Abstract

[This abstract is based on the author's abstract.] Members of effective health care organizations in the 21st century will have to have skills that promote flexibility in a rapidly changing environment. Organizations must establish authority for decision making at the lowest reasonable levels, anticipate and resolve difficulties before they become problems, encourage continuous improvement, and accomplish work in small groups and/or cross-functional teams. Leaders must instill the belief that employees have a right and responsibility to improve their immediate surroundings, a sense of ownership in services delivered to patients and other customers, a feeling of cooperation rather than competition, a desire to change and improve current situations, and a commitment to a common vision. To this end, organizational leaders and members need to understand how best to choose appropriate tools to encourage continuous improvement. Some tools can be used at only certain steps of the quality improvement process, and choosing the right tool at the right time is helpful as the process alternates between periods of expansive thinking to focusing on specifics. Some of the most widely used problem-solving and decision making tools include the affinity diagram, fishbone cause-and-effect diagram, force field analysis, flowchart, and process decision program chart. Team members must have the skills to allow them to select the most appropriate tool for their situation. They must know what each tool is, what it does, when it should be used, and how to construct it.