Problem
IHISustainingImprovementWhitePaper.
Nurse leaders as managers of ethically sustainable caring cultures 2017.
Scoville et al. (2016) presents a framework to guide health care organizations in sustaining improvements in the safety, effectiveness, and efficiency of patient care. They argue that sustaining improvement requires a focus on the daily work of frontline managers which necessitates a high-performance management system (HPMS) assigns standard tasks and responsibilities to all levels of management.
The authors ask: "What does it take to implement a high-performance management system?" (p.12) and identified three main drivers at the frontline of a sustainable HPMS. A driver diagram provides key "processes, structures, and cultural norms" which are necessary factors in order to establish and maintain HPMS (p.13). Review the figure on page 13 and the descriptions of each of the six secondary drivers (S1-S6) (pp. 13-14) of quality control as well as the three secondary drivers that support unit managers as they manage QI efforts (pp. 14-15). The aim is to establish sustainable QI efforts. As noted in the rest of the white paper, Scoville et al. recommend approaching QI efforts using the tier approach and provide examples.
Finally, Salmela et al. (2017) discuss the importance of sustainability in healthcare supported by developing and implementing evidence-based care models last as well as include all of the staff within a healthcare organization. Equally important is that sustainability requires the inclusion of ethics, and the starting point are the values respect and dignity. The authors sought to "identify the distinctive foundations of the care culture and how nurse leaders can manage and strengthen these in a quest for ethically sustainable caring cultures" (p.874) by asking the following questions:
• What are the ethical values and valuations that distinguish the care cultures of today?
• How can nurse leaders manage ethically sustainable caring cultures?
Respond briefly to these two questions with respect to your leadership style, expectation of staff, and efforts for a sustainable care culture.
• Scoville R., Little, K., Rakover, J., Luther, K., & Mate, K. (2016). Sustaining improvement. IHI White paper. Cambridge, Massachusetts: Institute for Healthcare Improvement.
• Salmela, S., Koskinen, C., & Eriksson, K. (2017). Nurse leaders as managers of ethically sustainable caring cultures. Journal of Advanced Nursing, 73(4), 871-882.