4 Steps to Improve Quality and Safety
Many industries must be highly attuned to eliminating mistakes and accidents. In healthcare, construction, aerospace/defense, airlines and automobile manufacturing, mistakes and accidents can be a matter of life and death.
Presently, the healthcare industry is experiencing alarming rates of physician burnout, which research has shown contributes to accidents that affect patient outcomes. In hyper-competitive industries such as manufacturing and retail, minimizing the waste from mistakes is essential to maintaining price competitiveness.
Many “programs” over the years have focused on tasks but overlook the important role that relationships play in achieving high levels of quality and safety. Here are four steps to improve quality and safety by being intentional about achieving both task excellence and relationship excellence.
Step 1 – Begin With Humility
Begin the process with an attitude of humility. Recognize that your team always needs to improve and that team effort is required to make substantial progress.
Improving quality and safety requires a mindset that acknowledges the necessity of day-to-day continuous effort and realizes that losing focus is all that is required for mistakes and accidents to pop up like weeds.
In addition, it’s important to recognize that lone rangers can’t do this. Teams must work together to maximize quality and safety. Team members encourage one another to be diligent and help each other see blind spots that can compromise the team’s quality and safety efforts.
Step 2 – Adopt a New Mindset
To improve quality and safety, adopt this mental model: Task Excellence + Relationship Excellence = Sustainable Superior Performance.
Most managers are intentional about achieving task excellence, but they fail to be intentional in achieving relationship excellence. This failure sabotages task excellence every time.
When relationships in the workplace are not excellent, people don’t give their best efforts, they don’t align their behavior with the team’s goals, they don’t communicate or collaborate as well as they should, and they tend not to make the effort to be creative and innovate. These areas of sub-optimal performance sabotage quality and safety. When relationship excellence is present, however, everyone pulls together to make progress.
Step 3 – Track Key Metrics and Respond to Findings
Task excellence requires measuring quality and accidents, identifying gaps, seeking ideas and opinions of employees to close gaps, implementing the best ideas, and giving credit where credit is due.
Relying on intuition can result in self-deception. To measure is to be humble and realistic. Measurement is necessary to bring objectivity, although we should not idolize the resulting metrics.
When metrics are unfavorable and there is a gap from the desired number, it should trigger an investigation to understand why the gap exists and what is required to close it. Go to people on the front line closest to the activity, share the data and ask for their ideas and opinions on how to close the gap. Implement the best ideas and give credit where its due to encourage future engagement.
When complex tasks are involved, checklists are necessary. The airline industry developed a checklist and it has reduced incidents of pilot error. There is a movement to uses checklists in healthcare too. This also requires humility to acknowledge that we can easily forget mundane but essential steps.
Step 4 – Create a Connection Culture
Relationship excellence requires creating a “Connection Culture,” which research has shown reduces accidents by 20-48 percent.
Johns Hopkins Hospital developed a checklist for teams performing open heart surgery. One step on the checklist was for each person on the surgical team to introduce himself or herself, describe his or her role, and explain any potential complications to be on the lookout for. Research found that when surgical team members followed these steps, individuals with lower power and status on the team (typically non-physicians) were more likely to speak up if they saw problems, which helped the team perform better and achieve superior patient outcomes. These steps helped create relationship excellence and a Connection Culture among the surgical team members.
Hard data confirms the effect of connection on improving quality and safety. Gallup’s research of 49,929 work units, comprising 1.4 million employees within 192 organizations across 34 nations, found that top quartile units that self-reported being the most connected experienced 41% fewer quality defects and 48% fewer safety accidents versus units in the bottom quartile of connection metrics. Those are staggering differences in performance. Neuroscience helps explain why.
Teams that feel connected to each other are more likely to be protected from the corrosive effects of stress. Chronic, continuous feelings of stress shift brain activity from the frontal lobes of the brain, where rational decisions are made, to the mid-brain, where rash decisions are more likely be made. In addition, chronic stress enhances the performance of the fight or flight systems of the body (i.e. heart, lungs and big muscles like thighs) but compromises four important bodily systems – the part of the brain (i.e. the hippocampus) where short-term memory is processed, the digestive system, the immune system and the reproductive system. If we are stuck in stress response, then we don’t feel well, don’t sleep well and our energy is drained over time. Eventually exhaustion sets in, which makes mistakes and accidents more likely to occur.
The Bottom Line
In summary, organizations that desire high levels of quality and safety must be intentional about creating a culture that achieves both task excellence and relationship excellence. If they do, sustainable superior performance is achievable.
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