Are improvements getting lost in committees?

Too many patients are getting injured from falls at your organization, and you've got the data to prove it. You've drilled down to identify specific units with the highest fall rates, and zeroed in on the exact shift and type of patient that are most at risk. An action plan is developed to make specific changes to reduce fall risk but requires funding and approval at the administrative level. The topic has been discussed in one committee after another. Six months later, your plan is still not implemented.

Does this sound familiar? If so, your organization’s committee approval process might need overhauling. "You need to take a look at your committees and make sure that their purpose and objectives stay current and fluid," says Judy Homa-Lowry, RN, MS, CPHQ, president of Homa-Lowry Healthcare Consulting, based in Metamora, MI. "You may need to look creatively at combining or collapsing some of the committees."

For example, some organizations are forming patient safety committees, which may overlap some of the activities performed by other committees, she says. "By adding another piece, you slow down the movement because it has to go to another group, which delays decision making," she says. "People don’t want to spend hours rehashing the same thing."

Combine functions of committees when possible.

Make a list of all your committees, teams and task forces and assess their purpose and why they are in place, says Homa-Lowry. "Take a look at the minutes and evaluate how effective they have been at what they are doing," she says. "Then consider potentially combining or collapsing some of these."

For example, there may be overlap between your quality improvement and patient safety committee, says Homa-Lowry. Smaller organizations might consider combining infection control and the pharmacy and therapeutics committee, she suggests.

Evaluate the purpose of committees, such as addressing regulatory requirements, and then assess whether these activities are being duplicated by other committees, teams, and task forces, Homa-Lowry recommends.

Always get input from committee members as well as the chief of staff, medical director for medical staff committees, and the CEO and COO for administrative committees, she adds. "Be prepared to justify why you think this change will be beneficial to the organization," says Homa-Lowry. "You may even want to present how this may be a cost savings by decreasing the resources needed to operate the committee and the potential delay in decision making."

Have a mechanism to move important issues through faster.

This usually takes place when a sentinel event occurs, but if a patient safety issue is important enough to bring forward as a priority, and you know your timeline of decision making is three to six months, then you should find a way to move it along more quickly, says Homa-Lowry.

"It might have an impact on patient care, and people will also lose interest if it continually stays on the agenda," she says. "By the time it gets approved, people may have already done workarounds to get around the problem, since it's been hung up in committee for so long. Sometimes you may have to go back and start addressing the issue at the beginning and also address the workarounds."

Have a mechanism for accountability.

Many times, issues are deferred or moved to the next committee because somebody hasn’t followed up. "Leadership or the board may need a report as to why it's taking so long to get this through the infrastructure, and hold people accountable for doing their job," says Homa-Lowry.

[For more information, contact:

Judy Homa-Lowry RN, MS, CPHQ, President, Homa-Lowry Healthcare Consulting, 560 West Sutton Road, Metamora, MI 48455. Telephone: (810) 245-1535. Fax: (810) 245-1545. E-mail: homalowry@earthlink.net.]