Mar 1999 Table of Contents

Improving Patient Care

Beginning With a Vision



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Any efforts to improve patient care must be guided by a clear vision that you, your staff and your colleagues share.

Fam Pract Manag. 1999 Mar;6(3):57.

This content conforms to AAFP CME criteria. See FPM CME Quiz.

Most family physicians are committed to quality, and they work hard to provide care that will help patients lead healthy, satisfied lives. When you leave the office at the end of each day, you probably feel that you have done the best job possible. But how can you know for sure? How can you know your practice is headed in the right direction? How can you determine what improvements you should be targeting? The answer lies in your practice's vision.

Developing your vision

Simply defined, a vision is a picture of the future, or “the art of seeing things invisible,” according to Jonathan Swift. What “invisible” achievements lie ahead for your practice? What does the organization want to achieve? Healthy, satisfied patients? Satisfied employees? A strong bottom line? A vision serves as a guide and helps the people in your practice maintain a common focus. Here's how you can develop a vision for your practice.

First, plan and chair a vision brainstorming meeting with other leaders in your organization (office manager, head nurse, etc.). Try to keep the number of meeting participants at about five, no more than 10. A smaller group can reach consensus more readily, and everyone's opinions can be heard in a shorter time period.

Your meeting should follow this structure:

Establish the meeting's purpose (10 minutes). Explain the purpose of the meeting and ask whether anyone has initial comments or questions.

Use an icebreaker (10 minutes). To help everyone feel comfortable about talking and sharing ideas, consider an exercise to break the ice. (An example would be asking each member of the group to tell about his or her favorite patient and why.) If the people in your group are already comfortable expressing ideas to one another, this may not be necessary.

Have a focused discussion (40 minutes). Your group's discussion should explore these questions:

  • What are the attributes of an ideal practice?

  • What do we do exceptionally well now? How can we build on our strengths?

  • Where do we want to be in five and 10 years?

  • What can we improve upon?

  • How do we want our patients to describe our practice?

  • How do we want our employees to describe their work environment?

  • How do we want the medical and nonmedical staff to feel about their jobs?

To facilitate the discussion, assign one member of the group to serve as scribe. Use a flip chart or hang pieces of paper on the wall for the scribe to record the group's comments and suggestions. At this point in the process, you are simply brainstorming, so don't criticize one another's ideas. Ask for clarification if needed, but don't veto anything.

Categorize comments and suggestions (30 minutes). Review the group's ideas and begin to categorize them. Can any of the ideas be lumped together? Do they fall into logical categories? Think of the big picture. Remember, you are developing a vision statement, not a detailed work plan.

Write the vision statement (30 minutes). If the meeting is running long or the group is getting tired, you might want to take a break or save writing the vision statement for another meeting (as long as the meeting is not postponed too far into the future). If the group is energized, keep going. You should at least be able to develop a draft statement that one volunteer can revise later.

Here's an example of a good vision statement: “Quality Care Family Practice is committed to providing timely, sensitive, state-of-the-art medical care; providing a highly professional, friendly work environment for its staff; and maintaining a profitable business.”

Gaining staff “buy-in”

To achieve the vision, it's important that all staff understand and accept it. Review the statement with your staff. Explain how it was developed and the thinking behind it, and allow the staff to make comments. The people who developed the statement may find it difficult to listen to the larger group's criticisms, but be open to suggestions.

Revise the vision until the group reaches consensus. Not everyone in the group has to love the vision, but all have to be able to live with it.

Once a consensus has emerged, ask for a volunteer to put the vision statement on a small poster, and give everyone a copy. Display it in the work area and, if you feel it's appropriate, in the office for patients to see. When you need to prioritize practice problems or need a touchstone for day-today decisions, look to your vision statement. It will also give you encouragement and verification that your practice is on the right track.

Stacey Eubanks is the AAFP's manager for quality issues.

Copyright © 1999 by the American Academy of Family Physicians.
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