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Recently, we received a large number of inquiries about our last several blogs here at Hospital Impact. In particular, people are interested in how they can create a culture of innovation in their organization. They're also interested in why it's so hard to get people to become more innovative, creative and capable problem solvers. Times are changing, and to make new ideas actually happen, people need to see, feel and think in new ways those elusive innovations.
Healthcare changes push hospitals and providers to rethink their core values, beliefs and behaviors: the essential elements of their culture.
Indeed, the movement from volume to value sounds cool, but what does it really mean and how do we actually do it? Keeping people out of the hospital sounds easy. Yet the trends suggest that as Baby Boomers age, their in-patient needs will accelerate, not diminish. What is the right direction? When will we know we are making strides? What are the key metrics that show progress, and when do we have to pivot and rethink the new processes or programs we have put into place?
by Sherri Loeb
As I reflect on my daughter Jennifer's first few weeks as a new intern in internal medicine, I can't help but look back at my experience with my husband during his battle with prostate cancer and think that perhaps there still is some hope for empathy, transparency and honesty.
Jennifer also witnessed her father throughout his illness through the lens of a loving daughter, as well as that of a medical student. At that time, I hoped what she learned not only through this experience, but for many years of discussions at the dinner table, she would carry on into her own practice as a physician.
Recently, I read a blog written by a physician who experienced first-hand what it was like being a patient. As H. Lee Kagan, M.D., writes, "There is no better lesson for a doctor than to be a patient." Later, he writes, "I wouldn't wish misfortune on anyone as a lesson in empathy. But as I get into the later stages of my professional career, it's become clear to me that one's capacity to empathize grows with life experience. Though there are exceptions, I believe there's only so much most healthy twenty-something-year-old medical and nursing students can know about loss, incapacity, disappointment, betrayal and triumph that make up the fabric of life within which illnesses play out. So we help as best we can by teaching skills, sharing stories and by setting examples at the bedside and in clinics."
I quip that I have amphibian DNA because despite having worked in 43 states, I learned the hard way that each hospital has different people, culture and expectations.
I was told that physicians clammed up when in a room with administrators.
Yet, when I taught leadership development to physicians at a hospital in the South, discussing the role of relationships, communication and team-building, a COO attended and participated in my sessions. We had a session on ways to avoid amygdala hijack, having the mid-brain take over at a time of stress, leading to deteriorating relationships. I mentioned that sometimes 20 to 30 seconds is all that we need to give the frontal cortex the opportunity to overcome the stress response and promote communication and team-building to improve patient care outcomes. For example, we can pause--take a breath, sip water, ask a question, and/or leave the room for a moment.
by Kent Bottles
In a famous 1927 essay titled "The Care of the Patient," Francis Peabody states that the personal bond between the doctor and the patient is the source of the "greatest satisfaction of the practice of medicine." Many providers who balk at the rapid transformation of the American healthcare delivery system complain that electronic medical records and other interventions interfere with this central relationship. It is always assumed the interaction between two living human beings is central to the care of patients.
My embrace of the above conventional wisdom was first challenged by Joseph C. Kvedar, M.D.'s concept of emotional automation with its belief that humans can and will develop trusting relationships with sociable humanoid robots. My skepticism was gradually overcome by Kvedar's examples of Karen, the virtual wellness coach/avatar, who motivates human patients to exercise more than a control group, and the Boston hospital patients who preferred a robot discharge planner to a human nurse. In the latter case, the patients commented that the robot was never in a hurry and did not talk down to the subjects.
Martin Luther King Jr. was able to attract over a quarter million people to the Mall in Washington, District of Columbia to hear his famous "I Have a Dream" speech. How was he able to do this without the internet, email, texting, Facebook or Twitter?
He did this because of how he communicated his beliefs and how those beliefs struck emotions in people of all walks of life. He did not have a 12-point strategic plan on a PowerPoint presentation--he had a dream. Leaders inspire and people want to follow them. Managers gain cooperation based on their hierarchical power. Which one are you?
What Do I Believe in?
Here are some of my common beliefs based on a lifetime in healthcare and from an executive's perspective. I believe:
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