#3 – Avoid the “Everything’s-Quality-Trap”
Tell me if you’ve ever been in a health center leadership team meeting like this?
Practice Manager: “We have had an increasing problem with the back office staff stopping up the toilet.”
Nursing Manager: “That sounds like a Quality Issue…[Insert QI Coordinator’s Name]? When are you going to fix this?
QI Coordinator: “I’m not sure that is really a Qual-” Practice
Manager: “But, everything’s a Quality Issue!”
Though this may be a little exaggerated (not much), QI Coordinators around the country have had conversations like this too many times to count. Often, QI Coordinators come into the job as well-rounded generalists. You might have been an ICU nurse who was good with Excel formulas. Or maybe you were an MHA (Master of Healthcare Administration) student who just graduated and knew how to make a pretty graph. You know a little about everything and you are a quick-learn. This Jack-of-all-trades job description creates a perfect landing spot for everything from building pivot tables to putting together office furniture.
Sometimes you may be part of the problem. This role naturally attracts people who are helpers and sometimes we helpers have a hard time saying, “no”. Pitch-in when you can and always have a team mentality. But when your work (or health) begins to suffer as a result, you are no longer being truly helpful to anyone.
This is how it goes… You say, “yes” one time and the people you helped give you positive feedback and tell you how wonderful and selfless you are. This causes a dump of dopamine into your system and instantly you’re hooked. You continue saying “yes” and before you know it, your work is falling behind. You start staying later…and then you start getting to work earlier as well. You may even start bringing work home with you. You are sleeping less and start skipping breakfast. Your spouse, “just doesn’t understand” and you kick the dog on your way out the door.
You arrive to work frazzled, irritable, and snapping at anyone who gets close to you. Your co-workers start passive-aggressively dealing with your irritability (and the fact that you are no longer doing their work) and then start talking to your manager about your poor attitude. Your manager then has to take time listening to the complaining staff members and then make time to sit down with you and counsel you on your behavior. You get frustrated and hurt and spiral downward into a nobody-likes-me-and-I’m-not-appreciated-victim-mentality-tail-spin. A grass-is-greener-on-the-other-side-job is offered to you by a neighboring health center when you sit next to them at your PCA (Primary Care Association) conference…and you leave.
The manager then has to pick-up the pieces, recruit another QI Coordinator, screen them, interview them, hire them and then train them for weeks. This costs thousands of dollars, countless hours, and lots of ground lost on the real QI side of the work.
Sound familiar? I’d bet my next paycheck that it does. So, in the big scheme of things were you really helpful to your team? No. In fact, you probably created more work for them.
Yes, everything may be related to the quality of the care you provide. And everyone has the responsibility to look for areas in which we can improve. But not everything should be handled by the QI Coordinator. A problem disguised as a “quality issue” may actually need a manager to…well, manage. Or maybe the health center needs to hire a handyman to go around and change lightbulbs.
If this describes your health center culture, you might need to set the tone early in the year by assertively (and professionally) communicating what you need to be successful in your role in 2017.
Stay tuned for #4 – Get Organized.