Keywords

 

Authors

  1. Thor, Johan MD, MPH
  2. Herrlin, Bo MD, PhD
  3. Wittlov, Karin MSc
  4. Skar, John PhD
  5. Brommels, Mats MD, PhD
  6. Svensson, Olle MD, PhD

Abstract

A clear aim is key for the success of improvement projects, yet many fail already at this stage. We studied how clinical teams and managers at a university hospital in Sweden identified problems and defined aims as they initiated 24 process improvement projects. Categorizing and comparing problems at 3 stages of problem definition, we found that the majority of problems fell into 1 of 3 categories: information issues, poor procedures, and waiting times. Going through these stages, managers and clinical teams prioritized waiting-time problems. We show how managers can ask such teams to quickly identify problems suited for improvement projects through this step-wise, facts-based approach. We conclude that they can add their management perspective when giving specific assignments, to harness the combined benefits of both a bottom-up and a top-down approach to improvement.