1. Emotional Intelligence Can Create A Culture of Safety and Leadership
Sylvia del Castillo, MD
Clinical Associate Professor of Pediatrics
USC Keck School of Medicine
February 11, 2019

2. Objectives Understand what “culture” is
Discuss what makes our unit have its own culture
Understand the components of Emotional Intelligence
Understand the 5 components of a dysfunctional team

3. WHAT IS CULTURE? Culture is the world you live in
Culture is the air we breathe
Culture is what you grew up with

4. WHAT IS CULTURE?
A pattern of shared basic assumptions…. To be taught to new members as the CORRECT way to perceive, think, and feel in relation to problems
Its power is derived by the fact that if or when the assumptions are discussed, we do not examine them, but defend them.

5. COMPONENTS OF CULTURE It is shared It is learned It is symbolic
It is transmitted cross-generationally
It is adaptive and integrated
Mental processes, beliefs, knowledge, and values are all part of culture

6. Culture eats strategy for breakfast

7. THREE TYPES OF CULTURES
Constructive
Members are encouraged to interact with others and approach tasks in ways that will help them meet their higher-order satisfaction needs.
Norms support:
Achievement
Self-actualizing
Humanistic-encouraging
Affiliate behavioral styles
to eliminate any possibility of interference from the bladder and to span the greatest surface area of the small intestine.

8. THREE TYPES OF CULTURES
Passive/Defensive
Members believe they must interact with people in ways that will not threaten their own security.
Norms promote or implicitly require:
Approval
Conventional
Dependent and Avoidance styles

9. THREE TYPES OF CULTURES
Aggressive/Defensive
Members are expected to approach tasks in forceful ways to protect their status and security.
Norms support:
Oppositional
Power
Competitive and Perfectionist behavioral styles

10. HOW DOES CULTURE CONNECT TO CLINICAL CARE?
98,000 deaths in the US from preventable medical errors
Sentinel events: 70% related to a failure in communication
1 of 3 verbal interactions between MD and RN are miscommunications that result in an error in care
Most quality improvement projects result in no or temporary improvements
Almost all of these facts are related to behaviors observed daily in healthcare
Pulsatility index is a measurement of downstream resistance to flow.
HR, SPO2, IrSO2 measured continuously over a 2 hour period, before, during and after a bolus feed.

12. Adapted from TR Krause et al., 2005
Delta for controls 32-34%
Delta for CHD 37-42%
Data listed as median (interquartile ranges)
Adapted from TR Krause et al., 2005

13. LEADERSHIP AND CULTURE*
LEADERSHIP AND CULTURE
ACCOUNTABILITY
Leaders get the behaviors they exhibit and tolerate. You change the culture of a workplace by changing the behavior of its leaders.
Larry Bossidy, Execution-the discipline of getting things done

14. PHILOSOPHICAL CHANGES
SELECTION AND DEVELOPMENT
Demonstrating behaviors consistent with our values
Leadership training and development
Redefining what success looks like in senior nurses and physicians (technical skills and knowledge are not enough)
Servant leadership principles.

15. ENGAGE THE ENTIRE TEAM Multidisciplinary input to patient care
Nurse facilitated daily rounds
Family Centered Care Committee
Nurse and RCP led quality improvement projects
Acknowledging and addressing moral distress
(tea for the soul)
Our study population was stable on bolus feeds with no signs or symptoms of NEC

17. HOW DO YOU READ CULTURE? The way people interact Expressed values
Rules of the game
Guiding principals
Special competencies
Thought and language
Shared meanings
Group norms of behavior
Climate
Emotional and aesthetic responses

18. https://youtu.be/8uSyvw5RR28

20. WHAT MAKES A TEAM COMPETENT AND EFFECTIVE?
Self awareness Self control Commitment Collaboration Emphasis on teamwork

22. Do you See what I See?

25. SEVEN KEYS TO EFFECTIVE TEAMS
Clear sense of direction
Talented members
Clear and enticing responsibilities
Reasonable and efficient operating procedures
Constructive interpersonal relationships
Active reinforcement systems
Constructive external relationships

26. HAND HYGEINE PROJECT

29. CONCLUSIONS
The change in culture, increased availability of Sterillium dispensers and the transparency of our audit results have contributed to our success of maintaining a 90% hand hygiene compliance rate since Q4 of 2011.
We continue to monitor our hand hygiene and discuss on a monthly basis at our PI meetings.

31. Thank you for all you do for our patients and each other every day! 
This starts with YOU!!
Thank you for all you do for our patients and each other every day! 