Last time, I wrote about management by checklist. I stressed the importance of relationships and helping your team connect to the ‘why’ behind the directives.
This time I’d like to expand on that and talk about the number of things that are on that checklist.
A few years ago, I was working at a hospital that really wanted to improve their patient experience scores (their words, not mine) so they decided to make a list of all the things that have been shown to do so: AIDET, hourly nurse rounding, bedside shift report, MD-RN rounds, leader rounds, empathy statements, in-the-moment coaching, physician shadowing… the list went on and on. At the end of the exercise, I think there were 28 things they wanted to implement.
I asked them what they wanted to start with. “We’re doing them all!”
“All?” I asked. “We’re starting with all of them?”
“Yep, we’re going to shake things up all across the board,” they answered. “We’ve designed checklists to ensure that everyone is doing these things and we’re going to see an amazing jump in our scores, just you watch.”
The next week our nurse leaders were presented with a list of 28 things they needed to start doing and monitoring. Some of those things were already in place but happening inconsistently, others were new. We didn’t leave a lot of time for training; most of the instructions were given verbally at the time of the rollout.
There was a blitz, with many units trying hard to do everything on the list, but after just a few weeks, they ran out of steam. Too many plates spinning, too many things falling off, and too many opportunities to fail.
Had we just gone with one or two at a time, given them time to become a habit, and let them see some success before adding another, I think we would have had a very different outcome.
When we give our teams too many things to accomplish, they end up accomplishing nothing.