Many innovators are not among senior management. In such cases, teams find it is essential to let senior administrators know about the improvement project, why it is important, and how it will enhance care for dying patients. When talking to senior leaders, most teams find it helpful to outline:
Some teams find that in early stages of their work, leadership may be unwilling to commit significant resources to the work. Once teams show progress and demonstrate the feasibility of making the change a routine practice, leaders are more willing to consider ways to support the improvements.
If senior leaders resist the idea of making breakthrough changes, team members should ask about objections and find ways to allay concerns. Some organizations, for instance, do not want to earn a reputation for being “a good place to die.” Right now, health care organizations can find it difficult to put a positive spin on such a claim. Worse, they cannot (or do not) manage the financial risks inherent in caring for patients who are extremely sick and dying. In such cases, innovators might discuss the benefits of being known as an organization that manages pain quickly and meets the needs of family caregivers. In the face of persistent objections, keep efforts small and low-profile until there is reason or opportunity to ask leaders to reconsider the project.
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.
For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].