The Four Agreements in Healthcare

The New Agreements in Healthcare

First New Agreement

find your purpose

Most people who are pulled to become healthcare providers do so with some sense of purpose. For many, the purpose and energy for their work becomes dulled or even lost in today’s stress-filled healthcare environment. There is a part of each of us that yearns to be energized to go to work and to feel that we have made a difference at the end of the day. Reconnecting with purpose reenergizes care providers at all levels to do the necessary work that creates sustainable change.

Second New Agreement

Grow and Serve the Frontline Staff

Leaders and managers, in particular, must integrate this Agreement into their leadership styles. The challenges and opportunities to improve quality and safety are best understood by the staff and employees directly involved at the point of patient care. When leaders focus on growing and serving their frontline people, the frontline staff can focus on improving systems and growing skill-sets, thereby promoting a culture of continuous care improvement. For any organization, improved financial performance through cost reduction is an important benefit of growing and serving the frontlines in this way.

Third New Agreement

Be A Systems Thinker

It’s not enough to be familiar with systems-based quality improvement. We must begin to THINK in a systems-based way. Healthcare delivery changes dramatically when we begin to think and lead in a systematic manner. It is well documented that in excess of 90% of the results we produce in the workplace, both good and not so good, are a function of the systems in which the people work, NOT the efforts of the people. Non-systems thinkers in healthcare tend to fault people for recurring problems over which they have no control. Worse, the solution to problems focuses on behavioral changes, which have little possibility of sustainable success. Hence, we repeatedly fight the same fires using the same unsuccessful strategies while demoralizing ourselves in the process.

Fourth New Agreement

Practice A Little Every Day

If we desire to learn and make new skill sets a part of how we operate in the workplace, we must practice. Ideally, the organization will support frontline staff in taking on initiatives where they can apply and practice the principles and tools of New Agreements Healthcare. Applied practice naturally moves principles and tools from concept to consistent and measurable action. Great achievements become reality through small actions taken every day. Practice and regular action should not be arduous. We do our best practice and our best work when we are inspired and having fun. With the support of great leaders, the new model for healthcare will be built by frontline care providers taking little actions every day.


Four Agreements in Healthcare
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