RAP Lesson Learned #1: The Power of a Conversation

Rhonda Barcus, Program Specialist

The Rural Hospital Performance Improvement (RHPI) Project is a federally-funded initiative that supports performance and quality improvement projects in eligible rural hospitals in the eight-state region of the Mississippi Delta. One of the ways hospitals are supported is through onsite, consultant led projects designed to impact operational, clinical, or financial issues. About 2 ½ years ago, we created a process called RAP, Recommendation Adoption Progress, as the vehicle to gather information from the participating hospital administrators concerning the extent to which they were able to implement consultant recommendations, outcomes, and the impact on the hospital and community.

Hired to create and implement this process, my background is actually in behavioral health and organizational development. Pure data collection and analysis is not my passion! But, I do know how to gather information and one of my closely held beliefs is that looking at data in the form of numbers alone will only tell a piece of the story. We began discussing what the RAP process would include and I knew that sending an impersonal questionnaire to be returned to me was not the way I wanted to go. Most people are “surveyed out”!

So RAP became a conversation with the hospital administrator. Yes, it involves the discussion of data and outcomes and “what has this project meant to the bottom line” but more importantly, it has become an opportunity to dive deeper. My first lesson learned was that just having a conversation can become a powerful motivator for the hospital. In the midst of impersonal communication, actually TALKING about the process, keeps the hospital focused. It also is an opportunity to coach and educate about the importance of the non-measureable ways the project impacts the hospital. If we only discussed measurable outcomes, we would miss the value of project impact such as “staff is more engaged” or “managers are taking responsibility for their budget” or “staff are now bringing ideas for quality improvement to their leadership.” While not necessarily measurable, these are the indicators of culture change. What we know is that without a change in the hospital culture or “the way we are”, there would not be sustainability, regardless of the excellence of the project.

And so, my first lesson learned with RAP is that we intuitively named it well. While an outdated term from the 60’s, it’s still a powerful way to receive and share information and build trusting relationships along the way. It’s just the power of a conversation.

Next time, RAP Lesson Learned #2: The Power of Meeting People Where They Are.