Support Opportunities for Further Improvement

Communication plays an important role for sustaining changes and improvements made. As discussed previously, workers may feel uncertain or unsupported when implementing continuous improvement projects. Hence, there is a need for open and transparent communication to address information gaps and misinformation that contribute to uncertainty. Workers should be receiving the relevant information to carry out the recommendations for improvements and be given the opportunity to voice their concerns.

Although transparent communication helps build openness and trust, there also needs to be a sincere intention to provide workers with the key information. Flooding workers with large amounts of information in attempt to achieve transparent communications can hinder a worker’s ability to fully understand the intent of the project (Yue et al., 2019). Accordingly, team leaders or workers should aim for participatory transparency when communicating recommendations for improvement to others. Participatory transparency refers to the effort made to involve individuals in identifying the most relevant information to meet their informational needs. This would involve making an effort to consult workers about the kind of information they hope to learn about continuous improvement projects they will be involved in. Information should be easily accessible and communicated to workers, thus giving workers a sense of ownership and control of the change. Subsequently, this increases worker motivation to implement changes.

Collaboration with Team Members

Collaboration among team members should also be fostered when communicating recommendations for improvement. Team collaboration involves multiple individuals interacting with each other towards a common goal. The role of each team member should be clearly communicated to all team members ensure each member has a sense of shared responsibility.

The following elements play a role in collaborative practice in healthcare (Morley & Cashell, 2017):

• Coordination: Team members should coordinate their goals and work towards a shared goal.
• Cooperation: Cooperation within a team involves understanding and valuing the contributions of each team member, while ensuring personal contribution to the team.
• Shared decision-making: While making decisions, team members should communicate openly with one another. This can be achieved through respecting each other’s opinions, while negotiating and asserting their personal opinions.
• Partnerships: Team members should form respectful partnerships that involve all members working equally together.

Collaborative practice was found to improve team member engagement and initiative, thus increasingly the likelihood of the team members meeting objectives. Accordingly, the elements of collaborative practice should be considered when communicating recommendations and objectives to team members.

Once changes have been implemented, ongoing documentation of work performance should be done to ensure that the changes made are indeed improving organisation processes. Monitoring the effectiveness of changes also allows workers to identify further opportunities for improvement. It is recommended that performance should be measured on a more frequent basis. For example, instead of measuring performance on a monthly basis, performance could be measured on a weekly or even daily basis. This is because monthly performance measures could mask important details of what could have led to a problem. On the other hand, frequent monitoring allows workers to quickly identify issues and engage in problem solving.

When documenting work performance, workers should take on a balanced approach that measures a variety of factors including, safety, quality, delivery, costs, and morale (Graban, 2017).

The following table summarises how performance can be measured:

Once workers have identified the appropriate metric areas to improve on, workers should document their findings and plans for improvement. A continuous improvement plan or reported can be completed to reflect this.

Continuous improvement plans generally involve the following components:

• Issues identified: Workers should record the area of concern or issues faced by the organisation that have led to the continuous improvement project.
• Planned action: Workers should clearly record the steps taken to address concerns.
• Measured outcomes: Workers should identify the appropriate outcomes to measure to monitor whether the project has indeed led to an improvement. Workers may refer to the previously identified metric areas of improvement when deciding on outcome measures.
• Date of completion: The project’s timeframe should be clearly recorded to ensure accountability.

Supporting Team Members

Work performance measures could potentially cause stress and anxiety in workers due to the fear of not being able to meet targeted goals (Tomczak et al., 2018). Performance monitoring could also lead to workers feeling an invasion of privacy and thus lower job satisfaction. To address these concerns, it is important to communicate the intent behind using performance measures. In contrast to placing blame on workers for not meeting targeted goals, the use of performance measures should stem from wanting to improve processes and develop skills in workers.

Daily huddles, which are short but structured meetings, can be used to ensure frequent monitoring is done in a way that is supportive of workers (Graban, 2017). Huddles are quick five to ten minute meetings typically done at the beginning of a shift where workers discuss work progress and raise issues faced. While smaller issues may be resolved within the huddle, larger issues may require a scheduled meeting later for more in-depth problem solving.

The following is an example of how a huddle may be structured (Graban, 2017):

1. Safety reminder of the day; review safety issues or risks
2. Immediate problems to be aware of (instruments down or people called in sick)
3. Review of yesterday’s metrics and trends
4. New employee suggestions or ideas; updates on previous ideas
5. Share any positive feedback

Records Management

Workers need to ensure proper documentation and recording of progress made through continuous improvement projects. Documenting decisions and actions taken can help enhance accountability (Touray, 2021). Proper records management can increase efficiency as workers may quickly refer records to identify how processes can be improved.

Records should be organised in a way that is easily accessed by workers who need the relevant information for continuous improvement projects. Furthermore, records should be stored securely to prevent loss of data. Electronic record management systems can assist workers with maintaining records. Electronic systems are a cost-effective method as it allows workers to store large amounts of information that can be easily retrieved in a short amount of time.

Kaizen Card

The kaizen card can be used to assist workers with documenting continuous improvement progress (Graban, 2017). In addition to reporting the steps taken to investigate problems and the subsequent recommendations made, the card aims to encourage workers to provide further detail about the reasoning and impacts of each action taken.

The kaizen card also encourages workers to record when communication has taken place and when updates have occurred. Specifically, workers should record when changes or recommendations have been communicated to relevant stakeholders and when changes have been implemented. The card should also detail the workers involved and how they have contributed to the project. Below is an example of a kaizen card:

Reporting Recommendations to Relevant Stakeholders

When improvements are made to processes and workers receive further training, organisations should communicate with and consider the perspective of the relevant stakeholders, which refers to individuals or groups that are involved in or are affected by a project. Stakeholders in healthcare organisations generally involve members of the public such as clients and caregivers of clients, as well as healthcare professionals, pharmaceuticals, and government agencies.

Stakeholder engagement should be meaningful and multidirectional (Petkovic et al., 2023). Meaningful engagement involves ensuring that the recommendations for improvement are beneficial for stakeholders. For example, training programs to improve communication skills of workers while interacting with clients should be beneficial for workers and clients.

Multi-directional engagement among stakeholders should also be encouraged. This refers to giving stakeholders an opportunity to engage with one another. This allows the various stakeholders to gain a better understanding of the concerns and needs of others and work towards changes that are mutually agreeable. Stakeholders should be given the opportunity to share their opinions about the change and contribute to decision-making. Accordingly, workers should actively seek to gather information on stakeholder experiences, perspectives, and values throughout the continuous improvement process.

With multiple stakeholders involved, there is a need to minimise conflict of interest that occurs when the interest of a particular group is favoured over another. Hence, attention should be placed on ensuring transparency in the documentation and reports. When preparing reports and documentation for stakeholders, workers should detail how all stakeholders were selected, as well as their roles and responsibilities. Furthermore, workers should document how conflicts of interests were evaluated and managed.

Given the ongoing nature of continuous improvement, worker should routinely monitor whether changes made to organisation processes have indeed led to improvements. To achieve this, workers should ensure proper documentation of actions taken and measured outcomes. Furthermore, workers should communicate to the various stakeholders through project implementation to ensure that stakeholder needs are fully met.

Graban, M. (2017). Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Third Edition. Productivity Press.

Morley, L., & Cashell, A. (2017). Collaboration in healthcare. Journal of Medical Imaging and Radiation Sciences, 48(2), 207-216. https://doi.org/10.1016/j.jmir.2017.02.071

Petkovic, J., Magwood, O., & Lytvyn, E. (2023). Key issues for stakeholder engagement in the development of health and healthcare guidelines. Res Involv Engagem, 9(27). https://doi.org/10.1186/s40900-023-00433-6

Stefirta, A. (2023). [Image of cartoon workers fitting puzzle pieces together]. Teamly. https://www.teamly.com/blog/lack-of-collaboration-in-the-workplace/

Tomczak, D. L., Lanzo, L. A., & Aguinis, H. (2018). Evidence-based recommendations for employee performance monitoring. Business Horizons, 61(2), 251-259. https://doi.org/10.1016/j.bushor.2017.11.006

Touray, R. (2021). A review of records management in organisations. Open Access Library Journal, 8(12). https://doi.org/10.4236/oalib.1108107

Yue, C. A., Men, L. R., & Ferguson, M. A. (2019). Bridging transformational leadership, transparent communication, and employee openness to change: The mediating role of trust. Public Relations Review, 45(3). https://doi.org/10.1016/j.pubrev.2019.04.012