Why Hospital Improvement Efforts Fail: A View From the Front Line.

In the 21st century, healthcare executives are facing changes of unprecedented magnitude in virtually every area, affecting their ability to compete. That hindrance brings with it a greater need for rapid and effective organizational change and improvement. Yet changes in the U.S. healthcare delivery system have historically been criticized as slow and less than effective in responding to the changes necessary for rapid performance improvement. To that end, the purpose of this applied research study was to help healthcare executives better understand the barriers to effective organizational change and improvement from the perspective of frontline leaders. Focus groups were conducted with 167 frontline leaders from four community hospitals to explore why hospital change efforts fail. Participants representing 11 different functional areas, including all facets of hospital operations, were asked to identify the primary causes of failure of a recent change initiative at their hospital. A content analysis of the focus group data identified 10 primary barriers to successful hospital change, some of which are ineffective implementation planning and overly aggressive timelines, failure to create project buy-in and ownership, ineffective leadership and lack of trust in upper management, unrealistic improvement plans, and communication breakdowns. Leadership lessons and recommendations based on the research findings are provided

Understanding Leadership Skills of Hospice Executives

The healthcare industry is a rapidly changing environment requiring leaders to possess a high level , of leadership skills. leaders in the hospice industry have experienced the same level of change, but over the brief span of 25 years.With the aging of hospice executives and the dynamic environment of the hospice industry, the need for strong leadership is more important than ever. This research study reports on the perceived leadership skills of hospice executives and is a replication of an earlier study (longenecker, 2006). All study participants were executives of organizations that participated in clinical and operational benchmarking activities at the national level. The study evaluated leadership skills using transformational leadership theory as the conceptual model by which leadership skills were measured. The results of the study identified that the participants perceived they displayed an ideal use of skills based on transformational leadership theory

The Ethical Balancing Act of Hospice Care

In providing hospice care, clinicians are confronted with ethical challenges on a daily basis involving their patients and families, their personal values and beliefs, and organizational practices. Being able to objectively understand these ethical challenges and having a plan of action to address is essential in effectively fulfilling the role of being a hospice professional

Evaluating Transformational Leadership Skills of Hospice Executives

Health care is a rapidly changing environment requiring a high level of leadership skills by executive level personnel. The hospice industry is experiencing the same rapid changes; however, the changes have been experienced over the brief span of 25 years. Highly skilled hospice executives are a necessity for the growth and long-term survival of hospice care. This descriptive study was conducted to evaluate the leadership skills of hospice executives. The study population consisted of hospice executives who were members of the state hospice organization in Ohio and/or licensed by the state (88 hospice providers). Three questionnaires were utilized for collecting data. These questionnaires collected data on transformational leadership skills of participants, participants’ personal demographics, and their employer’s organizational demographics. Forty-seven hospice executives responded (53%). Key findings reported were high levels of transformational leadership skills (mean, 3.39), increased use of laissez-faire skills with years of hospice experience (P = .57), and positive reward being a frequent leadership technique utilized (mean, 3.29). In addition, this was the first study of leadership skills of hospice executives and the first formal collection of personal demographic data about hospice executives

The Positive Impact of Individual Core Values

The role of values in organizations has been a highly researched topic (Collins in Good to Great, HarperCollins, New York, ; Collins and Porras in Built to Last: Successful Habits of Visionary Companies, HarperCollins, New York, ; Frederick and Weber ; Kouzes and Posner, The Leadership Challenge, 4th ed, Jossey-Bass, San Francisco, ; Pattison et al. Emerging Value in Health Care: The Challenges for Professionals, Jessica Kingsley Publishers, Philadelphia, ). However, little research has focused onvalues in health care settings. In addition, the research that has been done has focused on values from an organizational perspective, not from an individual perspective. Based on these two factors, in addition to the maturation and growth of the hospice industry and the researcher\u27s prior studies on hospice leadership and organizational practices, a research study was conducted to evaluate the core values of hospice professionals. Another key driver of the research was the expressed difference identified by leaders within the hospice industry that values of individuals new to hospice were different than those who have worked in the industry longer. A web-based survey was utilized to gather core values and demographic data from hospice professionals. Data were collected over a one-year period and involved 531 hospice professionals from 33 states. The demographic information collected was similar to comparative data from previous hospice studies. The top three core values identified in the study were family, faith, and love, and represented 76 % of all responses. No statistically significant identifiable differences, based on demographic variables, were found. Based on the findings, no support was found for the perceived differences noted by leaders working in the hospice industry. However, it identified that hospice professionals regardless of demographic characteristics appear to hold similar values as being important. Based on the findings, core values appear to be an area of commonality versus difference among hospice professionals and could serve as a focal point for building a positive organizational culture. Further research is suggested to evaluate the unique meaning of the key values identified by hospice professionals in the study. In addition, replication of the study in other health care settings would be encouraged