3 Management practices and role of leadership in an organizational transformation. (30th November 2022)

• Record Type: Journal Article
• Authors: Kumar, Sumeet; Black, Janine
• Is Part Of: BMJ open quality. Volume 11:Supplement 3(2022)
• Page Start: A4
• Page End: A5
• Publication Date: 2022-11-30
• Subjects: Medical care -- Quality control -- Periodicals; 362.106805
• DOI: 10.1136/bmjoq-2022-IHI.3
• Languages: English
• ISSNs: 2399-6641

Abstract

Abstract : Background: Ministry of Long-Term Care put the Hogarth Riverview Manor (HRM), the largest Long Term Care (LTC) Home in Ontario, Canada with 544-beds licensed capacity, under a Mandatory Management Order (MMO) when it repeatedly failed to meet the LTC regulatory standards to deliver safe resident care. Objectives: Remove the Mandatory Management Order imposed by Ministry of Long Term Care Meet regulatory compliance to standards set by Ministry of Long Term Care Establish practices and infrastructure to ensure sustenance Create a happy work culture Methods: Conducted transparent and honest conversations with staff while articulating the need for change. Balanced Scorecard measures established at the HRM level and cascaded to all clinical units and support areas. Management practices and infrastructure co-created with staff and leadership to implement quality improvement huddles daily, generate and implement change ideas, conduct mandatory program reviews weekly, senior leadership walkabouts every two weeks, quality, safety & risk steering monthly, and review balanced scorecard quarterly. Standard work created for key processes. Provided training to over 800 staff on PDSA and created safe environment for staff to experiment. Visual management leveraged to create organizational focus. Governance and audit process established to ensure compliance. Staff recognized and celebrated daily. Results: 574 change ideas implemented. Resident-care metrics trending in the right direction. Zero compliance orders in the past year based on multiple ministry inspections. Joy in workplace. MMO lifted and today a sustainable, accountable, and a highly effective team proudly delivers resident-centered care ( figure 1 ). Conclusions: Transformation and organization culture change is possible when the elements of the journey are co-created with staff and the leadership is on-board. Transformation takes leadership and practice to change norms, improve persistence and resilience, communication and knowledge sharing, and coordination and systems thinking. Providing infrastructure is critical to create operational sustainability and to change the culture.