Sunday, February 1, 2009

The Dark Side of Hospital Staff Empowerment

Now... before someone starts crying out...

We are all for staff empowerment. In fact, it is intrinsically woven into everything we do and help our clients accomplish. So much so that three of our clients submitted the patient flow transformational initiatives we helped them implement as their Nursing Magnet Status accreditation projects and all of them received that coveted certification.

Needless to say, a well executed staff empowerment initiative is critical to true Hospital transformational change and the key to sustainable long term results.

Having said that...

A poorly executed staff empowerment program can be extremely detrimental to staff culture and can set an organization behind for several years.

The purpose of this post is to illustrate the perils of an ill-conceived empowerment program and enumerate the elements necessary to be successful in this endeavor...

Saying your staff is empowered does not make it so...

I’ve never heard a senior Hospital executive say they do not wish their operational staff be empowered or that they do not currently encourage this throughout their organization.

Why is it then that so many hospitals have staff that feel disenfranchised?

Simple...true staff empowerment requires a protean effort and support from senior management to be implemented. In fact, the main reason to empower the staff is to encourage innovation and rapid cycle changes at the grassroots operational staff levels of the organization. By definition, this involves eliminating a lot of the bureaucratic, political, conceptual, and budgetary constraints to change that traditional Hospital administrators feel comfortable within. It also involves creating all the necessary supervisory interfaces to prevent “rogue” actions by the staff without stifling them into inaction or despondence.

All this is obviously easier said than done within the highly structured and hierarchical managerial framework of most hospitals. In fact, most hospitals have clearly defined vertical reporting mechanisms and well demarcated departmental silos which tend to shield “sacred cows” and detrimental processes from scrutiny. Meanwhile, most of the changes necessary for these empowered staff teams to enact true system transformation run horizontally across departmental boundary lines.

Bottom line...paying “lip service” to staff empowerment just won’t cut it unless all these issues are addressed in the empowerment strategy.

Full empowerment versus graduated empowerment...which is better?

Sometimes well-meaning senior Hospital Administrators attempt to empower their staff “cold-turkey” without any preliminary training or day they have little say in administrative matters and the next...they are supposed to change and manage their work environment and their cross-functional interdepartmental interfaces without a hitch.

This is as perfect a recipe for disaster and staff alienation as can be conceived.

First, a little known secret...most of the formerly disenfranchised operational staff couldn’t care less about being “empowered” and will actually fear what this might mean. From their perspective, this sudden “empowerment” looks and feels more like an abdication of managerial duties by administration and gives the impression that administration feels that their problems are so pervasive that they are basically guys fix it...

In fact, rather than welcoming “empowerment”, most operational staff members avoid it. To obtain their commitment they need to be reassured, and fully informed that they will be supported, mentored, supervised and protected by administration during this transition. They will also find comfort if they know there will be strict parameters and guidelines within which they will be expected to work and clear communication channels with administration whenever they reach an impasse or encounter an institutional barrier they cannot circumvent.