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Improve outcomes with information, empower staff

Imagine a basketball game played without a scoreboard.  Only the head coach knows the score, time remaining and statistics.  Assistant coaches are responsible for rebounds, points, fouls, turnovers and other elements.  Each assistant only gets data relevant to their responsibility.

How would the game be played?  Might each assistant direct the team to focus on their personal accountable statistic?  Some of these statistical goals are likely to conflict.  Don’t foul, create turnovers.  Score points.  Rebound.  The head coach knows time remaining, who is ahead.  He just yells.  Actually, this is probably no different from a real game.

Pity the players.  They get conflicting direction from each assistant, told to hurry, slow down, change defenses or offenses by the head coach – but do not have a clue about context or game situation.  Basketball is fast paced, play does not stop, players must make decisions, take actions and move the ball.  Play to win even if in the dark and confused.

This would be a bad way to play a basketball game.  Is this the way healthcare is delivered to some extent every day?

Hospital teams know about the patient in front of them, at least the data relevant to their role or specialty.  They may not know “the score” on incoming patients, expected discharges, transfers, diagnostic procedures, therapy or medication orders until they pop up to be performed.  They might not know how their individual and collective contributions to care are performing relative to patient and staff safety, length of stay, cost of care, medication safety and a host of other metrics used to evaluate quality, performance and compensation.  These elements also help create facility reputation.

In this setting, all that can be done is the job.  Head down and determined to do the best they know how.  Hoping that, if everyone contributes their best effort, the team collectively will be okay.  However, no player can help the team play to win.  Winning is management’s job.

A basketball head coach does not take a shot and cannot make every decision for every player while the game is in progress.  The players play the game.

Hospital teams deliver care.  Teams need to see the score.  To see the statistics.  To know the playbook, how to provide care (offense), how to prevent harm (defense) and how to deliver great outcomes (score!).  They need to know that they are winning or that there are changes required to become winners.

Performance, outcome and delivery data is sensitive.  Care must be taken to present views that are clear, constructive and productive.  Information should be shared with thoughtful attention to levels of detail, breadth of content, frequency, media, and interpretation.  Everything cannot be printed and posted on a bulletin board – perhaps nothing should be.  But players need to know the score, where they are winning, where improvement is needed and what progress is being made.

Players can help coaches win games.  They are the ones playing!

Engage BrightWork Advisory, LLC to help with quality programs today.

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