These 6 healthcare leaders say quality improvement is an organizationwide effort and a cultural imperative

https://www.fiercehealthcare.com/healthcare/6-inspiring-quotes-improving-quality-from-6-healthcare-leaders?mkt_tok=eyJpIjoiWVRNeE1HSTFPREkwTmpsbSIsInQiOiJtcHFUTmw4bU5UWE0rbE44Q0ExcUc5cEI5SSt0UVdcL0ZYVDllbUhMN3VNXC9ab2JTTlwvKzVYOXMyTmVmRlwvZjJ2VzNZWmp5Z2VJeERzVytyWUZOdkVyRmdnVWNWSEV6SVhkSWVHSFljSkhRV05rMUt5WFwvemVvM2dsMEpUeW1rYUx2In0%3D&mrkid=959610

Executive looking out window

Despite recent uncertainty about the government’s commitment to value-based care, healthcare organizations remain focused on efforts to improve quality, patient care and employee engagement.

In 2017 the Centers for Medicare & Medicaid Services cancelled mandatory bundled payment models for hip fractures and cardiac care and also asked providers for feedback on other value-based payment models.

But healthcare organizations seem committed to the initiatives they have already put in place to improve quality. Indeed, last year healthcare leaders shared their successes, challenges and lessons learned as they worked to improve quality and patient outcomes. We’ve rounded up the most memorable quotes from these healthcare thought leaders about quality, the importance of physician engagement and how to achieve a culture of patient safety.

Here are six of our favorite quotes from our interviews and industry news and event coverage over the past 12 months:

1. “We had to challenge our old paradigms. Physicians are instrumental in setting the tone, and unless the physicians believe we’re on the right path we don’t have the kind of alignment that will help us move forward.”

Gary Kaplan, M.D., chairman and CEO of Virginia Mason Health System, explained in a webinar this fall how the Seattle system improved patient safety using a patient-centered approach. Virginia Mason’s safety culture transformation began in 2001, Kaplan said, when system leaders realized that a physician-centered approach alone would not improve patient care.

2. “You need to start with the early adopters. You can’t start with folks who will fight you tooth and nail. You want to start with early successes and then evolve from there.”

Felipe Osorno, an executive administrator at Keck Medicine of the University of Southern California, spoke at the Institute for Healthcare Improvement’s annual quality forum about strategies to engage physicians in improvement initiatives. The secret was designing a program in which physicians were respected for their competency and skills, their opinions were valued, they had good relationships with their medical colleagues, they had a broader sense of meaning in their work and they had a voice in clinical operations and processes, he said.

3. “We really want to attract folks who believe at their core, not just intellectually but in their heart, that kindness can heal. … If we do it right the first time and we assess candidates based on the fit of the organization, ideally we will have more engaged employees who deliver care in a way that is patient-centered.”

Wanda Cole-Frieman, vice president of talent acquisition at Dignity Health, talked to FierceHealthcare this summer after the California system was named by an online job platform as the best place to interview in 2017. Among its techniques: It assesses candidates’ behavioral competencies for human kindness, compassion and the human experience.

4. “To create a true culture of safety and reliability we need to engage everyone, and it can only be driven when we have strong alignment. Everyone can play a role in safety.”

Gary Yates, M.D., a partner in strategic consulting at Press Ganey, explained in an interview that building and promoting a culture of safety at healthcare organizations is important to retain current staff members, but is also an especially effective recruiting tool for millennials, who will make up half of the workforce by the year 2020.

“People talk, and people ask about the culture inside different organizations,” Yates said. Putting the spotlight on safety and quality could “tip the scales” for young people.

5. “Our focus is safety, to fundamentally be a safe hospital. If we start there or if any hospital starts there, patient experience will take care of itself, quality metrics will take care of itself as will employee morale.”

FierceHealthcare caught up with Nicholas “Nico” R. Tejeda, CEO of The Hospitals of Providence Transmountain Campus in El Paso, Texas, at an American College of Healthcare Executives event. He talked about opening a new teaching hospital and establishing the culture of the organization from the beginning and with every hire.

There are no acceptable levels of errors, he said. And while it may be nearly impossible to achieve zero incidents, he still wants the organization he leads to strive for perfection.

6. “We don’t see quality as just a clinical goal. It’s an enterprisewide priority that encompasses customer service, compliance and wellness.”

A few years ago, Anthem decided to make a “rigorous” effort to boost the quality of its plans. And it’s demonstrating results, Anthem’s then-CEO Joseph Swedish said during the 2017 AHIP Institute & Expo. Now, more than half of the insurer’s Medicare Advantage enrollees reside in 4-star plans, compared to just 22% the year before.

 

NEARLY 50% OF UPPER-LEVEL MANAGERS AVOID HOLDING PEOPLE ACCOUNTABLE

Nearly 50% of Upper-Level Managers Avoid Holding People Accountable

 

46% of upper-level managers are rated “too little” on the item, “Holds people accountable … .” (HBR)

You missed the point if accountability is:

  1. Coercing reluctance to do things it isn’t committed to do.
  2. Expecting performance from weakness. Accountability won’t help squirrels lay eggs.
  3. Punishment.

Accountability:

  1. Says we are responsible to each other.
  2. Expresses commitment. Those who aren’t willing to be accountable haven’t committed.
  3. Defines dependability. What’s more insulting than one unprepared person on a team filled with talent?
  4. Demonstrates confidence and self-respect.
  5. Sets the ground rules for respect and trust.

Accountability recognizes strength and honors performance.

Mutual accountability:

I’ve never been asked to lead a workshop on how to hold ourselves accountable. It’s always about others. That is the heart of the problem.

Accountability is something to work on together, not mandate from on high.

One-sided accountability:

  1. Leverages fear.
  2. Depends on carrots and sticks.
  3. Promotes disconnection and arrogance. Relationships disintegrate when leaders stand aloof.
  4. Invites resentment and disengagement.
  5. Dis-empowers those who need to feel powerful.

Mutual accountability:

  1. Requires leaders to go first.
  2. Demands respect-based interactions.
  3. Strengthens connection and relationship. We are responsible to help the people around us succeed.
  4. Honors integrity and courage.
  5. Gives opportunity for humility.

Jim Whitehurst, CEO of Red Hat, said, “Go into every interaction with those who work for you believing that you are as accountable to them for your performance as they are to you for their performance.”, and author of, “The Open Organization.”

Practice accountability:

Blurry responsibility leads to vague accountability. Vague accountability is no accountability.

  1. Who owns the project or initiative?
  2. Who makes decisions? The group. A project leader. Someone who isn’t in the room.
  3. What are the deliverables?
  4. What are the milestones and deadlines?
  5. What happens when deadlines are missed?

Complexity is like fog to accountability.

What might mutual accountability look like in your organization?

How might leaders lift accountability out of the category of punishment?

4 MORE ENEMIES OF VITALITY ALL LEADERS MUST AVOID

4 More Enemies of Vitality All Leaders Must Avoid

Leaders who suck the life out of people promote failure and embrace defeat.

The first four enemies of vitality:

#1. Distrust.

#2. Disrespect.

#3. Proper channels.

#4. Excluding the outside.

Posted here.

4 more enemies of vitality:

#5. Isolation: the message that others don’t matter

3 ways ineffective leaders practice isolation:

  1. Avoid the front-line. Hang with the upper crust.
  2. Mandate don’t communicate.
  3. Make policies when something goes wrong rather than using values as guides.

#6. Favoritism: discouragement for the masses. Energy for the favorites.

Leaders play favorites when they:

  1. Believe they’re above flattery. “… we have a craving for anything that makes us feel good about ourselves. We’ll go to great lengths to get positive feedback, … .” (HBR, July 2010)
  2. Give cushy assignments based on the brown-nose index. (Those who brown-nose the most are at the top of the brown-nose index.)
  3. Promote suck ups. The more someone kisses up, the more likely they are to move up.

Suck-ups get ahead because flattery works.

#7. Lousy meetings: insulting the brains around the table

Talkative leaders suck the life out of meetings.

Rule of thumb: The leader of any meeting speaks no more than 25% of the time. (15 minutes in a 60 minute meeting.)

  1. Assign agenda items to team members.
  2. Create discussion by asking everyone to give one reason why the idea on the table won’t work. Turn the tables and ask everyone to give one reason the idea should be adopted.
  3. Call on quiet team members. If the person is an introvert, give them prep time. “Wilma, would you prepare to address item #2 on tomorrow’s agenda?”

The worst romance is infatuation with the sound of your own voice.

#8. Cowardice: playing it safe is rewarded with advancement

Cowardly leaders:

  1. Can’t make decisions.
  2. Hide behind policy.
  3. Throw people under the bus.

Cowardly leaders suck the life out of people who want to get something done.

Which one of the eight enemies of vitality is most deadly?

What leadership behaviors suck the life out of people?

 

THE LISTENING SANDWICH AND INSPIRING OTHERS

The Listening Sandwich and Inspiring Others

Banter provides relational energy but don’t focus on yourself.

People enjoy hearing leaders talk about themselves as long as they don’t talk about themselves all the time.

The listening sandwich:

  1. Show interest in others.
  2. Share a bit about yourself (Banter).
  3. Show interest in others again.

Illustration:

A leader told me his word for 2018 is “Care”. We practice the “One Word” principle described in the book of the same name.

Instead of asking him a series of questions, I shared a bit of myself, “My word for 2018 is “Book”. For a moment, the conversation turned toward me.

When banter turns ugly:

Banter turns ugly when it becomes a monologue about yourself.

Inspiring leaders make conversations about others. Yes, share a bit of yourself. Let people know what you think. But a series of machine-gun-questions makes people wonder what you’re after.

Banter lowers barriers.

From banter to curiosity and inspiration:

Banter – sharing a bit of yourself – sets people at ease.

I have questions about “Care” for my friend. The fact that he knows my “word” establishes a connection point as long as we discuss BOTH words.

I want to inspire my friend as he “cares” in 2018. The questions I have for him don’t feel like an inquisition because he knows my word.

Curiosity strengthens connection, nurtures humility, and inspires others.

Curiosity:

  1. You’re already a caring leader. How did you happen to choose “Care” as your word for 2018?
  2. What’s important about caring?
  3. How will you take your Care-game to the next level?
  4. How’s your care-game going?

Because he knows my word, curiosity about his word is vulnerability for me.

How might leaders employ the listening sandwich?

When is sharing about yourself out of line for leaders? Too much?

 

Nursing named most trusted profession for 16th consecutive year

https://www.beckershospitalreview.com/human-capital-and-risk/nursing-named-most-trusted-profession-for-16th-consecutive-year.html

Image result for 16 straight years most trusted profession

Nurses are the most trusted professionals in the United States, according to the 2017 edition of Gallup’s annual poll. The poll marks the 16th consecutive year nursing topped the list as the most honest and ethical profession.

For the 2017 poll, Gallup asked a random sample of 1,049 U.S. adults to rate honesty and ethical standards for 22 occupations. The respondents selected ratings of very high/high, very low/low or average.

Healthcare providers took three spots in the top five most trusted professions, with a high percentage of respondents rating their honesty and ethical standards as very high or high. They are listed below along with their rank:

  • Nurses (1) — 82 percent rated honesty and ethical standards very high or high
  • Medical doctors (4) — 65 percent
  • Pharmacists (5) — 62 percent

Since Gallup first included nurses in the survey in 1999, respondents have ranked the frontline providers as the most trusted profession in all but one year. In 2001, firefighters topped the list after Gallup included the profession in the poll in the wake of 9/11.

“Nurses provide much more than bedside care,” said Pamela Cipriano, PhD, RN, president of the American Nurses Association, in an emailed release. “We advocate for patients, deliver primary care, meet the complex needs of patients with chronic conditions, volunteer for disaster relief efforts, and are a trusted voice in boardrooms across the country.”

 

THE GIFTS OF LEADERSHIP: HOW TO GIVE ADVICE THAT PEOPLE RESPECT

The Gifts of Leadership: How to Give Advice That People Respect

the surprising truth about giving advice

People don’t want advice. They want the pain to go away. They want to keep doing the same thing but get different results.

The world is full of answer-givers, but who can find a skillful advisor?

The surprising truth about giving advice is it’s more about listening than talking.

What kind of advisor are you?

  1. Expert. You know something others need to know. Perhaps you have relevant technical knowledge.
  2. Experienced. You’ve been there and done that. You’ve failed and learned.
  3. Skilled. You have relevant abilities?
    • Problem-solving.
    • Conflict-resolution.
    • Option-generating.
    • Question-asking.
  4. Outsider. You see things differently. Perhaps you’re older or younger, married or single, on the front-line or in management, or from a different culture.

Warnings:

Don’t fall in love with giving advice.

Give advice from a position of humility. It’s heady to have someone seek your advice. Keep your feet on the ground.

Avoid these seven advice-givers.

#1. Needy advisors rush to answers. Good advice begins by exploring and defining problems. People who are eager to tell people what to do, don’t know the real problem.

Explore roots, not just fruits. There are symptoms to problems and there are root causes.

#2. Hard-headed advisors make up their minds quickly and defend their position.

#3. Inept advisors neglect values and strengths. Advice needs to fit the advisee. Generic advice should be presented as guiding principles that anyone might use.

#4. Bungling advisors think it’s all about advice and forget about energy. Good advice fits the situation AND lights people up.

#5. Incompetent advisors always have an answer. Instead say, “I don’t know, but lets figure it out.”

#6. Self-centered advisors talk about themselves more than asking about others.

#7. Confused advisors have it all together. They don’t have their own issues, challenges, and problems. Problem free advisors are blind, ignorant, arrogant, or all three.

Anyone who has it all together, doesn’t.

How might you turn the above warnings into suggestions for giving advice that people respect?

What are the qualities of skillful advisors?