Culturally diverse management teams. Mercy International sponsors project on Guam

In 1989 Mercy International Health Services (MIHS) sent a team of advisers to help upgrade the skills of the managers of Guam Memorial Hospital. Their experience offers lessons for U.S. healthcare organizations as they become culturally diverse. The hospital had a number of problems, including high management turnover, troubles with financial resources, political interference, and a building that did not meet codes. The advisers also planned to prepare the hospital for an accreditation survey by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). MIHS, which has a growing presence in the Pacific, does not take charge of healthcare organizations. Instead, it trains local persons to assume leadership roles. At Guam Memorial Hospital, the MIHS advisers spent their first year assessing the organization and the various cultures represented on its staff. Then the advisers devoted three years to coaching and mentoring their Guamanian counterparts. The advisers learned that the hospital had basically been run by one person. It had no management team, either formal or informal. The advisers began their coaching by forming a management team in the dietary department. When the rest of the hospital staff saw that team perform successfully, they became willing to join similar teams themselves. Guam Memorial Hospital had changed by the time the MIHS advisers left the island in 1993. It has not yet been accredited, but it does have management teams working to meet JCAHO standards. The hospital also has in place a continuous quality improvement system, with more than three years of documentation. And the hospital building now conforms to codes.