Implementation of Continuous Quality Improvement in a Community Mental Health Care Center: Effect on Morale
Morale is important to all service organizations because quality is dependent upon the nature of face-to-face interactions. Because the workers in mental health service organizations must care for patients, morale is especially important. Although studies suggest that rapid change due to cutbacks, privatization, and managed care, have demoralized mental health workers, the literature suggests that management is the problem. Mechanistic organizations with top-down, command-control management typically exclude and alienate workers. Continuous quality improvement (CQI) can improve morale as well as the bottom-line. However, there are no studies of how to implement CQI, from the perspective of workers, to improve morale in a private-sector community mental health program. This qualitative case study documents, from the perspective of workers, how a self-directed team implemented CQI to improve morale. Results reveal that CQI was successfully used to assess and increase morale. Moreover, the workers opted to improve patient care over pursuing a pay raise. In the end, morale returned to normal because the team did not obtain the training, the guidance, or the administrative support necessary to fully understand CQI, adequately use the quality tools, or get buy-in from management. The results highlight the fact that in order to transform the organization and sustain morale, self-directed teams must collaborate with management to obtain consultation and training necessary for the long-term success of CQI efforts. How to bring about that collaboration is the question. The researcher recommends starting by providing all CQI participants training in collaborative leadership. This would provide workers and management with an alternative, non-hierarchical model for implementing change.
collaborative leadership, Continuous Quality Improvement, Leadership studies, mental health center, morale, qualitative, training
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