Thursday, May 22, 2014

Tip 35: A patient-centered culture requires a strategy

A patient-centered culture requires a strategy

For those of you just joining us, we’re in the midst of an 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, the right mind-set and having a common direction can bring two people together to ignite an entire organization.

The following behind-the-scenes conversations between our fictional CEO Jane Carolli and her new, game-changing VPMA, Dr. Jack Martin take place as they begin to focus the culture at Angels of Seattle hospital around what matters most to patients. Our last issue centered around all the data we gather and what we do with it. Specifically, on tracking the behavioral and attitudinal data necessary to literally evolve a culture, and determining the questions necessary to really change what’s going on at the bedside. 

Join us as the conversation continues…

Jack knew better than to show up at Jane’s office without a couple of Grande Americanos - their conversations always run long and deep… and that’s what he loved about them.

Jack handed Jane a coffee and asked, ”Don’t you think culture requires a strategy just as any other strategic priority?”

Jane grabbed the coffee with a thank you smile saying, “You bet Jack, and it’s true. The problem is that too much has been left to chance… our current culture is stuck in its ways, and everyone’s scared to death of change. Everyone around here sees how culture impedes every strategy we try… actually, it overwhelms it. No matter how much effort we expend, we seem to end up not far from where we started.”

“It’s interesting,” said Jack, “Culture, or the shaping of culture should be looked at as a first priority strategic goal.”

“I never thought about it that way Jack, but it makes sense. How we interact with each other can be changed… that’s what we need to focus on here…”

“Yes,” Jack cut in, “We are, and when you think about it, evolving this culture is the only strategy that affects every aspect… every metric we’re tasked to improve.”

Jane sighed, “Looking at our current state, it’s obvious we’ve been trying to fix the symptoms of a culture that’s been left to chance. We’ve spent the last two years here collecting a ton of data and few around us know how to make use of it, other than tread water in a pool of initiative overload.”

“Don’t beat yourself up Jane. Water under the bridge, so to speak. Let’s stay in the moment and shift our thinking from content to context. Starting right now, we can focus on the quality interactions needed to turn this culture around.”

“But Jack, I’ve got so much time and energy invested in my current strategy…”

He interrupted, “But is it working?”

She shook her head no.

“Then pivot Jane. It’s not only okay to change course, it’s the smartest thing you can do. You know Jane, the most customer-centric companies are agile - they align their culture with their customer by involving everyone in the process. Some of the most successful people fail because they continue to count on game plans that they’ve had success with in the past… as I said, it’s not only okay to readjust… it’s imperative.”

“I get it Jack. That’s another thing I like when it comes to thinking about culture as my main if not only strategy… no matter what changes, it will always be the “be all end all” solution for success. It’s the only thing that will help us to give patients what matters most to them.”

When we rejoin the conversation next time, we’ll overhear Jack and Jane better clarify what the current state of their culture really is, and what they have to do to change it…

Is your culture aligned to what matters most to patients?... 
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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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