Seizing opportunities for change at the operational level

This article presents a method for handling everyday opportunities for improvement, led by floor staff in health care institutions. More than 400,000 incidents and accidents were recorded in Quebec health care institutions in 2013. The burden of treatment falls on hospital floor staff. The purpose is to raise the visibility of this problem and support staff better in their efforts to handle opportunities for improvement.

Based on issues identified in the literature, which have been found to exist in various organizations, the method involved reviewing practices in the field, proposing a solution, and testing it to assess its relevance and limitations. The method was tested in partnership with the Centre Hospitalier de l’Université de Montréal, in the internal medicine unit at Hôtel-Dieu campus. The test lasted three months. Indicators from this test have been compared to results in the literature.

The proposed method presents a 68% increase in ideas generated per person and per week compared to the reference study. The mean time for closing actions was about 41% better (lower) than in the reference case.

The test lasted 15 weeks; a longer test is needed to collect more data.

The first practical implication of this study was the creation of a method allowing employees to seize opportunities for improvement in their daily work. The application of this method revealed (1) the operational nature of the proposal (empowerment of the work team); (2) the operationalization of continuous improvement (71% of ideas were finalized while the initiative was monitored); (3) the smooth operation of the mechanism for facilitating continuous improvement (organization of weekly meetings and team participation in these meetings in 90% of cases); and (4) a shared feeling that intra- and inter-team communication had been strengthened.

The main value of this paper is that it proposes a simple problem-solving process that gives employees an opportunity to improve their daily work. The originality of this paper resides in comparing results to a standard case and observing an improvement. This paper proposes a new problem-solving structure and tests it scientifically.