornell...
TRANSCRIPT
Engaging Front-Line Staff to Improve Quality and Safety in Hospitals
Peter Lazes, Cornell University, ILR SchoolDonna Sullivan Havens, University of North Carolina School of
Nursing at Chapel Hill, NCPete Carlson, Cornell University, ILR School
Sloan Industry Studies Conference
Terms
• Front-line staff
• Levels of involvement
Assumptions
• Involving front-line staff can be
important in improving quality and efficiencies
• Involving front-line staff may play an important role in sustaining and spreading improvements
Research Questions• To what extent are hospitals involving
front-line staff in improvement activities?
• How are they involved in these activities?
• What kind of results are they getting?
Research Design
• Phase I: Screening hospitals using phone interview to identify promising sites for case studies
• Phase II: In-depth case studies
Site Selection Criteria
• Baldridge Awards• Labor-Management Partnerships• Lean and 6 Sigma• Magnet Hospitals• Pursuing Perfection• Transforming Care at the Bedside
Research Process
• Careful selection of sites • Phone interviews with the person
most familiar with their quality improvement activities
• 41 hospitals met criteria• 31 sites participated• 27 interviews completed
Current findings
1. Disconnect between the story we got from the person we interviewed and what we knew about the particular hospital.
Current Findings (continued)
2. There was a disconnect between how the respondent rated the hospital for the level of front-line staff involvement and how we would have rated them based on what they had told us
Current Findings (continued)
3. The improvement efforts described
were mainly driven by external
pressures
Current Findings (continued)
4. In several cases, unions were
actively partnering with
management
Reflections
• We are not sure whether we spoke to the most appropriate person
• There is a strong likelihood that there are significant silos between quality activities and meeting the needs of patients
Reflections (continued)
• How are hospitals going about balancing working on external measures and responding to patient care issues?
Next Phase
• Additional phone interviews to identify sites with the most extensive front-line staff involvement
• Conduct 4 to 6 case studies