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Understanding the System You Are in Is Key to Improving It.

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Citation: Healthcarepapers. 17(1):38-43, 2017PMID: 29278223Institution: MedStar Institute for InnovationForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Delivery of Health Care/mt [Methods] | *Patient Safety/st [Standards] | *Quality Improvement/st [Standards] | *Safety Management/st [Standards] | Delivery of Health Care/og [Organization & Administration] | Health Personnel/st [Standards] | HumansYear: 2017 ISSN:

1488-917X

Name of journal: HealthcarePapersAbstract: Front-line ownership (FLO) is an approach to change that is consistent with what we know about complex adaptive systems (CAS), such as a healthcare organization. Traditional change approaches can fail because they are based in the "organization as a machine" metaphor of traditional, scientific management. Both metaphors have their application. It depends on how closely the work naturally resembles a predictable machine. Often, the drive for detailed standardization is a misguided effort to make a human CAS behave more like a machine, so that our traditional approaches to change will work. FLO is a more appropriate tool in a CAS, where shared agreement at the level of a few simple rules (minimum specifications) and allowing flexibility for adaptation within local context is more appropriate than detailed standardization. Because humans in a CAS maintain some control over their discretionary effort, change advocates desiring sustainable change must work with stakeholders to co-create cases for change that resonate with the values of those being asked to change. FLO facilitates the emergence of this level of understanding of shared values.All authors: Plsek PFiscal year: FY2018Date added to catalog: 2018-01-18

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Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	29278223	Available		29278223

Front-line ownership (FLO) is an approach to change that is consistent with what we know about complex adaptive systems (CAS), such as a healthcare organization. Traditional change approaches can fail because they are based in the "organization as a machine" metaphor of traditional, scientific management. Both metaphors have their application. It depends on how closely the work naturally resembles a predictable machine. Often, the drive for detailed standardization is a misguided effort to make a human CAS behave more like a machine, so that our traditional approaches to change will work. FLO is a more appropriate tool in a CAS, where shared agreement at the level of a few simple rules (minimum specifications) and allowing flexibility for adaptation within local context is more appropriate than detailed standardization. Because humans in a CAS maintain some control over their discretionary effort, change advocates desiring sustainable change must work with stakeholders to co-create cases for change that resonate with the values of those being asked to change. FLO facilitates the emergence of this level of understanding of shared values.

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