Tuesday, July 29, 2014

Tip 39: Can an organization’s culture make patients safer?

Welcome Back…

The following Coach Leader is part of 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 having a common direction can bring two people together to ignite an entire organization.

Our last issue left Jack and Jane discussing that the quickest way to build patient trust is to ask the right questions and then truly listen. It turns out, the same strategy works for increasing trust between staff members.

Jack knew from previous experience that to improve an organization’s culture, you first have to improve the quality of interactions people are having with each other. To measure change and progress, Jack and Jane set out to develop a tool that would help everyone in the organization contribute to improving the quality of their interactions. We join Jack and Jane after Jack just broached the subject of building a tool to help them advance their culture...

“Jack,” said Jane, “Are you sure this is the right way to go… the last thing we need is another survey that provides us with a bunch of data we can’t do anything with.”

“I agree wholeheartedly Jane. We can design a tool that not only helps us get clarity on what’s going on in the trenches…  it gives us cues on a regular basis that forces us to examine if our culture is contributing to or hindering care… and it brings culture to the forefront of our conversations rather than leaving them to lurk in the hallways.”

“You mean, we can develop questions that will get them all talking amongst themselves?”

Jack smiled, “Exactly. Every physician, nurse and staff member in this hospital has strong feelings about this organizations culture even though we may not directly address the issue. We'll make culture become part of everyone’s daily conversation just like everything else around here. This is how we clarify what culture is and how to change it. This is our cultural strategy".

“Got it,” said Jane. “ We need to set a little context for what our culture should and can look like. When it comes to patient safety, all of our people believe checklists are a tangible way they can contribute to improving safety… but with culture, they don’t know what to look for or what they can actually do to change things.”

Jack said, “ Patient Safety is a great example Jane. What if the first question we asked was something like: Does our organization’s culture make patients safer?”

“I love it. They might not be able to define what culture is yet…”

Jack interrupted,”Or how we see our culture becoming…”

“Yep. But we all have perspective to share when it comes to if our culture is positively or negatively influencing patent safety.”

“Exactly. The insights we’ll collect will be beneficial, but what's even more important  to me is that we are helping everyone begin to see how our culture can impact things as important as patient safety."

“Yeah Jack, there is a lot going on out there and most of us forget to see that our culture either drives or hinders safety. For instance, maybe… hopefully not… but maybe we find that certain departments feel that safety is sometimes compromised because of the way people interact with each other… but they have no idea what to do about it.”

Jack added on, “It’s not a stretch to say that many of us have just come to accept these types of interactions as business as usual.”

“But that’s about to change. This tool will bring quality interactions to the forefront of everyone’s mind and let them know how they can contribute to changing things around here.”

“And as you said earlier Jane, it begins with us helping everyone to see how we can all play a role in improving culture. As leaders we can instigate bottom-up change by setting needed context...this will give them the tools to make changes on a local level. I just read an article titled: Reinventing Healthcare: 5 Strategies for Successfully Leading Change. And the author actually defined culture as a business imperative - let me read you this one part:  “Culture no longer is about the soft side of business. Without the "right" culture, the best-laid operational plans will stagnate in the vertical hierarchy or fail from poor execution.”

“It’s good to know we’re not the only people going down this path,” said Jane, “Culture is finally being recognized for what it is… the most important factor in making our hospital more patient centered.”

Jack and Jane continued on with the survey working to determine what they really need to know on an ongoing basis. Join us next time as they continue to shape their cultural assessment tool. 

Here’s the link to the article quoted in their conversation:

See you next time. 

Is your culture aligned to what matters most to patients?... 
Click here to take the poll

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>>
Forward to Friend

No comments:

Post a Comment