Good is not good enough when excellent is required.

Illinois Critical Access Hospital NetworkNovember 11, 2015

For Teams to Do and Be Excellentthey Need to Feel Excellence

Michelle RathmanMichelle RathmanPresident & CEOPresident & CEO

Impact! Communications, Inc.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 MissionALIGN 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

ProcessProcess. To improve quality outcomes on the clinicalclinical 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 peoplepeople breach in the processprocess, 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. 8

Developing a Culture of CARE

CC – Commitment, Compassion & Collaboration

A – Appreciation, Acceptance & Accountable

RR - - Respect, Reinforce & Realistic

EE – Empathy, Expectation & Examination of Self

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A CARE CultureA CARE Culture

100% Caregiver commitmentApproaches to innovationAttitudes toward changeStyle of conflict resolutionTrust in Management / LeadershipOpenness and honestyPledge to consistently uphold excellence

standards

A CARE CultureA CARE Culture

Teamwork and cooperationHuman resource orientationOrganizational directionCommunication StyleAccountability – what are the consequences

for…?

What is the Team’s Tolerance Threshold?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?12

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 WHY IS IT DIFFICULT TO GET AND KEEP

EVERYONE ON THE SAME EVERYONE ON THE SAME PAGE?PAGE?

Culture is Complex and Culture is Complex and LayeredLayered

National Political CultureReligious CulturesEthnic CulturesRegional CulturesLocalDomesticWorkplaceDepartment

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 touchSolid long-term relationshipsFamiliar facesConvenience HospitalityMore time to spend with patients

Roadblocks in Today’s Rural Healthcare Culture – Some old some new!Everybody knows everybodyRelated people working togetherAverse to risk taking and changeLack of exposure to new approachesBoard knowledge of the broader issuesCommunity knowledge of your valueStressors 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!”

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Start a new conversation.

• Knowing “who” you’re talking to is a brilliant long-term 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?

The number one problem in all relationships stems from one thing -- Communication!

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 toA Culture of Excellence

WILL Begin to Move Out of Your Way!

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LONG OVERDUECOURAGEOUS & CLARIFYING

CONVERSATIONSStrategies for Improving Communication &

Relationships with Employees & Co-Workers

DEVELOP A PROMISE OF EXCELLENCENext Stop

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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