The Role of Leadership in a Compassionate Culture February 6, 2018 Carol Santalucia, MBA Director, Service Excellence and Culture Cleveland Clinic

Agenda Culture Change at the Cleveland Clinic Defining a Compassionate Culture Overview of Communicate with H.E.A.R.T.® Understand the importance of leading with both Strength and Empathy. Lessons Learned

2005 New Leadership “What was the key to our historical success, would not be adequate in the future…..” We had to better centralize our care ‘around the patient’

  “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)

What is a Compassionate Culture? You cannot mandate you have to own it Upfront – taking responsibility before you know the outcome Self-Empowerment – how are you going to achieve it After the Fact taking accountability for the outcome

Empathy the Human Connection

The Thing About Culture “If it is to be, it’s up to me!”

Service Philosophy & Objectives Increase the awareness of the impact of every patient, visitor and employee interaction Understand the role of the employee is greater than the tasks associated with his/her job Empower employees to deliver world-class care

Lead with Heart SM Heart HuddlesSM

S.T.A.R.T. with Heart Smile and greet warmly Tell your name, role and what to expect Active listening and assist Rapport and relationship building Thank the person (Make a connection between Leadership Qualities that they identified??) Review the S.T.A.R.T. with Heart Model. And incorporate the importance of the expected service behaviors for you with your team(s) and for your team(s).

Respond with H.E.A.R.T. Hear Empathize Apologize Respond Thank (Make a connection between Leadership Qualities that they identified??) Review the S.T.A.R.T. with Heart Model. And incorporate the importance of the expected service behaviors for you with your team(s) and for your team(s).

Leading with Strength and Empathy: Why? Caregivers want & need the same consideration and emotional connection as our patients Employees appreciate clarity and consistency Using empathy builds trust and strengthens relationships with caregivers Using empathy doesn’t undermine your strength as a leader Consider deleting

Empathy is a leadership tool Empathize Empathy is a leadership tool Transformational leaders need empathy in order to show their followers that they care for their needs and achievement. Authentic leaders also need to have empathy in order to be aware of others. Empathy is also a key part of emotional intelligence that several researchers believe is critical to being an effective leader. This slide should be talking points under slide #15 Leading with Strength and Empathy Refer back to good qualities as a Leader How can we lead with Heart what is our responsibility … Empathy in the Workplace, William A. Gentry, Ph.D. Todd J. Weber, Ph.D. and Golnaz Sadri, Ph.D.

What it Means… Strong Leaders Empathic Leaders Inspires and motivate Coach for success (positive and constructive) Acknowledge difficulties Remove barriers Manage to expectations Communicate clear expectations Strive for respect, order, compliance, etc. Reinforce policies and rules; carry out orders from above Ensure consistency and fairness among their team Care about employee’s emotions Encourage teamwork and employee engagement Give the benefit of the doubt Step-in to help when needed or asked Leading with Strength & Empathy

What it Means… Strong Leaders Empathic Leaders Inspires and motivate Coach for success (positive and constructive) Acknowledge difficulties Remove barriers Manage to expectations Strive for respect, order, compliance, etc. Reinforce policies and rules; carry out orders from above Ensure consistency and fairness among their team Care about employee’s emotions Encourage teamwork and employee engagement Give the benefit of the doubt Step-in to help when needed or asked Leading with Strength & Empathy

Examples Strength Empathy “You seem upset.” “I expect…” “I can appreciate what a challenge this can be.” “This is important because…” “I’m sorry that you’re having a hard time.” “Here is the impact of that behavior.” “We will revisit this in {insert time} to see how you’re doing.” “How can we work on this together?”

What does it mean to lead with HEART? Communicate Clear Expectations Build Rapport and Relationships Remove Barriers Recognition & Appreciation Create a Caring Environment Demonstrate your Commitment

Communicate Clear Expectations

Let’s Communicate Replace with new paper folding activity Give everyone a sheet of paper Tell everyone to close eyes Give instructions Fold it in half Fold the lower left corner over the upper right corner Turn it 90 degrees to the left Fold it again Rid a half-circle in the middle of the left side Turn it another 90 degrees to the left and fold down the top corner Open your eyes Conclusions/Discussion Debrief: We don’t all start with the same base (some held paper vertically and some horizontally) so we don’t all have the same results Some interpreted to rip a piece as removing a big piece, some a small Having eyes closed = not receiving feedback on our performance Some instructions appear vague to some and clear to others “Without Clear Expectations People Are Being Paid to Guess” Winning with Accountability – Henry J. Evans 21

Build Rapport and Relationships

Connecting To Employees When you connect with your employees, they feel: Valued Validated More engaged and connected to the “big” picture

Connect Caregivers “I am helping to put a man on the moon” 1:35 – 1:37 The same is true of this place. People come to us with their last hope of healing. Their work is so much bigger than their tasks and as a leader so is yours. “I am helping to put a man on the moon”

Make a Personal Connection visible. Round. Conduct weekly / daily huddles. Be appropriate small talk. Make attention for things that matter to caregivers and to changes in behavior Pay questions. Respect privacy. “Is it okay if I ask you about this?” Ask appropriate information about yourself. Share

Remove Barriers

It’s Not Always Easy Acknowledge that things get in the way of delivering an optimal patient experience. Solicit barriers from your team. Do what you can to address those barriers. Involve employees in decisions and projects. Communicate results, progress and successes.

Recognition and Appreciation

The Bucket and The Dipper Each of us has an invisible bucket. When it’s full, we feel great. When it’s empty, we feel awful. Each of us has an invisible dipper. We can use it to fill buckets or to dip from buckets. Based on our interactions with others, we can fill their bucket or empty their bucket. Say: Using Communicate with C.A.R.E. is one way to connect with co-workers and to show them how much you care about them. Another way is to “fill their bucket”. The concept of filling buckets is written in a book called How Full is Your Bucket by Tom Rath and Donald O. Clifton, Ph.D. These authors say that each of us has an invisible bucket. When it’s full, we feel great. When it’s empty, we feel awful. They go on to say that each of us also has an invisible dipper. We can use our dippers to fill buckets or to dip from buckets. Our interactions with others determine if we are filling their bucket or emptying their bucket. How Full is Your Bucket, Tom Rath and Donald O. Clifton, PhD

Create a Caring Environment

Compassion Fatigue Discussion “These patients are so difficult. They yell and scream at me. Everyone talks about this empathy thing… I get it, but it’s hard. I put on a fake smile, but I’m really tired of it. My spouse says I’m checked-out at home. It’s because I give it all at work. I’m doing the best I can, and it’s never enough.”

Less Compassionate Reactions “I know it’s hard. You’ll be fine tomorrow.” “The patient is always right. Do what you need to do.” “This is how it is. Maybe this isn’t the right job for you.” “You have to leave your personal life at the door. Just focus on the patients.”

It Starts with Empathy Identification with and understanding of another’s situation, motives and feelings The power of understanding and imaginatively entering another person’s feelings The ability to understand the emotional makeup of another person Skill in treating people according to their emotional reactions Here are a few d efinitions of empathy that really resonate with me. What do these definitions have in common?

What is Caring Communication? How we verbally and nonverbally demonstrate our empathy and concern for others. It’s the action that is necessary to make human connections. Recognizing and attending to emotions are essential to caring communication. Caring communication is how we verbally and nonverbally demonstrate our empathy and concern for others. Caring communication is necessary to make human connections. After all, how will people know that we care about them if our communication does not show it? Finally, I can’t stress enough how recognizing and attending to emotions is key to caring communication and to making human connections. Because this is so important, we will focus much of our conversation today on how to express empathy.

Emotions Emotions “When dealing with people, remember you are not dealing with creatures of logic, but creatures of emotion.” - Dale Carnegie Dale Carnegie says it best, When dealing with people, remember you are not dealing with creatures of logic, but creatures of emotion.” This is so ironic, because as human beings, we uncomfortable with emotions. We try to avoid emotions at all costs. We say things like, “she’s so emotional!” Or “please don’t cry.” Or “be careful, you might hurt her feelings.” The fact is, we can’t avoid emotions. Especially those of us who work in healthcare. I’ve heard people say in healthcare we are in the “people” business. I’d add to that, we are in the emotions business.

Human Connection Human Connection I define connection as the energy that exists between people when they feel seen, heard and valued; when they can give and receive without judgment; and when they derive sustenance and strength from the relationship.” - Brene Brown Human Connection Human Connection Talking about here is making human connections. It’s a basic human need to connect with others. I love this quote by Brene Brown: “I define connection as the energy that exists between people when they feel seen, heard and valued; when they can give and receive without judgment; and when they derive sustenance and strength from the relationship.” At the core of delivering great care and service in healthcare. I believe this is what Dr. Berwyck was talking about.

Demonstrate Your Personal Commitment

Activity: Your Commitment What is your personal commitment to creating the culture you desire? Has it changed because of anything that we discussed today? How will you demonstrate your personal commitment?

Some Choices We Make The language we choose The attitude we choose How we take care of ourselves Who’s in our support circle Ask for and listen to the feedback

Some Lessons Learned Know yourself Understand others Build trust Demand debate Take risks

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” -Maya Angelou

Questions? Carol Santalucia santalc@ccf.org 216-444-0712