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pxa july 2014

The Accountability Factor in Healthcare: Link to Patient Experience

This blog post excerpts an article by HealthStream's Brad Weeks, Director, Performance Improvement and Research, HealthStream, in a recent issue of HealthStream's PX Advisor, our magazine focused on improving the patient experience.

Geoff Colvin famously debunked several myths of exceptional performance is his 2008 book Talent is Overrated: What Really Separates World-Class Performers from Everybody Else (Colvin, 2008). The essential premise of the book is that success comes not primarily from natural talent and skill, but is instead earned through deliberate practice and hard work. Whether you choose to believe LeBron James was simply born with the innate ability to play basketball better than anyone else on the planet or that his work ethic is stronger than that of his competitors, the results cannot be argued. He is the best in the world at his craft, and the teams for which he has played have experienced tremendous success. But to what can we specifically point that differentiates his teams’ success from the rest?

What is the Secret for Success in Providing Healthcare?

The same question can be applied to any industry, but finding an answer for healthcare is particularly challenging. Despite all of the attention devoted to individual achievement in sports, a team’s success is ultimately defined by wins and losses. That is the single measure by which one is compared to the competition. In healthcare, however, success is defined quite differently depending on whom you ask. We have found that a commonly held opinion of staff is that senior leadership team’s attention is primarily on financial success. Those responsible for quality are likely to be particularly concerned with achieving outcomes and maintaining accreditation. There are numerous measures of performance in healthcare, and even the patient experience is a comprehensive collection of data points that can be confusing for our workforce to understand.

The Importance of a Culture of Accountability

Despite the challenges we face about measuring success and the uncertain complexities of the industry, what we have found after years of research and coaching is actually quite clear—the most important and foundational aspect of success in healthcare is to create and sustain a culture of accountability. There is a significant challenge associated with the concept of accountability, namely that it can perceived as punitive or unnecessarily harsh if not executed correctly. Like anything else, this is a function of the variability of your organization’s leadership. The extent to which they can consistently apply the best techniques that engage their people to perform will determine the amount of success they achieve.

How Do You Foster Healthcare Accountability?

It is no easy task to change an organization’s culture, particularly one as diverse and complex as what is often found in healthcare. However, what we have learned is that there are key actions leaders can take that will have a dramatically powerful effect on their teams’ success. Just as we can argue the issue of talent versus hard work, we can debate the issue of whether results come from a shift in organizational culture or whether the culture changes after the success comes.

This article includes four practical steps to create a culture of accountability:

  • Setting Clear and Aligned Goals
  • Goal-based Performance Evaluations
  • Transparency of Results
  • Reinforce Standards of Performance

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