In 1998 Jeffrey Pfeffer published an article in California Management Review describing what he sees as the seven practices of a successful organization. Comparing these practices to your typical health care organization today portends a crisis (some say the crisis has arrived).\u00a0\u00a0 Here is the list (with sarcastic commentary included for comedic effect \u2013 because if we didn\u2019t laugh\u2026) :<\/p>\n
Employment security<\/strong> \u2013 apparently the data suggests that when employees fear for their jobs, they under perform \u2013 who knew?<\/p>\n Selective Hiring<\/strong> \u2013 the larger the applicant pool the better your workforce\u2026mmmm \u2013 pediatric professionals weren\u2019t in abundance as of \u2026 yesterday. Choosing employees to your organizational culture and the unique needs of your teams\u2026 is currently a luxury.<\/p>\n Self-managed teams and decentralization as basic elements of organizational design<\/strong> \u2013 uh \u2013 I\u2019m not sure Dr Pfeffer realizes this\u2026 but it\u2019s hard to empower practices and units in health care to actually manage their own performance \u2013 it takes time, training, dedicated people and robust real time data management \u2013 not to mention team meetings and engagement of front-line staff in analysis, action plan formulation, testing ideas, and managing sustained change. It\u2019s easier to just tell them what to do, even if it\u2019s wrong.<\/p>\n High compensation contingent on organizational performance<\/strong> \u2013 define performance, define high.\u00a0\u00a0 Is it ok to do high compensation no matter what? That would be great, because then we wouldn\u2019t have to change anything.<\/p>\n Extensive training<\/strong> \u2013 Doesn\u2019t everyone come into the health care workforce already trained? \u00a0Can\u2019t they train themselves?<\/p>\n Reduction of status differences<\/strong> \u2013 we might actually be improving on this one in health care, but I\u2019m not sure it\u2019s having the impact we had hoped for. \u00a0Instead of collaborating we created more silos. Professionals who do shift work can\u2019t make it to meeting where having reduced status differences allow for free exchange of perspectives and ideas. \u00a0Physician burnout has increased, because more and more tends to be dumped on them in this new order of everyone is equal and no one should do menial work, except the person who is ultimately responsible (oh, right, that difference still exists).<\/p>\n Sharing of financial and performance information throughout the organization<\/strong>– we have been tying to get better at this, but it\u2019s …well… complicated.<\/p>\n So, what is the secret sauce for changing our organizational practices? \u00a0Sarcasm aside, let me put on my sunshine hat (yes, I actually have one). Accountable care will create the forces needed to shift health care into the realm of organizational success. \u00a0Fee for brief units or services of care has created a system of volume rather than value with regulatory and tort systems that drive fear rather than rationale thinking.<\/p>\n Working in teams, driving local continuous improvement, and driving true waste out of our processes, using the data management and sharing necessary to do so, with the staff training and professional development required, which will attract people to health care where professional joy is a given, will get us to the seven practices, and will create a care system that patients and families find value in and the workforce is proud of.<\/p>\n","protected":false},"excerpt":{"rendered":" In 1998 Jeffrey Pfeffer published an article in California Management Review describing what he sees as the seven practices of a successful organization. Comparing these practices to your typical health care organization today portends a crisis (some say the crisis has arrived).\u00a0\u00a0 Here is the list (with sarcastic commentary included for comedic effect \u2013 because […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[9,7],"tags":[],"_links":{"self":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/211"}],"collection":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=211"}],"version-history":[{"count":3,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/211\/revisions"}],"predecessor-version":[{"id":214,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/211\/revisions\/214"}],"wp:attachment":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=211"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=211"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}