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Lazes and Rudden: How frontline staff can save America’s healthcare

December 30, 2020

Topics: Quote of the Day

By Peter Lazes and Marie Rudden

The purpose of this book

As both of us have been occupied in our careers with what makes organizational systems more effective and have observed the central role of frontline staff and caregivers in this effort, we offer methods for restructuring healthcare systems in a way that makes collaboration and active communication among administrators, medical staff, and patients a key value. This book explores exactly what it takes to effectively engage staff and providers in improving the patient care shortcomings within their institutions. We do this by presenting case studies of institutions that have successfully implemented major systemic changes in this manner, by reviewing research findings and outcomes, and by conveying the direct words and experiences of staff who have participated in changing their healthcare organizations.

We have shaped this book around the specific methods that healthcare systems can employ in order to enlist their frontline staff in diagnosing and rectifying difficulties in providing high-quality patient care. This book not only is a manual detailing what can be achieved when frontline staff have a direct voice in controlling their practice environments, but also was written to provide a method for accomplishing transformative changes in how our hospitals and outpatient clinics work.

All Americans deserve and should have access to high-quality, affordable healthcare services delivered by professionals who know them and who have sufficient time and resources to care for them.

In sum, this book will inform you about the historical development of approaches for engaging frontline staff in job redesign and in the creation of more effective organizational systems. The book gets you under the covers, so to speak, exploring what it really takes to effectively initiate, implement, and sustain employee involvement activities. It demonstrates how Labor-Management Partnerships particularly can help organizations to evaluate the effectiveness of their current systems and to design more functional structures. We emphasize too the importance of establishing collaborative leadership processes to engage and sustain employee participation efforts.

Peter Lazes, PhD, a clinical and industrial psychologist, was the founder and former director of Programs for Employment and Workplace Systems and of the Healthcare Transformation Project, both at Cornell University.

Marie Rudden, MD, his wife and co-author, is a psychiatrist and psycho-analyst, an associate editor for the International Journal of Applied Psychoanalytic Studies, a member of the North American Editorial Board of the International Journal of Psychoanalysis, and a clinical assistant professor in psychiatry at Weill Cornell School of Medicine.



By Don McCanne, M.D.

In a personal email communication, Peter Lazes writes, “In addition to a national payment system, I would suggest that it is critical to create ways for frontline staff and unions to become active partners in the creation of new structures and systems to improve access and coordination of care. Bills, administrative actions and some form of Medicare for All are important, but it is critical that we find ways to make use of the sufficient knowledge of frontline staff (from housekeeping staff to attending physicians) in order to achieve needed breakthroughs… structures themselves will not be sufficient nor will just “bold” leadership from management. Current healthcare management leadership has achieved only anemic improvements in improving the quality of patient care. And a national payment system by itself will not achieve reducing inequalities nor improve overall health outcomes. Systemic changes along with a national payment system is needed.”

It is absolutely essential that we replace the current dysfunctional health care financing system with one that ensures equitable, affordable health care for all – single payer improved Medicare for All. Although the financial realignment will certainly correct many of the deficiencies in the health care delivery system, it will also greatly benefit from continual oversight, analysis and improvement from those most important to the patient – the frontline staff and their patient-oriented organizations, such as the unions.

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About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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