Dveirin G F, Adams K L
Change Navigators, Inc., Loveland, CO 80539.
Jt Comm J Qual Improv. 1993 Jul;19(7):222-32. doi: 10.1016/s1070-3241(16)30003-7.
The shift from compliance to continuous improvement requires a bridge--empowerment--that enables the creation of an environment in which employees can contribute the full range of their expertise in service to the organization. Leaders are responsible for creating this empowering environment.
An operational model that describes the nine aspects of empowerment (for example, mission and values, access to information, avenues of influence) can serve as a template for leaders to use to promote an atmosphere of empowerment in their organizations.
The authors adapted this model as a survey instrument to uncover some hospital success stories that demonstrate several aspects of empowerment in action. The survey was administered at two hospitals. CASE STUDY 1: At Beth Israel Hospital (Boston, Mass), Nutrition Services rated the "mission and vision" aspect of empowerment in their department at an average of 3.5 out of a possible 4.0. The department attributes this high rating to their focus on specific goals that reinforce the larger mission and vision of the hospital as a whole. These goals form the basis for annual employee evaluations. For example, a 1992 patient-focused goal was to provide nutrition counseling and education. The department approached this goal by developing a daily format ("Eat Smart") for the daily hospital cafeteria menu that provided nutritional information. The rationale was to educate employees, who could then bring back information to their patients. Alignment of the department's efforts with the larger mission of the hospital enabled Nutrition Services to extend its influence beyond departmental and professional boundaries. Implementation of other plans at the hospital demonstrate a sustained process of vision development on the part of the executive leadership. CASE STUDY 2: At Robert Wood Johnson University Hospital (New Brunswick, NJ), Support Services gave the "environment of trust and respect" aspect an average rating of 3.7. The key to this success story lies in the upgraded role of the housekeepers as "hosts." The "Pro-Act" restructuring model for patient care delivery creates and upgrades positions to relieve nurses of their task loads. The three nursing services that participated in the survey gave their highest rating to the "access to the education and training" aspect of empowerment. The high quality of professional excellence is supported by tuition reimbursement, incentives for credentials, the extern program and scholarships provided to attract outstanding nursing students to their staff and encouragement of nursing staff at all levels for publication, presentations, and poster sessions.
These case studies demonstrate how leaders created an environment in which collective learning has become a way of doing business. Given the multifaceted nature of the empowerment model, some may wonder where to begin to focus leadership efforts. It is important to emphasize that the constellation of empowerment aspects constitutes an integral system; the full potential for empowerment arises from synergy among all nine aspects.
从遵循规定到追求持续改进的转变需要一座桥梁——赋能，它能营造一种环境，使员工能够贡献其全部专业知识为组织服务。领导者负责营造这种赋能环境。
一种描述赋能九个方面（例如，使命与价值观、信息获取、影响力途径）的运营模式可作为模板，供领导者用于在其组织中营造赋能氛围。
作者将此模式改编为一种调查工具，以发掘一些医院的成功案例，这些案例展示了赋能在实际中的几个方面。该调查在两家医院进行。
案例研究1：在贝斯以色列医院（马萨诸塞州波士顿），营养服务部门对其部门赋能的“使命与愿景”方面的评分平均为3.5（满分4.0）。该部门将这一高评分归因于他们专注于强化医院整体更大使命与愿景的具体目标。这些目标构成了年度员工评估的基础。例如，1992年以患者为中心的目标是提供营养咨询和教育。该部门通过为医院自助餐厅日常菜单制定一种每日形式（“明智饮食”）来实现这一目标，该形式提供营养信息。其基本原理是教育员工，然后员工可以将信息带回给患者。营养服务部门的努力与医院更大使命的契合，使其影响力超越了部门和专业界限。医院其他计划的实施表明行政领导方面有持续的愿景发展过程。
案例研究2：在罗伯特·伍德·约翰逊大学医院（新泽西州新不伦瑞克），支持服务部门对“信任与尊重的环境”方面的平均评分为3.7。这个成功案例的关键在于将客房服务员的角色提升为“接待员”。用于患者护理服务的“积极主动”重组模式创造并提升了职位以减轻护士的工作负担。参与调查的三个护理服务部门对赋能的“教育与培训获取”方面给予了最高评分。专业卓越的高质量得到学费报销、证书激励、外部项目以及为吸引优秀护理专业学生加入员工队伍提供的奖学金的支持，并且鼓励各级护理人员发表论文、进行演讲和参加海报展示会。
这些案例研究展示了领导者如何营造一种集体学习已成为一种经营方式的环境。鉴于赋能模式的多面性，有些人可能会想从何处着手集中领导精力。必须强调的是，赋能各方面构成一个整体系统；赋能的全部潜力源自所有九个方面之间的协同作用。
