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Clint Maun, CSP

There isn't a word that has been more misused in the healthcare industry than the word "fair". Fair could mean legal, honest, consistent, ethical, moral - but it doesn't mean "equal". In today's time of unfair reimbursement competition and regulatory oversight, it's important that organizations move beyond trying to ensure they end up with mediocrity.

Mediocrity occurs when an organization spends time trying to make sure everything is equal for everyone. There is no guarantee that each employee, or for that matter, customers will be treated equally in all circumstances. For customers it's important to individualize their plan of care and treatment to ensure success. This success includes the quality of care necessary for them and the appropriate care delivered for the right price. That is different for each individual. In fact, with the new PPS (Perspective Payment System) program there are 44 different levels of care and treatment for individuals involved in Medicare.

Likewise, you can't assure every employee is given equal assignments during every shift and/or department and is treated alike in all circumstances. Each individual department, unit, section, etc. have different job demands. Too many organizations are spending time listening to co-workers indicate they didn't get the same number of residents to care for, the same number of charts to work on or the same amount of time off related to the schedule.

Facilities today must ensure there is no prejudice, discrimination or inconsistent treatment of individuals. However, it is interesting to watch that some of the loudest squawkers in today's organizations don't want it fair when they use the words, "that's not fair". What they actually want is an unfair advantage. In fact, what they really want is to be treated unfairly so they don't have to do as much work, don't have to complete the same amount of work effort and don't have to play "team ball".

The "team ball" concept is how a championship team emerges. The captain, manager and owner of the team does not make sure team members receive equal treatment in the "sports activity". In fact, they tell people to play their position and do what is needed to win the game, for the "team first". That's entirely different than setting up systems for a championship team that are based around "me first" concepts.

If your organization wants to move toward success it must implement procedures that apply to everyone related to what the organization needs versus what individuals want for their personal success. Allowing a few people to constantly complain about things not being fair is the quickest way for the organization to be held up to emotional extortion and drive it into mediocrity. What we ought to do is develop systems that say if people produce more work, have more success and accomplish more effort than others, they have different rewards/recognition than everyone else. Then, we will have put a system in place that rewards and recognizes extra effort team based involvement and productivity at a higher level.

This "unfair" recognition/reward system will then allow people to move toward a higher level of productivity involvement rather than drag everybody down to a lower level where we can't get everything done because we're worried about ensuring "sameness" for everyone.