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As it relates to performance improvement, the term deployment has come to mean different things to different people. Regardless of how it is defined, it is widely accepted that, as with any organizational change effort, a plan is essential. To some of those who do develop a deployment plan, it is little more than a training schedule; to others, it may include a list of processes that require improvement. To facilitate a successful deployment, it must be both of these and much more. The deployment plan should provide a roadmap to a successful and sustainable performance-improvement program. It should clearly address the strategy for how performance improvement will be used to facilitate the attainment of organizational goals today and in the future. It is not an easy task, but the rewards are well worth the effort.

Who Leads the Performance-Improvement Deployment?

While the deployment plan sets the path for the journey, someone must lead the way. Most successful deployments appoint a deployment champion. The deployment champion should be an executive-level leader (e.g., chief quality officer, vice president for performance improvement, etc.). At a minimum, deployment champions should have a working knowledge of performance-improvement tools and techniques. If possible, they should attend practitioner training. While it is optimal for them to complete projects as is normally required for practitioner courses, this may be waived—allowing the champion to attend much in the same manner a student may audit a college course. While not the favored approach, this may be preferred over a void in performance-improvement knowledge.

The primary duty of deployment champions is to execute the deployment strategy. This is accomplished through the executive leadership team (ELT). Many healthcare organizations have multiple entities that oversee, report, or execute improvement efforts across the enterprise—or even within departments. While this ubiquity does help to ensure a degree of focus on quality issues, it is somewhat counter to a systems approach to quality throughout the organization. For the Committee on Quality of Health Care in America, the Institute of Medicine (IOM) stated that "whatever the organizational arrangement, it should promote innovation and quality improvement." Top-level management ought to ask, "Does the current decentralized structure promote innovation and sharing?" Additionally, the IOM found that a healthcare organization's structure must be able to support both formal and informal ways of learning to share information. Otherwise, improvements will be suboptimized, with improvements limited to just one division or team instead of reaped throughout the organization, as Samantha Chao attests in her report, "The State of Quality Improvement and Implementation Research."

In many cases, relegating the responsibility of quality outside the highest echelon of management serves to absolve executive leadership from direct involvement in improving quality within their organization. While the focus of these entities is usually on quality-of-care issues, the organization's raison d'être, it fails to address opportunities in the areas of capacity, Throughput, ...

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