Is Somebody Stifling Performance Improvement Where You Work?

April 14, 2010 at 5:53 pm Leave a comment

You can’t improve performance if you’re not solving problems. And you can’t solve problems you don’t know about. Performance improvement is a team sport.

You come to work every day to do a good job. From time to time you find problems that affect your work and perhaps that of your co-workers. You mention the problem to the person you report too and you hear “Don’t bring me problems – bring me solutions!”  Its good advice to try to bring a solution to this conversation. But what do you do when a solution is not readily at hand? Not even bring up the issue?

The supervisor who only wants to hear solutions, or even worse doesn’t want to hear about any problems, is encouraging an atmosphere of intimidation. In this setting I am not going to identify problems I can’t figure out how to solve. If I work in this kind of environment I just try to survive. I stop trying to make things better today than they were yesterday.  The mantra of, “Don’t bring me problems – bring me solutions,” or “Don’t bring me problems period”, is really saying, I only want to hear about problems you can solve.”

I might be able to identifying problems but finding solutions to those problems usually requires the effort of more people than just me, especially when the problems are complex. Problems and solutions don’t usually come in one neat little package. If all the supervisor wants to hear about are problems I can solve, my organization is missing out on many opportunities for improvement.

I know. When the supervisor tells me to bring solutions it sounds like he/she is giving me power. “You’re smart, you’re capable, I trust you to do it!” Right? Sounds good but it is misguided. Maybe the supervisor uses this as a mechanism to get rid of chronic complainers but says it to everybody. But I’m not a chronic complainer. Any good realized by quieting “squeaky wheels” is more than offset by the damage caused by stifling creative collective solutions. The team needs to find a way to deal with whiners that doesn’t prevent observant, well-intentioned people from pointing out problems that limit the organizations performance.

Many healthcare environments are resistant to exposing problems. In these settings there is a premium on doing things right the first time. Making a mistake may have dire consequences. Some physicians may even make it feel dangerous for me to point out problems – especially when I don’t see an immediate solution. In the kind of environment where it is not safe to talk about problems, performance lags, errors occur, and bad things can happen. The same urgency may not be present in the CME office. But failure to continuously try to improve the work we do does have consequences. The metrics may be different but bad things can still happen.

There is another way. Healthcare settings and CME offices with a relentless focus on performance improvement don’t see problems; they see challenges that, when met, allow people and the organization to grow. In these settings there is a commitment to excellence that makes it safe to bring up problems. It is actively encouraged.  If anyone sees a problem he/she is supposed to call it out before the problem can go any further. People are encouraged to spot problems and are actually recognized for doing so.

Creating a culture of improvement doesn’t limit recognition only to those who find both the problem and the solution. It rewards creative problem solving and celebrates the person who spots the problem. That person is as much a part of the solution as the people who actually formulate the fix.

Accredited healthcare organizations and CME providers are required by their accrediting bodies to engage in improvement efforts. Failure to do so results in loss of accreditation. Not a good consequence.

What kind of environment do you work in? Is it one that fosters performance improvement, one that stifles it, or one that just plain ignores the opportunities?

Every CME operation should have a systematic, repeatable, sustainable approach to performance improvement. That’s my story and I am sticking to it.


Entry filed under: CME Issues, Improvement, PI CME. Tags: , , .

Factors to Keep in Mind When Selecting a PI CME Project to Pursue Quality Improvement Examples

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