Welcome to our ongoing series based on the characters created in my book, Heroes Need Not Apply, “How to build a Patient-Accountable Culture without putting more on your plate.” The book shows how focusing on what matters most to patients, having the right mind-set and a common direction can bring people together to ignite an entire organization.
My characters, CEO Jane Carolli and VPMA Dr. Jack Martin continue to craft a strategy to improve their culture by developing a cultural assessment tool to help drive change.
Building a patient accountable culture doesn't happen over night. As with any long-term endeavor, data continually flows in… which not only stimulates more ideas to work with, but validates the direction Jack and Jane are going… always a good thing…
Jack asked Jane to meet him for a beer “off campus,” thinking that they’d both been buried in work, and although it would be a “working beer,” they both would benefit from a change of venue. When Jane slid onto the bar stool alongside of Jack, he could sense her frustration.
He gently prodded her, “Long day huh?”
“Aren’t they all - this was a great idea Jack, I don’t remember the last time I’ve sat in front of a cold pint…”
He went a little further, “So, come clean, what’s on your mind?”
“Something is definitely bothering me, but we can talk about it later… we need to get back to the assessment.”
“Jane, whatever you’re troubled about will tie into what we’re doing. And either way, you look like you need to get something off of your chest.”
“It’s the ED Jack - we’re seeing a significant percentage of patients returning unnecessarily because they are anxious about their symptoms and are not getting the assurance they need. It’s costing us and them a bundle, and we’ve got to do something about it.”
Staying true to the coach he is Jack said, “Why do you think this is happening?”
“When this data was brought to me last month, I tasked our staff to further assess why we had so many patients returning shortly after discharge. What they saw was frightening— we found that their decision to return was fueled by uncertainty regarding medical conditions as well as a perception that the ED and our employed primary care physicians were not responsive to their needs. In addition to expected insurance challenges, these patients were generally dissatisfied with their primary care physician, and noted the lack of trust they have in their primary physician. Needless to say, I did some rounding myself and found similar themes.”
”Tell me more Jane.”
“Many patients suggested that nobody really listened to them. One woman shared that her doctor was in the room with her for ten minutes and never once looked at her as he was typing on the computer… another said that he watched several doctors walk by his room for hours. He told me he thought the doctors went out of their way to avoid him. One woman had seen her physician three times and she didn’t even know his name.”
“What’s more important than being reassured when you’re the patient?”
“Jane this reminds me…several years ago, I worked at a hospital, that had actually built a hidden stairway system so that the docs could move about without having to interact with staff and patients in the hallways.”
Jane sighed, “Why doesn’t that surprise me.”
“So what’s your plan Jane?”
“We just have to figure out how to help our clinical teams to understand that spending a small amount to time reassure a patient, explain a medication or a diagnosis can do us and our patients a world of good. Oh yeah, and that treating people like humans, not cattle will be a complete game changer.”
Jack added, “ I think the only way to do that is to make them all become patients… just kidding… but I’m not. They need to remember what it feels like to be vulnerable and ignored. But that’s another discussion. What we can do now is get back to the assessment. Because everything you’ve told me validates that this is the same cultural challenge we see all over this hospital… and we need to deal with the root cause of all of it.”
“You’re right… so let’s get back to it. I already have some assessment question ideas in mind because of this conversation .”
“How about something like whether or not physicians at our organization are accessible to patients and that are our physicians approachable? What do you think?”
“I think that questions like those just might make these docs think… and that’s a start.”
Jack added, “We should add similar questions for leaders, nurses and staff.”
“Agreed Jack, this is about reminding everyone that for us to improve care we all must become accountable to what matters most to patients.”
Is your culture aligned to what matters most to patients?...