Wednesday, January 22, 2014

Tip 27: The Hard Costs of Soft Skills

Quicksand! Have a Nice Day

The Hard Costs of Soft Skills

Q: Do you really have time to take on soft skills?

We healthcare leaders and providers have no time to spare. On an average clinic day, we barely have time to deal with our basic personal needs. I get it… having spent many days caring for patient after patient only to forget to eat or check-in at home. So why should we set aside time to work on non-clinical skills that don’t come with a guaranteed ROI?

Bill Santamour, Managing Editor of H&HN, cleverly shared his readers concerns in a recent review of my new book. He shared, “I can see you rolling your eyes at the termchange the culture.”

A few years ago, management/branding guru Peter Drucker, provided a then new, but now accepted maxim that refocused the world of Organizational Development, “Culture Eats Strategy For Breakfast.” So why can’t we in healthcare take their lead and stop letting the “C” word stymie us? So many of us have developed a content over context mind-set that only focuses on operational efforts that minimize risk and are easy to measure. But where does that leave us when it comes to the practical skills we need every day?

I understand the mindset and the reticence toward change. But every Doc I know began practicing medicine to help patients - yet the current mindset is taking us further away from what matters most to patients.

A: The folks at Apple might say, "There's An App For That.”

Leaders like Joel Peterson, CEO of JetBlue, define trust as the key ingredient for organizational performance. Pauline Chen MD, of the New York Times knows that in cases of medical hierarchy, disrespect among physician hurts patients. Dr. Leonard Feldman, director of an urban health residency program at Johns Hopkins, has concluded our body language has significant consequences on patient satisfaction. In fact, his recent study also shared that when he followed two groups of medical interns for a month, he found they sat down at the bedside only 9 percent of the time.

So what do these leader-anecdotes have in common? Each of these leaders is setting a new context by digging deeper and asking the right questions. Questions that shift our current context and help us recognize the need for relational answers to operational problems. In other words, "There's A Soft Skill For That”.

I recently asked a group of physicians what was so special about the doctor-patient relationship?  Their responses focused on: empathy, listening, connection, compassion, confidence, trust.  Not only is this what matters most to patients, it matters most to us. I then asked, what would the benefits be if these skills we’re present in every interaction with our peers, staff and patients? They cited widespread impacts on collaboration, efficiency, quality, safety, satisfaction and fulfillment.

Aligning these so called “soft skills” around your organizational and/or departmental goals isn’t hard to do. It does, however, require attention, intention and focus.  As you discover and discuss the root cause of a problem, develop a solution that takes relational factors into account. When you put a relational lens on your operational problem solving, you’ll find that solutions become less time consuming and more durable. To become more patient-centered in our problem solving, we’ll need to work under the context that “soft skills” can provide hard results. Culture not only eats strategy for breakfast… it may even give some of you the time to grab a bite to eat once in a while.

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.

H&HN Daily, December 10, 2013

Heroes Need Not Apply... now on eBook

Kindle  iBookstore   Nook
Dr. Brian WongImproved 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
On Sale Now!
Kindle  iBookstore   Nook
To order your copy today and/or get quantity discounts for your organization visit:

A portion of the profits from the sale of Heroes Need Not Apply goes to support the Josie King Foundation.
Dr. Brian Wong
To learn more about Heroes Need Not Apply, and/or schedule an author’s interview for your organization please Click here>>
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