1. Hader, Richard PhD, NE-BC, RN, CHE, CPHQ, FAAN

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We've all heard someone talk about a sporting event in which a team lost to their opponent by a large margin, but it's recalled by stating, "The score didn't tell the story of the way the game was played." The true win wasn't the final score, but rather the passion and commitment the team demonstrated while working together to achieve their goal. This passion was the true essence of the game.

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As leaders we're constantly tracking and trending numbers. Among some of the indicators we review are operating margins; turnover rates; patient, employee, and physician satisfaction scores; market share; and admission volumes. We often rely on these numbers to inform us whether our area of responsibility is performing at expected levels. Are numerical data truly reflective of how the organization is performing or may they be camouflaging ills that are corroding the fabric of the organization? Quantitative data are important to provide a cursory overview of performance, but they shouldn't be used in isolation when determining the overall efficiency and effectiveness of a business unit.


We may be far too fixated on analyzing the numbers rather than attempting to determine what might really be going on within a department. For example, let's look at a unit that's suffering from poor employee satisfaction results following the hire of a new department leader. This leader may have set performance expectations that are much higher and will yield more positive results in the future, but some of the staff members are resisting the change and demonstrate their discontent when surveyed about their overall satisfaction. Does this mean that the leader is doing a poor job? I would contend that this leader is establishing a new standard for performance and providing a vision for excellence that's not being accepted by all. The data indicate poor employee satisfaction, but this may indicate a unit that's in a controlled state of chaos, which will ultimately yield positive results.


It's the qualities of the unit that may be more important than the bottom line. A leader's ability to influence performance, promote positive collaboration among the team members, provide a vision, garnish attention to detail, and role model a positive culture may be more defining than what the numbers on a dashboard may indicate. Given several factors, an outstanding leader may have outstanding quantifiable results; given a closer look, an entirely different story may be revealed. A small pre-op area with a short patient stay might illustrate high patient satisfaction, whereas a large, complex medical-surgical unit with a longer length of stay demonstrates marginal patient satisfaction scores. Given the environmental differences of the two areas, it can't be concluded that one unit is more focused on customer satisfaction than the other.


The effectiveness of a leader shouldn't be evaluated solely on numerical indicators. As such, we shouldn't rely on quantity when analyzing the performance of our staff members. A nurse who's punctual, documents flawlessly, and provides accurate clinical assessments may also be the worst performer on the unit. The diligent nurse might be the one who doesn't demonstrate caring and compassion in his or her attitude or commitment. This nurse may be the best interpreter of an arterial blood gas result, yet he or she's the most difficult when it comes to changing destructive behavior.


Beware and don't be fooled by the performance on the dashboard: You must take the time to thoroughly analyze all quantitative and qualitative data before rendering a conclusive decision. The true results are in the detail.


Richard Hader

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