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Are you flopping at fitting initiatives to your organization?

Written by Jen Volland, DHA, RN, MBB, CPHQ, NEA-BC, FACHE, Vice President Program Development, NRC Health


The healthcare industry is centered on data and best-practices adoption. An application for the Baldrige Award requires data to show a trend in performance; Magnet designation criteria have a performance threshold above the median/mean of national-level benchmarks; clinicians use research data in their training and to stay aware of the latest professional advancements. And organizations are constantly seeking to improve the patient experience they provide, while also accelerating toward being industry top performers themselves.

Sometimes adopting best practices is a straightforward process—for instance, with practices like hourly rounding. Nurses and support staff can easily take up conducting hourly rounds at patients’ bedsides, in order to ensure their needs are being met and their questions are being answered. But understanding an improvement or best practice that’s been adopted at a larger organization and trying to fit it within a different or smaller setting is not always so easy. So what can you do to increase your odds of success, and not simply implement a “flavor-of-the-month” flop initiative that your staff talk about derisively for months afterward?

Understand the market’s challenges and your focus.
Where does your organization fit into the larger picture of healthcare and your competitive landscape, and what are consumers seeking from you as a provider of both health and illness?

  • Are you trying to be high-tech or high-touch?
  • What services are your focus that you seek to engage the community at a deeper level and what’s their preferred method of outreach for communication?
  • Within that context, how does the initiative fit that you’re wanting to adopt?

Learn from top-performing organizations both large and small.
Contrast is more readily apparent when you’re looking at multiple sources. If you’re a smaller organization, and the initiative you’re trying to learn about is implemented by only studying what’s being done in a larger facilities, there will necessarily be omissions of important items in the transfer from one to the other. The demographics, resources, and considerations are very different when implementing an initiative at a large academic medical center, versus at a critical-access hospital: location and access, the coverage availability of providers, and what you’re asking patients to accommodate can differ vastly between these two settings. While some process items will overlap, looking at a similar organization to your own while also studying organizations that are different will provide you with a broader range of ideas and points to consider as you embark on your own adoption of the industry best-practices.

Tailor the experience to your audience.
Similar to a fine-dining restaurant, a five-star hotel, or other organizations that consistently “surprise and delight,” top healthcare performers know their niche and exceed expectations within it. To do this, they need to treat each patient/resident/family member as unique, and build connections in ways that resonate with individuals to create loyalty over time.When adopting best practices, your approach must be tailored to what your consumers want, in a manner that is convenient and provides an exceptional experience.

When downsizing an initiative, some items to consider are:

  • Brand messaging, around what you promise to patients and how you meet their expectations
  • Differentiators that make your organization stand out from the competition
  • Demographic or setting-based logistics (e.g., rural-population considerations) that need to be
    accounted for as part of whatever process is being implemented
  • Time commitments being requested, and what support needs to be built into the process (e.g., education, class size, availability)
  • Work with community providers (e.g., coordinating, educating, and doing as much locally as possible)

Once a process has been adapted for your organization, be sure to test the system before going live, so you can experience it in the same way a patient/resident/family member will. This way, you may find additional gaps that you hadn’t anticipated.

Use a framework as the roadmap for transformational change.
Any change requires a dedicated focus for success. Five frames of reference can be used by organizations wanting to successfully embark on any endeavor1:

  • Where do we want to go?
  • How ready are we to get there?
  • What do we need to get there?
  • How do we manage the journey?
  • How do we keep moving forward?

Each of these items is more deeply examined in the NRC Health Best Practice Webinar, “Tailoring Improvement Strategies to Meet Organizational Needs.”

Tailoring an industry best practice or initiative to your organization requires proper planning to be done effectively. Long gone are the days when consumers were happy with a one-size-fits-all approach. They expect more. And healthcare needs to rise to the occasion if we want to consistently deliver an exceptional experience. That can be done effectively—but it requires engaging people and thinking about processes differently than in the past.


1. Blackburn, S., Ryerson, S., Weiss, L., Wilson, S., & Wood, C. “How do I implement complex change at scale?” McKinsey & Company white paper, 2011.