Hardwiring Excellence by Quint Studer.

Gulf Breeze, FL: Fire Starting Publishing; 2003. 280 pages, paperback, $28.00.

The purpose of the book is to provide a practical guide to positive improvement in the health care industry, utilizing many of the author's personal experiences in his work as a health care administrator. While the featured audience are those members who work in hospitals or other acute care facilities, the book is easily adaptable to other health care arenas. The book is easy to read and provides realistic situations with suggested solutions.

The author defines the underlying premise of change to the healthcare industry as a "Healthcare Flywheel." The flywheel describes how organizations create positive change and motivate their employees by applying "prescriptions to-do," which are 9 principles of service and operational excellence that results in improved bottom-line results. Subsequent chapters speak to the principles: (1) commit to excellence; (2) measure the important things; (3) build a culture around service; (4) create and develop leaders; (5) focus on employee satisfaction; (6) build individual accountability; (7) align behaviors with goals and values; (8) communicate on all levels; and (9) recognize and reward success. Within each chapter there are specific stories and experiences that enhance the author's point, along with specific tips of how to make a change in your own organization.

The content was easy to read, with practical solutions to normal activities in a health care organization. I utilized some of the suggested solutions at my work site and saw immediate change. The 2 areas I found valuable were how to measure the important things and focus on employee satisfaction.

Many of the ideas and tips in this book are things that just make sense. The book should be a must for health care providers and health care administrators. In many cases, both of these groups see their specific purpose as the most important reason a health care facility is open. As a nurse it was nice to see a book that addressed not only what to do to keep the medical provider happy and how to deal with administrators, but how to work with these sometimes opposing forces for the advocacy of your profession and the patients.

While there were many positive suggestions for change, the one concern I had was that change does not happen overnight. Change requires commitment from all players even when the tools that measure change have not immediately improved.

I enjoyed reading the book. The solutions for a positive organizational change are simple and easy to implement. It would be a good book to have when explaining quality improvement in a health care system and relates easily to non-acute care organizations such as community clinics or even private providers' offices.