|
In total quality management efforts, teams play a central
role. Each team could focus on an objective, task, charge, project,
mission, purpose, crisis, or problem as a total quality management
tool. All quality activities are aimed at trying to meet the needs
of patients in the form of patient satisfaction. They can be in the
form of quality cost, or service.
Some examples in quality management efforts might include:
medication errors, outpatient departmental wait times, back safety
and patient transport issues. It becomes the role of the
organization to create an environment in which mistakes are used as
learning tools, and not punishment. Coordinating the efforts of a
variety of teams will become the challenge of the manager.
An example of total quality management specific to an
operating room could be the operating room team identifying problems
that affect either real or perceived outcomes to their patients.
These problems could include; turnover time, delays, scheduling
problems, housekeeping, room cleanliness and procedure start time.
None of these problems are the sole responsibility of one person;
therefore, it takes a collaborative effort by everyone on the team
to solve the problem.
None of the problems
listed above have quick fixes, yet they present an opportunity for
improving current and future situations. It will become important
for the teams to investigate and research the relevant issues as
they search for solutions and improve the delivery of patient care.
Frustration, lack of knowledge and even anger may impede
progress. For example if the operating room experiences an average
turnover time of one hour and everyone wants the time to be no
longer than 30 minutes, changes must take place. If implementation
of changes decreases the turnover time to 45 minutes, the team
members should celebrate the improvement and work toward achieving
its established goal through a willingness to change.
The Joint Commission on Accreditation of Healthcare
Organizations is also focusing on how organizations identify
improvements and outcomes. The object is that changes are evident in
the form of outcomes to patients and are understood and articulated
by all in the organization.
An example could
include hospital policies and procedures as guidelines in the Joint
Commission evaluation process. If an organization’s policies and
procedures state that a process will be accomplished, then the
accrediting body will want to see how it is being done.
In addition, organizations are finding new uses for total
quality management methods, and departments that interact daily are
working together to resolve conflicts and problems to improve
processes and create alternative systems. For example, the intensive
care unit and pharmacy may desire an efficient, effective drug
delivery system.
When the two
departments work through the quality management process, the outcome
could reduce lost charges, ensure that the right drug gets to the
right location at the right time and create a user-friendly system
for the intensive care and pharmacy personnel.
Questions
and Answers to Identify Improvements and Outcomes
·
Question:
What is the first and most important thing a leader can to help a
team get off to a good start?
Answer: An effective leader orients the team by clarifying
the team’s objective, mission, defines the goals, and establishes
some work procedures.
·
Question:
What about managers who may feel afraid or threatened when
subordinates are given more responsibility?
Answer: All managers think they are very capable of making
decisions. After all, that’s part of being a manager. So, a
manager who wants to develop self-management capabilities in
subordinates must encourage them to make decisions.
·
Question:
Is “storming” an inevitable part of the team process?
Answer: Actually, many teams may not go through a storming
stage. These teams are able to focus and become productive without
strife. Storming might occur, but it doesn’t have to. However, if
the team assumes it will happen, it probably will.
·
Question:
Should a manager leave the team on its own after the initial
overview meeting?
Answer: No. Many organizations underestimate the amount of
training and support that the teams need. Teams do not just happen.
They need ongoing help and team building to get the job done.
·
Question:
Should the manager address individual performance of team members?
Answer: Team members contribute in different ways. As long as
the team is satisfied with individual contributions and the overall
performance of the team is acceptable; the manager should not assess
individual goals and performance. If the team asks for help to
resolve a problem with an individual team member, however, that help
should be provided.
·
Question:
What can be done to control rumors that seem to spread like wildfire
from team to team throughout the organization?
Answer: Rumors can be destructive, so it is important to end
them as soon as possible. When you hear a rumor, focus on the facts.
Ask the team to commit to discussing only facts. If the topic of the
rumor is very pertinent to the team (e.g., organizational downsizing
or layoffs), get the appropriate and up to date information from the
person who will know the facts. You may even want to consider
inviting that person to talk to the team.
·
Question:
What can be done when the team does not follow its own plan?
Answer: Being off plan continually can be a team performance
problem or issue. It can also stem from being a system or
organizational issue. A large percentage of team breakdowns are a
result of problems within the organization, not a lack of team
commitments.
First, look at
system and organizational issues (e.g., frequent shifting of
priorities, lack of time and personnel for projects or assignments,
failure to support the team process, etc.) that may be driving teams
to ignore plans. Then, look at team performance problems.
·
Question:
How can my team avoid problems that occur every time it’s
necessary to coordinate work with other teams?
Answer: Problems between interrelated teams can often be
avoided if the teams begin the project with an open dialogue about
needs and expectations. Holding periodic updates and problem-solving
meetings with representatives from each team may also be an option.
·
Question:
How can one team make sure that the other teams communicate and
deliver on time?
Answer: If
conflicts do arise, don’t ignore them. Get help quickly before
resentment builds or the work of the team begins to suffer.
·
Question:
How can a team help new team members fit in quickly?
Answer:
First, consider choosing a team member who is a good fit. If member
selection is within the team’s control, establish a process for
selecting members and decide what skills are needed to round out the
team. New team members can make a satisfactory entrance by carefully
orienting them to the team mission, group process and roles and
responsibilities that they need to fill.
Also, assigning a
mentor or preceptor to guide new members and answer questions is
often helpful. Sending new team members to and teamwork training and
development classes.
·
Question:
Is there a way to help teams survive downsizing?
Answer: The
reality of the current work world is that any organization may have
to resort to downsizing for survival. Unfortunately, downsizing is
emotionally wrenching for those who are laid off and for those who
survive. The damage of downsizing can hinder the team’s
effectiveness for weeks or months.
Emotional support
and open discussion can help. Team members need to understand that
layoffs are not a reflection on performance.
Team members need a chance to air their concerns and
express emotions. The work of the organization must go on, so it is
important to encourage the team members to figure out ways to fill
the gaps created by reduced staff in the downsizing effort.
|