But take a look anyway, if you have an interest in process improvement in hospitals. This is a collection of my best posts on this topic.

Thursday, January 31, 2008

Organizational Wiki

This is a request for advice. As I have noted below, we are engaged in a major process improvement and staff engagement process we now call BIDMC SPIRIT. We are designing a system that will enable staff people throughout the hospital to call out problems that they see while doing their everyday work, and then have help teams focus in on those problems, do root-cause analyses, and construct sensible solutions and diffuse them throughout the organization. This process, in part, relies on experience from Toyota, but it also uses some newer work done by other organizations.

Our folks are excited and intrigued by this and are starting to get engaged. Among other things, we plan to conduct formal training in the approach for about 600 people -- roughly 10% of our staff -- to create a core group from whom the process will spread.

Because this is a really new approach to things for an academic medical center of our size, one of my goals is to make sure that people feel they can also participate in the actual design and implementation. For example, I'd like for the training and communication process to be modified from suggestions of people as it proceeds, so that we refine it and keep things clear and relevant as we implement the program.

In essence, I want to create the organizational equivalent of a wiki -- a process that is organic during its implementation as a result of multiple and transparent contributions by the participants themselves. Think about that as allowing the people in the hospital to enhance the process improvement process itself even as that process is being rolled out. Think about it further as an incredibly and intentionally democratic design approach that puts great faith in the staff to know what will be most effective in teaching themselves about the program, for the benefit of one another. Now, add on to that characterization the fact that this needs to occur in a real-time manner and in multiple languages (English, Spanish, Creole, and others) and across multiple job categories so that all people feel confident that their points of view are heard and respected in a culturally sensitive manner.

We have some ways we are employing to do this, but I would love to hear from others -- whether in the medical field or elsewhere -- who might have tried this and can provide stories or references to their work. Please don't focus solely on computer information systems: Remember that lots of our people do not regularly look at a computer.

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