Sourcebook : 2.1 How to make improvement happen

The following table highlights the key reasons for including different staff from all levels of the organization, and the skills and resources they can bring to improvement projects. Assisted living facilities, which may not have on staff all of the people needed to create change might look to communities for links to pain clinics, hospice programs, or care managers.

System Leadership — Vice President for Patient Services, Director of Palliative Medicine Enough clout to institute change Authority to allocate the necessary time and resources Power in all areas affected by the change

Technical Expertise — Physician Champion In hospitals, teams that do well usually include at least one physician champion. He or she should have a good working relationship with colleagues and with the day-to-day leader(s) and should be interested in driving change in the system. Look for physicians who are opinion leaders in the organization – those to whom others go for advice, and those who are not afraid to try new approaches. Knows the subject intimately Understands the care process Has expertise in improvement methods to help the team determine what to measure, assist in the design of simple, effective measurement tools, and provide guidance on the collection, interpretation, and display of data.

Day-to-Day Leadership — Nurse Manager, Pharmacist, Clinical Social Worker A physician may be the team leader, but usually is not. Having a physician to explain to other physicians the work and goals of the improvement efforts can generate wider support and acceptance for the project. Drives the project Assures that tests are implemented and data are collected Understands the details of the system and the effects of making change(s) to it. Works effectively with the physician champion(s) and the system leader(s).

This text is derived from the book Improving Care for the End of Life : A Sourcebook for Health Care Managers and Clinicians.