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3/8/2017

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Want to Improve the Experience?

Then Get Ready to Lead Culture Change!

Carol Santalucia – Cleveland Clinic

Richard Corder – Wellesley Partners, Ltd.

Tuesday March 21st 2017

Tweeting? Follow the conversation @carolsantalucia @richardcorder #PX2017 #ptexp

Carol and Richard

• #PX2017• #ptexp


@richardcorder@carolsantalucia

Our Expectations – Commitment to you

• Conversation OVER Reading Slides

• Stories OVER Theories

• Questions AND Answers

• Good, Bad, AND Ugly

• Find and Grow TRIBE


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TRIBE


Your Expectations of Us


What is an Experience?

All that is perceived, understood, and

remembered.


What do your patients and their families remember about their last visit to your

hospital or practice?

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Our Time Together

1.Philosophy

2.Plan/Action

3.Outcomes



How can we craft an experience for those we serve?


Clarity

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Clarity of Priorities in Healthcare

Ours

1. Productivity/Efficiency

2. Competence/Expertise

3. Safety

4. Kindness/Compassion

Patients and Families

1. Kindness/Compassion

2. Competence/Expertise

3. Productivity/Efficiency

4. Safety


Put Another Way…

1. Please be kind to me and my family

2. Please heal/fix/help me

3. Please don’t waste my time

4. Please don’t hurt (or worse) me


Clarity of the Problem – Team Effectiveness Model


Interpersonal Relationships

Management Processes

Roles

Goals

Model developed by Rubin, Plovnick and Fry

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Culture

“Organizational culture is the behavior of humans within an organization and the meaning that people attach to those behaviors”

Edgar Schein PhD (1992)

“The way we do things around here”

Deal and Kennedy (2000)


Culture Questions


Is this the culture we want and are proud of?

Is our culture purposeful, positive and productive?

This is a Marathon

• Don’t focus on changing culture

• Get clarity on the goal – the future state of the experience

• Focus on getting yourself and those around you involved and engaged in: • Where you are and where you want to be• What is in the way?• How will you solve those problems?• How will you lead?


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If It Is To Be It Is Up To Me

“If we could change ourselves, the tendencies in the world would also change. As a man changes his own

nature, so does the attitude of the world change towards him. … We need not wait to see what others

do.”

(Be the change you want to see in the world)

Mahatma Gandhi



Can’t have accountability without clarity

“If you don’t know where you are going any road

will get you there.”

Lewis Carroll


18

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Change is a Personal Choice

Before an organization can change – individuals must change

• For each individual – change is a choice

• To understand your team:• One must first understand relationships

• To understand relationships:• One must first understand individuals

• To understand individuals:• One must understand oneself – “personal mastery”


94%Tweeting? Follow the conversation

@carolsantalucia @richardcorder #PX2017 #ptexp

Strategic Change Model – The Plan

Visioning Process:Create the Future State

Step 2Step 1Document Context

for Change

Context forChange

(The “Why”)

The Future State

(The Vision/Goal)

The CurrentState

(The StartingPoint)

Step 3

Milestones/

Enabling Goals

Step 4

Execute PlanStep 5

Build Strategy(The Translation,

The “How”)

Build the Plan(The “What”)

21Tweeting? Follow the conversation

@carolsantalucia @richardcorder #PX2017 #ptexp

3/8/2017

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One JourneyThe Cleveland Clinic Health System


Cleveland Clinic Health System

Mission in 1921

• Care for the sick

• Investigate their problems

• Educate those who serve

Dr. William E. Lower Dr. John Phillips

Dr. Frank E. Bunts Dr. George W. Crile


Standing on History

• The values established 95 years ago are the same ones that guide Cleveland Clinic today:

Better care of the sick

Investigation of their problems

Further education of those who serve.

• Since 1921, the goal has been consistent, to put patients first


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“The patient coming into the hospital should feel the touch of human kindness all through

his treatment.”

-John Phillips, MD

Co-founder, Cleveland Clinic (1921)


2005 New Leadership

“What was the key to our historical success, would not be adequate in the future…..”


Cleveland Clinic Performance HCAHPS Ratings - 2009

58

24

3628 30

18

37

26

0

20

40

60

80

100

D/CInfo

DoctorComm

NursingComm

Clean PainControl

Response MedsComm

Quietat Night

CC National %ile Ranking

National Average

% Yes % Always


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“Patients were coming to us for our high quality care, but they

did not like us very much.”

- Toby Cosgrove, MD

President & CEO




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What Shapes Culture?


Empathy the Human Connection


Transforming the Patient Experience2008

•Chief Experience Officer

•Office of Patient Experience

• Increased Focus on Patient Experience


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Cleveland Clinic Experience


Engaged Leaders

Hire for Success

Service Excellence

Feedback Caregivers

Recognition

Patient Feedback

Caregiver

Service Philosophy & Objectives

1. Increase the awareness of the impact of every patient, visitor and employee interaction

2. Understand the role of the employee is greater than the tasks associated with his/her job

3. Empower employees to deliver world-class care


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How can you measure culture change?

The number of people that attended “cultural renewal training”

The number of values posters that have been hung

The number of value “wallet cards” that have been distributed


An Index of sorts…

• Knowledge – do people know our values, standards, expectations, etc.

• Behavior – What do we observe – “inspect what you expect”

• Perception – Of those you serve - Patients, Families, Caregivers, Physicians, Vendors, etc.


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Cleveland Clinic Hospital Experience Ratings2009 Compared to 2013

% Yes % Always%

Strongly Agree


58

24

3628 30

18

37

26

88

66

80 7772

61

72

38

90

0

20

40

60

80

100

D/CInfo

DoctorComm

NursingComm

Clean PainControl

Response MedsComm

Quietat Night

CareTrans

National %ile Ranking

So does changing our culture make a difference?

• Research 1 shows that:

Kinder care

Better information sharing

Compassionate practice

• Leads to a range of improved health outcomes…


• Faster healing of wounds

• Reduced pain

• Reduced anxiety

• Reduced blood pressure

• Shorter hospital stays

• Shorter duration and severity of the common cold.


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A kinder work environment benefits caregivers:

More engaged

Less exhausted

Less likely to quit

Less likely to burn-out



Some Lessons that We’ve Learned

• Know yourself

• Understand others

• Build trust

• Demand debate

• Take risks


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Some Choices that We’ve Made

• The language we choose

• The attitude we choose

• How we take care of ourselves

• Who’s in our tribe

• Ask for and listen to the feedback




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