Doing More with Less or More with Many?

How many times have your heard “we need to do more with less”? This language of scarcity is coming from a leader’s surrender to the changes that are unfolding in healthcare.  Doing more with less is a recipe for disaster.   To me, doing more with less when it comes quality and safety in healthcare means doing more harm with less thought.

As leaders, we owe those we lead an inspiring, optimistic approach to doing things a new way when we are asked to do more.  Can we, for a moment, shift our thinking from scarcity to abundance?  Instead of fretting over another problem  that needs to be fixed by Monday, take on the “more with many” approach and engage your staff in solving the problem.

Abundant mindset

The people closest to the work need to be the ones to fix the problems.

So why don’t you let them fix it?  Feeling guilty to ask a front line clinician or leader to take on an improvement project?  Think back to how you felt when a supervisor asked you to take on additional responsibilities.  What did that mean to you?  Did you feel awesome and honored?

What’s holding you back from engaging your front lines in quality improvement? Too busy?  Afraid to give up control?  Unable to trust others to step up and meet your expectations?  Clueless on how to start unloading these rocks from your back pack?

Your staff want to be pushed to pursue excellence.  Start small.  Turn to your key, positive influencers to be your foot soldiers in solving problems and improving quality.  Your font line staff want to be part of something bigger.  They want to make a difference. You can give them this opportunity as a gift.

The next time you have a quality improvement project or problem to solve consider these tips to engage your staff and lighten your load.

1.  Ask staff for their opinions on the problem being solved.  Use email, posters in break rooms, huddles to gather ideas.  Round on key stakeholders and physicians to gather information.  Share what ideas are being carried forward.  By gaining input front line staff, you will prevent rework from poorly conceived solutions.

2.  Involve staff in small tests of change.  Ask highly engaged staff and physicians to pilot-test work flow processes.  Start small – one nurse or one doctor or one patient at a time to experiment with new process.  Gather feedback, revise and retest on a small scale.  Staff involved in small tests of change will gain so much insight into quality improvement and you will benefit from this in the future.

3.  Recognize a Champion.  Meet them where they are in terms of what they can or are willing to do.  Start small and let them bloom or give them the project to lead.  If there will be administrative time needed, sit down with the Champion and determine how much time and how they will schedule to get the work done. Depending upon the skill of the Champion, they can take care of steps 1 and 2 for you.  This is a great way to begin grooming your future leaders and create a culture of continuous learning and improvement.

It’s up to you on how many rocks you want to carry in your back pack.  Sharing the load with key front line staff has so many benefits.  You get to give front line staff the gift of being part of something bigger, build the department’s leadership and quality improvement capacity, and create your leadership legacy.

Thanks for reading my blog!

Happy thinking, creating and being!