The Coach Leader highlights regular front-line coaching conversations to provide you with new insights and perspective on how to improve care coordination and lead your organization to a more Patient-Accountable Culture.
Wednesday, January 8, 2014
Tip 26: The Unengaged
Q: The latest Gallup poll on the State of the Global Workplace is reporting that only 13 percent of employees feel engaged at work. Some experts I know suggest the physician numbers might be slightly worse than reported. While larger systems are better equipped to deal with the symptoms associated with disengaged physicians (i.e. retention, recruitment, etc.), for smaller hospitals, the consequences of an uninvolved physician can be devastating for the bottom line and seriously hamper care coordination, patient experience, and safety.
Now back to you and your organization. A recent coaching session with one of my physician executive clients, revolved around how to address physician engagement metrics. My client asked, “How much do these engagement numbers have to do with the lack of trust our physicians have towards the organization?”
A: I won't try and convince you that a lack of trust is the single root cause for this complex issue, but it’s a darn good place to start if you’re in need of strengthening relationships with your physician community.
Joel Peterson, Chairman of JetBlue Airways shares great perspective in a recent LinkedIn post, “I've come to believe that the most important ingredient in a business’s success is, simply, trust.” Mr. Peterson goes on to share his world-view on trust, “In firms where people trust their leaders and colleagues trust one another, there’s more innovation and better business outcomes. Mistrust and politics are expensive, time-consuming and dispiriting. When a company has a reputation for fair dealing, its costs drop: trust cuts the time spent second-guessing, worrying, and lawyering. Trust strengthens every part of any deal: its durability, its potential profitability, and its flexibility. Like most things, business works better when the energy spent on doubt, fear and suspicion are reduced. Empowered workers can sense they are trusted. For most people, the feeling of being trusted leads to an increased desire to be trustworthy. This virtuous cycle can take your team to great interdependent heights.”
To move metrics and gain efficiencies required in this reform era, we must look to trust building as a solution rather than adding more initiatives to our already full plates.
As leaders we can't expect improved engagement if we don't first invest in building trust.
This might look like a futile battle to some, but when trust is wrapped in the context of the patient, it quickly rises above the "touchy feely", and becomes an essential ingredient to improving care. We can learn all there is to know about the value of trust from a patient. Consider how much trust our patients place in you and your team. As you consider working to improve trust among your team begin with the end in mind. Focus the conversation on how we need to “show up” with each other. Specifically, the types of interactions, behaviors, and actions that encourage patient trust.
You’ll be surprised by how easy and productive these conversation can be, how individual differences diminish, and how consensus builds for what really counts.
A focus on what matters most to patients is the quickest way to dissolve our differences while we build trust.
In The News...
A Patient Dies. A Hospital Heals
By Bill Santamour
H&HN Managing Editor
A fictional account of a tragedy and how a hospital changes for the better.
A patient dies after surgery despite the fact that checklists and other cutting-edge policies are in place to prevent such a tragedy. The clinical staff become defensive. Physicians close ranks to deflect blame. Nurses know that if somebody has to take the fall, it will, no doubt, be one of them. The hospital CEO understands that the fault lies not with individuals or policies, but with a staff too focused on their own task-filled workdays to see the bigger picture and too cynical to believe that things can ever fundamentally change. And the CEO herself is so overwhelmed by putting out everyday fires that she has no time to think about long-term solutions.
That’s the set-up of Heroes Need Not Apply, Brian D. Wong’s fictional account of Angels Hospital and the aftermath of a patient’s death, a death that could and should have been prevented. Wong, an M.D. and founder of The Bedside Trust, paints a familiar picture of today’s hospital staff, in which the sincere goal of putting the patient at the center of everything they do can get lost in the crush of workloads, silos, egos, long-standing hierarchies, skepticism and plain fear. His vivid cast of characters includes a brilliant but intransigent surgeon, a young doctor with conflicting loyalties, an outspoken nurse, a new CEO and the person she brings in to help change the culture.
OK, I can see you rolling your eyes at the term “change the culture.” But by getting inside each individual’s mind and allowing us to listen in on their thoughts and conversations, Wong avoids consultant jargon and preachiness. He presents a true-to-life scenario of personality conflicts common to all hospital staff and the endemic skepticism that often straitjackets any leader’s efforts to foster meaningful change. And he shows how a hospital CEO can overcome those obstacles to, as the book’s subtitle puts it, “build a patient-accountable culture without putting more on your plate.”
The crux of that culture change is eliminating the chain-of-command structure and moving to one in which listening and respect across job titles and individuals can lead to true team care. As someone at Angels Hospital says, “No one person, no matter how smart, was nearly as smart as a roomful of people.”
In his introduction, AHA President and CEO Rich Umbdenstock writes that Wong’s story “brings a human element to the equation and underscores the importance of making patients and their families full partners in the care process."
Heroes Need Not Apply is an excellent resource for you and your physicians, nurses, C-suite and board members. Might even make a good stocking stuffer. For more information, click here.
The opinions expressed by authors do not necessarily reflect the policy of Health Forum Inc. or the American Hospital Association.
Improved care coordination is essential to gaining the efficiencies required in this healthcare reform era. To move metrics in patient safety, experience, and quality, we must become effective at delivering coordinated team based care.
In his new book, Heroes Need Not Apply, Brian Wong MD, uncovers the reasons why many of us experience spotty improvements in patient safety, episodic service excellence, and insufficient engagement and accountability. To make sustainable improvements, we need to know how to migrate from a system that can best be described as uncoordinated (i.e. poor hand-offs, suboptimal staff interaction, medical hierarchies, etc.) to one that delivers consistent coordination of team based care.
The purpose of Heroes Need Not Apply is to give healthcare organizations a template for creating a strong foundation for effective coordinated care. This “how-to” book gives every executive, physician, nurse, and clinical team member the tools to make specific changes at the local level, and uses relatable characters to showcase effective patient-centered skills to improve efficiency, decrease costs, and improve the patient experience. If your hospital is looking to accelerate improvements in care coordination and improve team care,Heroes Need Not Apply is a timely resource designed to equip your organization with the practical skills required for improved care coordination.
The book has already caught the attention of many top physicians, nurses, and executives as an innovative resource to lead our industry into a new era of value based healthcare that is both cost effective and accountable to patients.
Dr. Wong's Heroes Need Not Apply is receiving praise by noted physician leaders and industry experts throughout the country...
“Heroes Need Not Apply examines the root causes of healthcare’s most pressing safety and quality challenges. It offers practical strategies to improve communication among staff, dismantle silos, and build high-performing teams.” — Richard J. Umbdenstock, President and CEO of the American Hospital Association
“I believe this book will help save lives, improve quality, and recommit healthcare providers and patients to new levels of trust.” — Sue Collier, MSN, RN, FABC - Performance Improvement Specialist, Patient-Family Engagement, NC Quality Center/NC Hospital Association
“Dr. Wong’s book “Heroes Need Not Apply” breaks new ground as a field manual for what WE can all do on the front lines to be leaders as opposed to “reactors’ of healthcare transformation.” — Stephen K. Klasko, M.D., M.B.A., President and CEO, Thomas Jefferson University Hospitals
"...[Dr. Wong] speaks the truth of what we must become as leaders in health care."
— Jeff Selberg, EVP and Chief Operating Officer, Institute for Healthcare Improvement.
“Amazing! Timely, accurate, stunning, motivating, frightening. More than reading, I consumed the book. What a wonderful story of cold truth.”
— Jack Cochran, MD, Executive Director, The Permanente Federation, LLC
“On the journey to team-based and patient-centric care the evolving healthcare system is indeed a place to which Heroes Need Not Apply."
—Joseph S. Bujak, MD, FACP
“Dr. Wong draws the reader into the world of the hospital and an understanding of the cultural barriers that contribute so much to preventable medical error.”
— Gordon R. Clark, President and CEO of iProtean