Creating a Culture of Clinical Excellence

Getting Started – Everyone knows that culture springs from leaders – leaders with strong opinions and values, leaders who actively express ideas, and leaders that demonstrate active commitment in every action taken, every process designed and every policy pronounced.  But do not assume that such vision always comes from executive or senior management. In fact, culture can be driven at all levels of the organization.

Culture is deeply embedded in the DNA of an organization.  It is resilient and self-replicating.  Often executive leaders view culture as a force to be coped with or limited by. Rather than something that can be actively designed, managed and materially changed.  If your organization enjoys a robust culture focused on clinical excellence, lucky you!  But if you sense a need to raise standards, improve clinical attitudes, build institutional pride. Then it is time to dive into changing culture!

What is “culture”? 

Before you can design something, it would be good to know what the elements of the “something” are, right?  So, what are the elements of “culture” and particularly “clinical culture”?

Culture is about values, real values (not the ones in our Mission Statement, in our marketing campaigns or that we tell ourselves we believe).  I am talking about values that guide every action taken, every decision made and every dollar spent.  While some organizations have achieved alignment in what they say and do – many struggle with inconsistency in this area and have simply grown to accept it.

“Clinical culture” is the set of operating values that drive decisions and behaviors in a clinical setting – and the relative importance of those values to leadership and staff in the organization.  Cultural values can influence employee relations, medical staff relations, cleanliness, safety, financial stability, respect for patients and their families, tolerance, privacy, regulatory compliance, and many other areas.  Every facet of an organization’s activity has a cultural value. It declared and conscious or “everybody knows how we do this”, to guide it.

But “clinical culture” cannot be approached in a vacuum.  A focus on clinical excellence, without regard to cost, will likely lead to hospital closure, acquisition or leadership change.  Quality does not come free and cannot be sustained without some measure of financial discipline. Clinical excellence must be a shared value and commitment across the entire organization, not just by Nursing, Lab, Imaging or Surgery. However, Clinical excellence must be clearly defined.

So what might that look like?  Here are a few ideas:

  • Local practice must be rooted consistently in current published best practices from credible professional leadership sources and standards.
  • Every clinical work product is accurate, and created and supported by carefully designed processes, practices, cyclical education, personal and team compliance, execution metrics, physical environment engineering. Software like MEDHOST products which “fit” a hospital’s scale, complexity and clinical services menu, while providing metrics and clinical artifacts to sustain your commitment to excellence.
  • Every clinical artifact (medication, therapy, lab/imaging report, etc.) is delivered on time and at the earliest possible moment. Speed is an undervalued characteristic of service in many hospitals but can impact your efficiency and reputation.  Imagine never having to track down a diagnostic report, having late or slow medications, or missing a therapy session?
  • Everything and everyone is measured as an integral part of every clinical and operating practice. Especially, for accuracy, speed and compliance with defined professional standards.  Metrics are an integral element of every workflow design, safety practice, and tool implementation.

These are just a few examples of how you might get started. Whatever your approach, clinical excellence depends on a clearly defined action plan and a suite of tools that can provide real time input, documentation and record sharing which, most importantly, “fits” your hospital’s operating practices, staffing and medical service delivery commitments.

More next time!

Joseph G Seay

Gary Seay is Principal of BrightWork Advisory,LLC., a practice focused on enabling innovative healthcare solution success.  Mr. Seay is an author, speaker and advisor possessing extensive executive experience with major healthcare provider systems, managed care organizations, venture capital firms, and academic programs.  He can be reached at josephgseay@BrightWorkAdvisory.com.