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Case Study | Productivity and Process Improvement

IMPACT: The qualities required to promote engagement in change initiatives in any organization

Case Study | Productivity and Process Improvement

IMPACT: The qualities required to promote engagement in change initiatives in any organization

Philadelphia-based Main Line Health attributes its success with its Performance Excellence 2020 initiative not only to its specific efforts to foster a culture of collaboration, but also to the conceptual framework it used to design and implement the initiative. To guide the effort, the health system’s leaders adopted a conceptual approach to transformational engagement called IMPACT, which encompasses the following six interrelated capabilities or qualities that leaders should cultivate to foster effective collaboration. 

Insight. Leaders require informed insight using meaningful analytics to understand causes of identified problems. Analytics should include:

  • A focused set of measures connected to organizational priorities and relevant to physicians
  • Analytical tools to empower decision-making, enable action and create clarity by creating a validated source of truth that makes measurement of improvement consistent and verifiable

Motivation. Physician’s work should be connected to their contractual obligations and professional satisfaction while capitalizing on competitive spirit. Tapping into each physician’s motivations helps organizations understand how to effectively align incentives, where to invest resources and how to rally all stakeholders around a shared vision and goals.

Participation. Health system leaders should ensure providers are involved early and often in identifying opportunities to transform processes and develop solutions. Participation has bidirectional benefit: Medical staff are more likely to engage in and lead change, and the solutions developed with their input tend to be more practical and easier to implement.

Accountability. A culture of accountability encourages high performers, empowers leaders to act and fosters a sense of fairness that helps individuals and teams work together. Health systems should implement mechanisms for holding individuals, departments, service lines and other areas accountable by identifying and acting upon performance that falls short of expectations. These mechanisms should include a structure and processes that empower teams to act.

Collaboration. Impactful improvements require cross-department and cross-functional collaboration. To achieve transformational culture change, organizations should foster cross-disciplinary teamwork through working groups, on-on-one meetings between key stakeholders, and a dyad or triad model for leadership. A culture of shared learning promotes integrated solutions that can be embedded into workflow.

Transparency. Communicating transparently with physicians acknowledges they are part of the organization and critical to its success, thereby building the foundation of trust necessary when embarking on change initiatives. To establish an environment of transparency, leaders should share data, timelines and project progress through a structured framework and create a venue for bidirectional flow of ideas and solutions. Communications should be pertinent, prompt and succinct.

About the Authors

Andrew Norton, MD,

is chief medical officer, Main Line Health.

Lawrence L. Livornese Jr., MD,

is chair of medicine, Main Line Health.

Matt Magargal, RN,

is regional vice president, patient care services, Paoli Hospital and Riddle Hospital, Main Line Health.

Kathleen J. Goonan, MD,

is a partner, healthcare, Navigant, a Guidehouse company.

Apurv Gupta, MD,

is a director, healthcare, Navigant, a Guidehouse company.


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