Sourcebook : 2.3 How to avoid common problems

4. Problem: Tackling everything at once

A team may be eager to tackle it all - pain management, advanced care planning, and meaningfulness and spiritual support - aiming to improve every problem in patient care at once. However, starting changes in each area simultaneously takes a tremendous amount of staff time and requires tolerance of uncertainty and disruption in many areas at once. If team members feel that they cannot pay attention to all the changes the team wants to make, then the team has taken on too much.

Solution: Focus and sequence the changes

Focus on one area first.

Choose the change that will be the "easiest." The easiest is likely to be the one with a strong champion, senior leadership support, and popular appeal. Be sure it is a real change, preferably one that will improve patient or family experience, not just education or data collection.

Let senior leaders know what you need to make progress and ask for help.

Select subsequent changes based on what the team is already accomplishing. For example, working on advanced care planning may naturally lead the team to find ways to improve bereavement support.

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