Case Study - Excellence Healthcare
Organization Overview
Excellence Healthcare is a pseudonym for a rural hospital located in Minnesota which provides health care services to the local area. As a privatized health care facility it is operated with funding from both the Government of Minnesota and Excellence Healthcare's parent organization. Services available within the hospital include but are not limited to:
Emergency department
Diagnostic imaging
Medical/surgical unit
Therapies department
Dietary services
Environmental services
Health information management department.
The hospital was opened in 2007 and is part of a rapidly growing community. Due to its rural location access to resources frequently found in metropolitan or urban areas is not always possible (Matson, 2019).
Identified Problems
The facility was built in 2007 and after growing economic pressures the organizations leadership made the decision to implement Studer Initiatives. This implementation was intended to build and sustain change. Previous change initiatives implemented by the organization were unsuccessful which led to discontent, frustration, and change fatigue amongst team members. The primary drivers for the organizations decision to shift to Studer Initiatives correlate directly to Studer's five pillars (Matson, 2019):
· Address financial shortcomings by improving workplace efficiency (Finance)
· Improve patient satisfaction through change initiatives (Quality)
· Enhance staff engagement within the organization (Service)
· Decrease feelings of change fatigue amongst team members (People)
· Continue to expand the capacity of the facility/organization (Growth)
Organizational Barriers
Organizational barriers can be broken down into three distinct categories. Institutional barriers are the rules and norms which govern team members behaviors within the workplace and are most common in health care settings. Strategic barriers impact the long-term outlook and objects for an organization while operational barriers are practices or processes which hinder efficiency (Bocken & Geradts, 2020).
Change fatigue (Institutional)
Change fatigue is observed in team members via feelings of burnout, stress, and/or exhaustion accompanying the frequent and continues change within the workplace/organization (Brown, Wey & Foland, 2019).
Transparency (Strategic)
Organizational credibility is frequently directly impacted by the perception of organizational transparency (Holland, Seltzer & Kochinga, 2021).
Value added work disconnect (Operational)
Experienced team members within changing organizations may feel that new organizational approaches are designed to fragment work, build a new culture and overwrite their history (Bolton & Houlihan, 2006).
Competing Priorities (Operational)
Team members within healthcare organizations are frequently presented with conflicting system priorities (Le Boutillier et al, 2014).
Proposed/Actioned Solutions via the Nine Principles
An overview of Studers Nine Principles Framework can be found here. Healthcare Excellence demonstrated an attempt to evolve and improve their organization by actioning the Studer Model as evidenced by the following:
Principle 1: Commit to excellence
The organization committed to sustained change by acknowledging that previous organizational change was unsuccessful.
Principle 2: Measure the important things
The organization routinely surveyed patients via patient satisfaction surveys and employees via employee engagement surveys.
Principle 3: Build a culture around service
The organization implemented quality improvement initiatives which simultaneously addressed efficiencies and patient satisfaction. The most applicable example was through nutritional services and the multiple units which were provided food. Instead of sending the extras back to nutritional services a process was developed to ask clients if they would like any of the excess meals to supplement what they had been provided. This approach provides the optics of a patient first approach while also emphasizing decreasing wastage.
Principle 4: Develop leaders to develop people
Recognizing that not all leaders hold formal titles the organization engaged with informal leaders, such as charge nurses or supervisors, to enhance their understanding of the external health care environment. This work was highlighted as important due to the acknowledgment of how complex and rapidly-evolving health care is.
Principle 5: Focus on employee engagement
In addition to the employee engagement surveys provided by the organization there was an increased emphasis on transparency. Feedback from front line staff reinforced that there was underlying change fatigue amongst team members from previous initiatives. The organization implemented a variety of communication and feedback tools, inclusive of the employee engagement survey approach, to better address staff members needs.
Principle 6: Build individual accountability
Through the Studer Initiatives the organizations leaders developed three foundational components of accountability:
Requirement for objective measurement
Clear expectations
Established priorities (Studer Group, 2023f)
Principle 7: Align behaviors with Goals and Values
By sustaining the change and 'staying the course' the organization will continue to align itself with their shared values. Any further deviation to a separate model or strategy of change would lead to a misalignment of the Studer approach.
Principle 8: Communicate at all levels
An emphasize within health care settings is ensuring that leaders are participating in rounds or huddles throughout the facility. These frontline moments support engagement, transparency and the ultimate commitment to excellence (Studer Group, 2023g).
Principle 9: Recognize and reward success
Within the huddle communication strategies an important characteristic of successful huddles is the recognition of a success or positive moment within the workplace. Leaders are encouraged to begin each huddle on a positive note via this strategy (Studer Education, 2023f).
Discussion/Key Takeaways
Organizational Structuring
Healthcare organizations are complex and rapidly evolving which highlights the need for purposeful and meaningful organizational structuring. Utilizing Studers Nine Principles leaders and organizations have an evidence based framework to follow for successful organizational culture (Studer Education, 2023a).
Self Reflection Question #1 - Does your healthcare organization share any approaches which align or overlap with the Nine Principles?
Maximizing Engagement
Communication strategies with team members is a core competency for successful organizations. When considering the Healthcare Flywheel it is clear that the Studer approach emphasizes the importance of human and social capital alongside other motivational strategies to build team engagement (Spaulding, Gamm & Griffith, 2010).
Self Reflection Question #2 - What does your healthcare organization do to communicate effectively? What communication strategy do they utilize that is ineffective?