Leadership http://www.experiahealth.com/ May 29, 2013 Scotland Martha Donovan Hayward Lead for Patient and Public Engagement Institute for Healthcare Engagement

Why Are We Here? Is there anything else we would truly rather be doing? At the end of the day, everything every one of us does somehow impacts the people who use our services. The person and family is at the center of all we do. IHI - TRANSFORM - Oct 2011

Exceptional Experiences Not about being nice Not an educational program They result when: Mission, vision, values align Leadership team commits Discipline is instilled Infrastructure, education, expectations, and core processes are complimentary Behaviors are clear Experiences are consistent across the continuum IHI - TRANSFORM - Oct 2011

It is about… Intentionally designing a culture of excellence. Creating a culture that oozes a sense of care, compassion, respect and concern. Being clear about our goals and intentions. The goal is to see beyond our walls The goal is to see care through the eyes of each person The goal is partnership and collaboration with all parts of the system that touch each person IHI - TRANSFORM - Oct 2011

Expected outcomes Experience and loyalty Improved quality and safety Improved community perception and reputation Increased market share/volume Financial Health Decreased dissatisfaction and associated costs Decreased claims/losses Better health outcomes PPT Demonstration_CA_050508*

Essential skills for leaders Developing relationships outside your four walls Naming the experience for each person Holding self, peers and team accountable Label and link Stop List PFA’s Rounding and Observation

3 Key Steps Executive Leadership Alignment Level set expectations for everyone in the organization. Focus on infrastructure, targeted processes and development.

Culture What is it? The total learned, shared, taken-for-granted assumptions that a group has learned throughout its history; base of daily behavior Deep, broad, stable Schien, Corporate Culture Survival Guide, 1999 Seen in behavior Changed over time by working on behaviors that eventually shift mental models – not the reverse

How Culture is Embedded Primary Secondary What leaders do, pay attention to, measure and reward on a regular basis How leaders react to critical incidents and organizational crises Deliberate role modeling, teaching and coaching Observed criteria by which leaders allocate rewards and status Observed criteria by which leaders recruit, select, promote, retire and terminate organizational members Organizational design and structure Organizational systems and procedures Organizational rites and rituals Design of physical space and buildings Stories, legends and myths about people and events Formal statements of organizational philosophy, values and creed E. Schein, Organizational Culture and Leadership,1994

Whose Job Is It? All in Utilize Change Package HR connection Leadership essentials Engaged partners: staff, physician and PFA’s IHI - TRANSFORM - Oct 2011

Hire for Values Clarify the values you are hiring for. What do the values look like in action? Position descriptions; performance reviews Develop behavior-based interview questions; use scenarios. Involve patients/families in interviews. Orient to the values. Systems in place to listen and learn from new employees HR leaders should be expert in these – if not, have them do the research on tools that work for you What happened in first month that did/did not match what they heard in interviews and orientation?

Key Change Ideas: Leadership Leaders take ownership of defining purpose of work and modeling desired behaviors. Purpose Label and link “All in” behaviors Storytelling Leadership rounding Leadership behaviors Champions What would people in your organization say about your leadership “We have a new 2-day orientation – a cultural indoctrination of what we are about and what we expect. But if we lack the culture to nurture it once they are in the work setting, it is even worse than never talking about it. It sets us back because we say one thing and do another.” “As leaders, we need to pause occasionally and become more educated; it has taken different forms, e.g., ‘How do we really help staff understand what it means to treat a patient with dignity and respect? What is a truly collaborative partnership?’ We all have to learn since this is not necessarily intuitive.” “There is no one bullet “You cannot put patient experience in a separate bucket. It is part of everything we do” – it is incredibly multidimensional”

Identifying Patients and Families 1414 Identifying Patients and Families Ask clinicians “Do you know a patient/family member that comes to mind as a potential members?” Are there patients/family members who have contacted healthcare leaders about concerns and who were highly effective in communicating their requests? Are there Patients/Families with unique perspectives as previous patients or family caregivers for a project? Use your internal and external network of Board members, faith community, volunteers to cast a wide search

Developing Health Care Team Members 1515 Developing Health Care Team Members Remember – it is not just Patient/Family Partners who need development to work with healthcare team members! Most healthcare team members are not skilled in working in true partnerships with patients/families. We are used to being “in charge.” Specify listening behaviors to use in activities with Partners to assure their talents are being used effectively.