Remerciez-le!

Remerciez @Admin pour avoir partagé cet document gratuitement, de la manière la plus simple, en partageant sur les réseaux sociaux.

Using Workforce Practices to Drive Quality Improvement: A Guide for Hospitals J

Using Workforce Practices to Drive Quality Improvement: A Guide for Hospitals June 2010 ACKNOWLEDGMENTS The Health Research & Educational Trust (HRET), an affiliate of the American Hospital Association (AHA), is dedicated to transforming health care through research and education. The research and publication costs for this guide were funded by the Agency for Healthcare Research and Quality (Contract No. HHSA290200600022, Task Order No. 5). HRET would like to express our sincere gratitude to the following important contributors who served as advisors to this project: Peter I. Buerhaus, PhD, RN, FAAN Professor of Nursing Vanderbilt University Myron D. Fottler, PhD Director of Programs University of Central Florida Jane Grady, PhD Assistant Vice President, Human Resources Rush University Medical Center Stephen R. Grossbart, PhD Corporate Quality Officer Catholic Healthcare Partners Stephen R. Mayfield, DrHA, MBA, MBB Senior Vice President for Quality and Performance Improvement Quality Center Director American Hospital Association Nicole Morin-Scribner, MBA, SPHR Director of Human Resources St. Mary‘s Health System Nancy Pratt, RN, MS Senior Vice President, Clinical Effectiveness Sharp HealthCare Suggested Citation McHugh M, Garman A, McAlearney A, Song P, and Harrison M, Using Workforce Practices to Drive Quality Improvement: A Guide for Hospitals. Health Research & Educational Trust, Chicago, IL. March 2010. Contact Information Megan McHugh, PhD, at HRET. Email: mmchugh@aha.org Phone: 312-422-2634 The authors of this report are responsible for its content. The authors and investigators have all provided assurances to AHA and AHRQ that they did not have any affiliations or financial involvement that created a conflict of interest with respect to any of the material or conclusions presented in this publication. Funding of the Guide by the Agency for Healthcare Research and Quality in the U.S. Department of Health and Human Services was provided to collect and disseminate employment practices that have yielded high quality outcomes. The contents of the Guide should not be interpreted as mandatory national standards of clinical practice or quality health care. Using Workforce Practices to Drive Quality Improvement: A Guide for Hospitals INTRODUCTION There is ample evidence showing that health care quality in the United States is poorer than it should be and that lapses in patient safety are common and preventable. Health care organizations have been investing significant resources to implement systems and processes to improve care quality, but must pursue these efforts strategically in order to maximize their effectiveness within an environment of growing resource constraints. A considerable amount of information suggests that workforce practices may represent an important and underutilized resource for supporting quality improvement activities in health care organizations. The availability of a stable, capable health care workforce has been shown repeatedly to be critical to the efficient and effective delivery of health services. Although researchers are still investigating links between workforce practices and care quality, the findings so far suggest that that several practices hold the potential to positively affect organizational outcomes. The purpose of this guide is to provide hospital leaders and human resources staff a basic description of four high performance work practices (HPWPs) that hold the potential to improve an organization‘s capacity to effectively attract, select, hire, develop, and retain and deploy personnel in ways that best support a high-performing health care system, and to offer approaches and recommendations for implementing HPWPs in their organizations. These HPWPs fall into four categories. HPWP Category 1: Organizational Engagement Practices Practices that ensure all employees‟ awareness, understanding, and personal stake in the organization‟s vision, including its current level of success in pursuing that vision Communicating mission, vision, and values Sharing performance information Involving employees in key decisions Tracking and rewarding performance HPWP Category 2: Staff Acquisition and Development Practices Practices that build the quality of the organization‟s workforce through attention to attracting, selecting, and developing staff Rigorous recruiting Selective hiring Extensive training Career development Using Workforce Practices to Drive Quality Improvement: A Guide for Hospitals HPWP Category 3: Frontline Empowerment Practices Practices that affect the ability and motivation of frontline staff to improve the quality of care that their teams provide Employment security Reduced status distinctions Teams/decentralized decision making HPWP Category 4: Leadership Alignment and Development Practices Practices that develop leaders and align behavior with organizational goals. Management training linked to organizational needs Succession planning Tracking and rewarding performance Facilitators These numerous HPWPs can be facilitated by the following actions, which will be expanded upon in a later section of this guide: Commit to an organizational culture that focuses on quality and safety Engage senior leadership support Involve the human resource department in strategic planning Identify opportunities for shared learning Hire human resources professionals with training and experience in HPWPs Involve employee representatives Monitor progress Using Workforce Practices to Drive Quality Improvement: A Guide for Hospitals The implementation recommendations presented below were distilled from a review of peer-reviewed and gray literature covering health care and other industries, and from findings from case studies of five health care organizations that have been recognized for their successful workforce practices (e.g., Fortune magazine‘s ―Best Companies to Work For,‖ Baldrige National Quality Award). Page 15 contains a checklist for readers to document and assess the extent to which HPWPs are used in their organizations. HPWP CATEGORY 1: ORGANIZATIONAL ENGAGEMENT PRACTICES Organizational engagement practices are designed to enhance employees‘ awareness and personal stake in the organization‘s vision and its current level of success in pursuing that vision. Four HPWPs fall under the heading of Organizational Engagement. 1. Communicating mission, vision, and values Description: Practices that communicate the organization‘s scope and purpose to employees, and clarify their role in supporting that purpose. Implementation Recommendations:  Incorporate the organization‘s mission and values into new employee orientation.  Incorporate the organization‘s values into performance reviews; have employees ―sign off‖ on the mission as part of their annual review.  Discuss mission and values at the start of all internal meetings; discuss management decisions in the context of mission and vision; present the organization‘s mission on the first slide for presentations. 2. Sharing performance information Description: Practices that communicate organizational performance and other information affecting employees‘ jobs and job performance. Implementation Recommendations:  Hold town hall meetings and other open forums to provide overviews of organizational and departmental performance.  Share performance ―report cards‖ regularly and widely.  Communicate news to employees through multiple channels (e-mail and voicemail bulletins, intranet, newsletters).  Monitor the effectiveness of communication strategies designed to reach different audiences. Using Workforce Practices to Drive Quality Improvement: A Guide for Hospitals 3. Involving employees in key decisions Description: Practices supporting employees‘ ability to influence the ―decisions that matter.‖ Implementation Recommendations:  Create employee councils or committees and empower them to influence key decisions.  Hold town hall meetings and other open forums during which staff can interact with leadership.  Develop suggestion systems.  Use a quality/process improvement model that empowers employees to implement system improvements (e.g. Baldrige National Quality Award criteria, Lean training). 4. Tracking and rewarding performance Description: Policies and practices that provide formal rewards/recognition for employees‘ success in achieving organization-supportive goals. Implementation Recommendations:  Provide recognition awards to individuals and/or teams that are tied to actions supporting the organization‘s mission and vision. Criteria for individual awards should consider employees‘ contribution to teams.  Award spot bonuses when employees go ―above and beyond‖ demonstrating organization‘s values.  Provide annual bonuses based on organizational performance using balanced scorecards. Organizational Engagement in Action Several years ago, an academic medical center in the Midwest launched a large project focused on integrating the organization‘s mission, vision, and values (MVV) into the work and culture of the organization. The project, led by the organization‘s chief operating officer, was adopted because of the belief that strong MVV can lead to greater employee engagement and better organizational outcomes. The goal of program during the first year was simply MVV awareness. All employees received an hour of training on the organization‘s MVV, and the training was incorporated into new employee and manager orientations. A survey of employees following these trainings showed that the trainings were effective in increasing awareness of the MVV. The second year of the program focused on engagement. The HR department developed several tools for managers to increase the focus on MVV within their departments and to foster an environment in which the values would flourish. Specifically, managers were instructed on how to establish goals for Using Workforce Practices to Drive Quality Improvement: A Guide for Hospitals employees that align with the organization‘s MVV and to incorporate MVV into the annual performance reviews. The goal of the third year of the project was adoption. Each month, the HR department developed events and programs that focused on a different core value of the organization. For example, ―collaboration‖ was a value selected for one month, and the HR department arranged for employees to create large greeting cards to show appreciation for the work done by different teams. The project is overseen by a Work Culture Committee that includes the CEO, CFO and vice president of HR, and two positions were added to support the project. Progress uploads/Management/ using-workforce-practices-to-drive-quality-improvement-a-guide-for-hospitals.pdf