The Truven Health Blog

The latest healthcare topics from a trusted, proven, and unbiased source.

Organizational Fibrillation: Studying the Cause of Organizational Malaise

By Robert Sutter/Monday, September 16, 2013
Robert Sutter imageWhen I ask my clients how their performance improvement system is working, they often respond that it’s not working well, and they can't seem to make progress on performance improvement projects. Upon further discussion, it becomes clear that these organizations are afflicted with organizational fibrillation with respect to performance improvement.

When the heart is afflicted with fibrillation, the muscle fibers contract rapidly at their own pace and not in coordination with other muscle fibers. As a result the amount of blood pumped to the body is reduced. In other words, there is a lot of heart activity, but reduced heart output.

Many healthcare organizations are in same state with respect to their performance improvement system; there is a lot of activity, but minimal results. This is typically characterized by more performance improvement projects and other projects, such as tasks, being conducted simultaneously than can be supported by the performance improvement project leaders. Hence, they exist in a state of organizational fibrillation.

The causal factors associated with this condition are the lack of two important components of an effective performance improvement system:
1.    A supportive organizational infrastructure
2.    A systematic approach to performance improvement.

Joseph Juran said it best, "All improvement happens project by project and in no other way." This is the beacon guiding the implementation of an effective performance improvement system and the treatment of organizational fibrillation. It means that the key to improving organizational performance is to successfully execute as many performance improvement projects within a given time frame as possible. In order to achieve this, objective organizational defibrillation is required.

Robert Sutter, RN MBA MHA

Enhancing Analytical Capability

By Robert Sutter/Tuesday, June 25, 2013
Robert Sutter imageWith the advent of electronic health records healthcare providers are in the midst of an unprecedented digital revolution - They are becoming awash with data. The question they face is: How to harness all of this data in a manner that facilitates enhancing organizational performance?

The first step to answering this question is to perform an organizational assessment to understand the current state of the organization's analytical capabilities relative to the five stages depicted in Table 1. With that accomplished, the organization can plot a course to advance to the successively higher stages of analytical competency - which will facilitate achieving higher levels of organizational performance.

Table 1

Analytical Objective
Analytical Process
1:Analytically Impaired
None established
Adverse to fact based decision making
2: Localized Analytics
Sparse, not integrated or aligned
Narrow focus, fragmented
Isolated, minimal
Isolated, not uniform
Craves for more and better data
3. Analytical Aspirations
Organizational performance metrics established
Fragmented, not aligned
Analysts to produce dashboards
Early stage of awareness of the advantages of analytics
Senior management support for fact-based decision making
4: Analytical Company
Develop an integrated analytics program
Some integrated, aligned analytics
Analysts with moderate skills but not aligned
Generalized senior management support
Change management underway to transform into fact-based culture
5. Analytical Competitor
Well developed and focused
Fully integrated, aligned analytics
Advanced: predictive modeling, data mining
Genuinely committed
Fact-based decision making is the way business is conducted

In order to be successful at becoming an analytical competitor an organization must have a senior management team that is genuinely committed to fact-based decision making. In addition, a well defined strategy is required to provide direction on the goals to be accomplished, the analytic questions to be answered and how to allocate analytical resources.

Robert Sutter, RN MBA MHA