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Focus on the positive to inspire change

Nurse Leader Weekly, May 15, 2003

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Instead of focusing on what's gone wrong on your unit, take a look at what's going right. Analyzing "the best of times" can not only reveal helpful information, but it can also refresh staff who might be feeling low because their mistakes are so often scrutinized.

The buzzword for the technique of studying positive events is "appreciative inquiry," or "appreciative management," says James A. Espinosa, MD, FACEP, FAAFP, medical director of the department of emergency medicine at Overlook Hospital, which is part of Atlantic Health System in Summit, NJ.

"Fortune 500 companies are spending a little bit of money on figuring this out," says Espinosa. He credits Joseph Roebuck, a health care consultant and the former director of organizational development for Atlantic Health Systems, with introducing him to the idea of appreciative inquiry.

When Roebuck first started working as a trainer in a New Jersey health care system, he discovered that some staff members were reluctant to get involved in process improvement, "because of the negative connotation," Roebuck says. He read up on appreciative inquiry, and started opening staff members' eyes to the good things happening all around them.

You can use appreciative inquiry techniques, such as the positive root-cause analysis (RCA), on a variety of processes.

For instance, Tina Maund, MS, RN, Overlooks's director of performance improvement, has used the same idea on a process improvement project designed to reduce mislabeled blood specimens. Her department conducted a positive RCA to uncover the major contributors to achieving 100% correctly labeled specimens.

The people involved enjoyed participating in the process. "It is an opportunity to really congratulate staff and help them feel good about a positive outcome," Maund says. "We spend so much time dissecting problems, and we do learn from that-absolutely. But this is looking at the process from another vantage point."

Adapted from: Briefings on Patient Safety, www.hcmarketplace.com/Prod.cfm?id=234&S=ENMW.

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