Transcript develop a promise of excellence

Good is not good enough
when excellent is required.
Illinois Critical Access Hospital Network
November 11, 2015
For Teams to Do and Be Excellent
they Need to Feel Excellence
Michelle Rathman
President & CEO
Impact! Communications, Inc.
Quality Transformation
is a Complex Process
and a Never-Ending
Pursuit for Excellence
Overarching Strategies to Achieve Excellence Across the
Healthcare Delivery Spectrum
NOT TRAINING. DEVELOPMENT!
– Reignite and Build Team Trust
– Create Opportunities to Teach about Personal and Shared
Accountability
– Improve Communication
– Leadership to Clarify, Reaffirm, Reinforce and Model
Service Excellence
– Teach Tolerance (acceptance) and Establish a Higher-Level
of Awareness around Personal Behaviors and the Impact
on Team and Patients
– Demonstrate Appreciation for all Team Members –
Caregivers who feel cared for deliver better care
– Reinforce the Commitment to Patient-Centered Care
Grounded in a Safe Culture
To Accomplish the Mission
ALIGN AROUND IT
 Permanently change quality scores and other issues that fall in the Red
Zone (patient complaints, customer service issues, repeated grievances,
unresolved and common communication problems);
 Eliminate swinging scores and missed opportunities and reduce
miscommunication;
 Understand the origin of negative patient feedback and prepare strategies
to reduce/eliminate contributing conditions;
 Develop and implement strategies to reduce errors in communication;
 Identify and shift individual and group behaviors impacting patient
perceptions and experiences;
 Ensure that every person understands the full financial implications of
their actions;
 Develop a shared understanding of the organization’s Philosophy of Care
and Service;
 Generate ideas that will build a principled approach that will provide clear
and thoughtful communication and behavior standards that each member
of the care team is committed to uphold.
“A culture of excellence
begins with people not
practice.”
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Data-driven clinical quality initiatives are fueled by
Process.
To improve quality outcomes on the clinical side, we have
multiple systems in place to ensure that all people in
contact with the patient are following the right and relevant
protocols for their care, every time.
This is the “DO”
When there is a people breach in the process, the direct
and indirect consequences to the patient, family and
hospital can be catastrophic.
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Data-driven patient satisfaction initiatives are centered
around communication . To improve quality
outcomes on the patient satisfaction side, it requires
people (all staff) to participate in training and education
that focuses on behaviors and on how best to deliver a
‘patient-centered’ experience.
This is the “BE”
When there is a people breach in communication, the
direct and indirect consequences to the patient, family
and hospital can be difficult (maybe impossible) to
overcome.
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Developing a Culture of CARE
C – Commitment, Compassion & Collaboration
A – Appreciation, Acceptance & Accountable
R - Respect, Reinforce & Realistic
E – Empathy, Expectation & Examination of Self
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A CARE Culture
100% Caregiver commitment
Approaches to innovation
Attitudes toward change
Style of conflict resolution
Trust in Management / Leadership
Openness and honesty
Pledge to consistently uphold excellence
standards
A CARE Culture
Teamwork and cooperation
Human resource orientation
Organizational direction
Communication Style
Accountability – what are the consequences
for…?
What is the Team’s Tolerance Threshold?
• Do any of your team members draw more complaints
than compliments?
• Is there anyone on your team whose behavior you or
others make excuses for or tolerate even though they
are disruptive to the team or compromising the
patient experience?
• What about initiating or participating in gossip,
negative talk about the hospital, tardy for shift, not
attend staff meetings?
• Give less than 100% and then justify?
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Over 20 Years Ago…
Nursing Economics Reported…April 1993
“Hospitals, to survive, must be transformed into
responsive, participative organizations capable of
new practices that produce improved results in
both quality of care and service at reduced costs.
Creating, managing, and changing the culture are
critical leadership functions that will enable the
hospital to succeed.”
…Strategic planning and effective
implementation of planned change will
produce the desired culture. Work
restructuring, a focus on quality management
along with changes in clinical practices, as
well as the care and support processes, are
all a part of the necessary hospital cultural
revolution.”
WHY IS IT DIFFICULT TO GET AND KEEP
EVERYONE ON THE SAME
PAGE?
Culture is Complex and
Layered
National Political Culture
Religious Cultures
Ethnic Cultures
Regional Cultures
Local
Domestic
Workplace
Department
Making the Connection to Cul·ture
Culture in your hospital is the:
SHARED OBSERVATIONS OF THE
LEADERSHIP TEAM!
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What are some of the things
Right with Rural?
Personal touch
Solid long-term relationships
Familiar faces
Convenience
Hospitality
More time to spend with patients
Roadblocks in Today’s Rural Healthcare
Culture – Some old some new!
Everybody knows everybody
Related people working together
Averse to risk taking and change
Lack of exposure to new approaches
Board knowledge of the broader issues
Community knowledge of your value
Stressors of Adjusting to Reform
“Behavior modification does not
move at the same speed as
decisions made.”
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“Fundamentally, we know there
are big payoffs for better quality
and service. In reality, people do
not become nicer even when
they’re paid better.”
Making Change Real and
Sustainable
Becoming an “ALWAYS” 24/7 Culture of Quality,
Care and Service Excellence is challenging.
It requires unwavering COMMITMENT, consistent
REINFORCEMENT and visible ACCOUNTABILITY -guided by LEADERS and CAREGIVERS of the
organization who agree to uphold the new
standards for relating and communicating.
“Communication is the key
not a cliché!”
Start a new conversation.
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The number one problem in all
relationships stems from one thing
-- Communication!
• Knowing “who” you’re talking to is a brilliant longterm communication strategy!
• Higher performing leadership teams know the inborn
strengths of each person on their team and how they
appreciate being communicated with.
• All too often, it easier to focus on weaknesses instead.
• Does your team lean toward searching for the guilty
party?
Different Needs and Views
Selling the idea of culture transformation, and
the way caregivers respond to -- and embrace
change is personal. While we all have different
needs, the key is everyone traveling in the same
direction. Arriving at quality relies on it!
“Your main objective is to
focus on shifting behavior vs.
changing people.”
Higher Performing
Leadership Teams are
Multi-lingual
“Speaking a universal language
can remove the roadblocks to
excellence.”
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Once the Team is Speaking a
Language that Everyone
Understands…
The Roadblocks on a Path to
A Culture of Excellence
WILL Begin to Move Out of Your Way!
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LONG OVERDUE
COURAGEOUS & CLARIFYING
CONVERSATIONS
Strategies for Improving Communication & Relationships
with Employees & Co-Workers
Next Stop
DEVELOP A PROMISE OF EXCELLENCE
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How do you get everyone to ‘act’
the same?
• If you have:
–
–
–
–
–
An employee handbook
Dress Code
Code of Conduct
Mission, Vision, Values Statement
Compliance Guidelines
• The next thing you may consider is a
– A PROMISE OF EXCELLENCE and CULTURE OF
SAFETY MOVEMENT!
Why have a Promise of Excellence
and Culture of Safety Movement?
• To be Known for your Excellence in Patient Care and
High Quality Service
• To Employ ONLY those who Embrace a “WILL-Do” Attitude
• To Achieve Consistently High Patient Satisfaction Scores
• To Ensure a Shared Mission of Zero Readmission
• To be Supported By and Better Connected With Your
Community
How can you develop your very own
Promise of Excellence Plan?
• Identify and Discuss the Hot Zones
• Develop Strategies to Get at the Fires
• Explore Options to address:
• People Issues
• Process Issues
• Procedure Issues
• Review “Wish List” for Customer Service
Improvement Tools and Programs
• Draft a Promise of Excellence Guideline that Clearly
Spells Out Acceptable Behavioral Standards
Give your team the right words to
say when their words matter the
most!
Provide team members with key language and
conversational prompts to be used to enhance
communication with patients, families, visitors
and providers.
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When you make an investment (and protect it) in your
team’s communicating and relating skills, you will feel,
see, and be able to quantify the positive impact on your
bottom line, in their lives, and in the experiences of
your patients!
How do you measure the impact of
culture shift?
• Decrease in the number of disciplinary interventions
by Human Resources
• Increase in individual and team goal attainment
• Improved safety measurement and performance
• Improved patient satisfaction
• Increased employee engagement
• Improved hospital-wide communication