J Healthc Manag. 2014 Mar-Apr;59(2):147-57.
In the 21st century, healthcare executives are facing changes of unprecedented magnitude in virtually every area, affecting their ability to compete. That hindrance brings with it a greater need for rapid and effective organizational change and improvement. Yet changes in the U.S. healthcare delivery system have historically been criticized as slow and less than effective in responding to the changes necessary for rapid performance improvement. To that end, the purpose of this applied research study was to help healthcare executives better understand the barriers to effective organizational change and improvement from the perspective of frontline leaders. Focus groups were conducted with 167 frontline leaders from four community hospitals to explore why hospital change efforts fail. Participants representing 11 different functional areas, including all facets of hospital operations, were asked to identify the primary causes of failure of a recent change initiative at their hospital. A content analysis of the focus group data identified 10 primary barriers to successful hospital change, some of which are ineffective implementation planning and overly aggressive timelines, failure to create project buy-in and ownership, ineffective leadership and lack of trust in upper management, unrealistic improvement plans, and communication breakdowns. Leadership lessons and recommendations based on the research findings are provided.
在 21 世纪，医疗保健高管们几乎在每个领域都面临着前所未有的变革，这影响了他们的竞争能力。这种阻碍带来了对快速有效的组织变革和改进的更大需求。然而，美国医疗保健提供系统的变革历来被批评为缓慢且对快速提高绩效所需的变革反应不足。有鉴于此，本应用研究的目的是帮助医疗保健高管从一线领导者的角度更好地理解有效组织变革和改进的障碍。对来自四家社区医院的 167 名一线领导者进行了焦点小组讨论，以探讨为什么医院变革努力会失败。参与者代表了 11 个不同的职能领域，包括医院运营的各个方面，他们被要求确定医院最近变革举措失败的主要原因。对焦点小组数据的内容分析确定了成功医院变革的 10 个主要障碍，其中一些障碍是实施计划无效和过于激进的时间表、未能建立项目认可和所有权、领导不力以及对上管理层缺乏信任、不切实际的改进计划以及沟通中断。根据研究结果提供了领导力经验教训和建议。
