Understanding the System You Are in Is Key to Improving It. - 2017

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.


English

1488-917X


*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]
Humans


MedStar Institute for Innovation


Journal Article