Why Improvement Efforts Fail (part 1)

I’ve recently read an article by Clinton O. Longenecker, PhD entitled “Why Hospital Improvement Efforts Fail: A View From the Front Line” (link). Why? That’s part of what I do; try to find better, more effective ways to make improvements stick. As my mind wandered, I began to see similarities between the reasons listed in the article and reasons why my personal improvement efforts fail. In the next few posts I’ll share my thoughts with you, and I hope that there will be some exchange of ideas and plans that can be mutually beneficial. Let’s get on with it, shall we?
The article identifed a list of “Top 10 Barriers to Successful Hospital Change as Identified by Frontline Hospital Leaders” from four midwest community hospitals. But forget about that source. Try to see these from a more personal perspective. I argue that they’ll still apply.

  • Key Factor 1: Poor Implementation Planning and Overly Aggressive Timelines.
    This one is a gimme. Here’s an example: I’ve signed up to run a half marathon this summer, and even though I haven’t run more than 10k at a time in 3 years, I should be FINE for the half. I’ll just run a few more times a week, no big deal.
    Wrong. This is a SET UP for failure. Although there is a goal (half mary), the improvement has no real starting point and has no solid PLAN to get there. In order to be successful with your (my) improvement efforts, you (I) need to PLAN AHEAD and set REALISTIC timelines.
  • Key Factor 2: Filing to Create Buy-in for/Ownership of the Initiative.
    The article says, “A strong sense emerged from the discussions that hospital frontline personnel were frequently not included in important discussions surrounding how change initiatives might be rolled out to the organization” (emphasis added). In Wellness, this is akin to going to the doctor/chiropractor/personal trainer/INTERNET and just doing what they tell you to do, no questions asked. Doctor says you need to lose 15 pounds so stop eating pasta. Personal Trainer sees that you ‘need’ to lose 15 pounds, tells you to start doing HIIT or (choke) crossfit (ermagerd, crossferrrrt!) exercises 3x/week. You see workouts being done online and just start doing them willy-nilly, increasing frequency and intensity beause they SAY SO.
    If any of these Improvement Efforts are to be a success, YOU, yes YOU need to be ACTIVELY INVOLVED in your weight loss, fitness, yoga, running, cycling, swimming plans.
  • Key Factor 3: Ineffective Leadership and Lack of Trust in Upper Management
    This one is a doozy. How many times, in your own job (even if you are self employed!) thought, “management has NO IDEA what is going on down here in the trenches!” ? Dr. Longenecker, PhD., found “ineffective leadership was a primary cause of an inadequate effort involving change in performance improvement.” Seems simple enough, right? Then why do we keep hanging on every.single.word that some of these self proclaimed experts say? (Paging Dr. Oz, white courtesy telephone, please) Dr. Oz Do your research before you jump on some fitness/wellness bandwagon to learn if the people pushing thier aganda really know what they are talking about, and whether or not it applies to YOU.

Stop by later in the week to read my take on Key Factors 4-7, and then again for 8-10. Good times…

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