Monday, August 25, 2014

Tip 41: A State Of The Art Experience

Patient-Accountable Culture

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 a common direction can bring people together to ignite an entire organization.

When we last left Angels of Seattle, CEO Jane Carolli and VPMA Dr. Jack Martin, they were continuing to craft a strategy to improve their culture by developing a cultural tool to help drive change.

As they build the tool, the day-to-day issues of running a hospital couldn’t be put on the back burner. Our current issue finds the two coming out of a board meeting…

Walking down the hall, Jane spoke first, “Jeez Jack. I was prepared to talk about our new insights on improving our culture, but everyone wanted to talk growing revenue and the brand research.”

“I hear you Jane, but I get it.”

Jane shot back, “I do too, but we just spent 45 minutes listening to a marketing consultant school us about growing brand equity - don’t they realize that this culture must be the basis of improving our brand in this community… to shaping how our patients and potential… I hate to use this word… customers think of us?

Jack smiled, “ It makes sense to me Jane… and we need customers. Have you looked at the advertising lately? We do a great job focusing on state of the art equipment, new surgical techniques, awards and new OB suites… when we should be selling the state of the art experience our people provide. Sometimes it feels like our industry takes the ultimate human experience and reduces beneath a transaction into a commodity.”

“I know” said Jane, “It is interesting…here we are in the most human of industries and our marketing mailers look like they come from a lawn care company… not too emotional. We’re not going to build lasting relationships with patients if we don’t put the value of their experience first. It seems like the only way to truly differentiate ourselves from other systems is to focus on the quality of each and every interaction we have with patients.”

“You nailed it Jane. It would be interesting to ask patients what matters most to them and build a marketing campaign around that. Do we really think we’re going to build trust in this community by touting national awards? Patients I talk to already expect clinical proficiency…what they really want to hear is that our physicians are going to be accessible when their family has a question, that their care team takes time to huddle on their behalf, and that everyone in this new finely decorated building is easy to approach.”

“You know Jack,” said Jane, “ Everything we’ve been doing with our cultural strategy - especially crafting this assessment tool, is all about helping us build better relationships with patients. There are no short cuts when it comes to building a trusted brand. It must flow from focusing on the human factors that matter most to patients in our community.”

Jack smiled. “Let’s get back to your office and talk about the next couple of assessment questions - lets write a couple that ask just how accessible our care teams are around here… “

“And maybe one about how approachable they are…”  

The board’s concerns at Angels of Seattle is far from unique. But as Jane explained, their concern about the bottom line is connected at the hip with having a trusted culture that’s accountable to what matters most to patients. And one of the first things you can do to promote moving in that direction is to start having the same discussion Jack and Jane just had. We all have to look at how we interact with each other and our patients more closely. What do your patients value?

See you next time.

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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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