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118 Section III. Implementation4. Try to salvage the CIRS project as follows.Directly address the problem of accountability. Currently, no one is specificallycharged with the responsibility for facilitating process improvement. Overhill shouldimplement an accountability structure with guidance and input from her senior colleaguesand at least some of the managers. Options for this include:• A stable IR resolution team that would include managers (and possibly others)from different departments, who would have dedicated time to perform this task,in collaboration with employees and managers in the departments where any particularCIR originated.• A system for assembling a temporary, self-organizing, multidisciplinary team foreach computerized incident report submitted, which would be responsible foraddressing issues raised in the incident report. These teams might be constitutedaccording to a fixed “recipe,” e.g., the individual who filed the report, the managerfrom the corresponding department, and a dedicated employee from the qualitymanagement department, which could potentially be Overhill.There should be a formalized process of feedback whenever an error is reported.When employees see that error reporting does make a difference, maybe they willbe more likely to report incidents. Fortunately, CIRS software provides the abilityto support many communication requirements.• There have been several significant successes with the CIRS already. For instance,the system facilitated a solution to a long-standing problem that the paper-basedsystem never caught. These successes need to be communicated, loudly andrepeatedly, to the entire LHS community so that the potential value of the systemis understood.• Increased resources for training and user support, especially for employees whoare uncomfortable with computer technology in general. It might be possible toachieve this without additional expense by recruiting some employees who aremore facile with the system to champion it and support other employees who arehaving difficulty.Overhill should explore the options of adding more workstations or making it possibleto run the CIRS software on all the LHS computers. Easier access wouldencourage more employees to use it.• Develop ways to reward reporting without rewarding the incidents that lead toreporting. This would be challenging but might be structured as a reward to IRreport filers for suggesting solutions to systemic problems should the suggestionbe adopted. Another option is to focus the reward at the unit level to foster anatmosphere of cooperation among unit members. This will improve morale andenable the teamwork necessary to correct errors due to complex issues of workflow.• The CQI approach toward IR, with its nonblaming, nonpunitive approach, shouldbe communicated more effectively to the employees to reduce fears that individualsmight be targeted for mistakes made. This could be achieved in multipleways—through newsletters, posters in employee break rooms, and meetings withemployees.Pros: This approach would result in an effective, usable CIRS if successful. Itbuilds on the financial and human resources that have already been invested in theCIRS project. In addition, it would be counterproductive to waste the institutionalmomentum that has been generated to initiate this implementation. None of the difficultieswith the CIRS project are insurmountable. If Overhill is able to make theproject a resounding success, with enthusiastic adoption by the employees, it will be