I think that Healthcare Innovation starts when we ask questions like these. We need to take care of those who are providing our care.
Too often we get distracted by shiny technology, or efficient processes, when we need to stay focused on the quality of relationships between caring people. Here is a quick example.
Today I shared a panel with 3 brilliant people at an Interactive Case Study led by Mark Kenny (a client) and his team of professional actors at Hippo Solutions in Nashville, TN (see the link here). The theme was “Hospitality in Healthcare,” and this conference/ showcase occurred at Vanderbilt University. Imagine 3 scenes, 6 actors, 50+ in the audience, 2 skillful facilitators, seamless integration of the audience and the actors and the panelists, and you get a picture of how well this case study entertained and educated everyone.
My co-panelists included Paul Sternberg, MD, Chief Medical Officer, Chief Patient Experience Officer, at Vanderbilt University Medical Center, Darren Hodgdon, National VP of Strategy and Innovation at United HealthCare, and Connie Schroyer, PhD, VP at the Hay Group, based in Arlington, VA. And me. The expert on physician burnout, resilience, positive psychology and executive coaching. We focused on the emotions below the surface of behavior, and concluded that the simplest way to improve the quality of hospitality in healthcare is to ask for feedback, listen well, then support constructive changes.
Years ago we had buttons stating “Hug a Nurse” and “Hug your Doctor.” What happened to those buttons?
WHAT TO DO NEXT?
If you or someone you know is a healthcare professional and would like to know more about burnout and what can be done to help and prevent this Contact Us Here or Call Us: 1-615-905-1892
Recently I was asked to deliver a webinar on physician burnout. You may know that burnout is higher among physicians than for any other service professionals. The effect on nurses, patients, loved ones and administrators is significant, and preventable.
For complimentary assessment, a confidential session or the 30-page ebook, please contact us today.
For a riveting version of the content please visit here.
The other side of burnout is resilience, our ability to adapt successfully in the presence of risk or adversity.
The goal of coaching is behavioral change toward a desired personal or professional outcome. For instance, Sarah may need to develop her business development skills to grow her new franchise by 50% within the next 6 months. John may need to develop an assertive meeting style with his new manager, in the next 30 days, or risk opportunities for promotion. How do these leaders attain their goals?
Some leaders like to imagine the coaching process in the following 4 phases. My experience, since 1997 with hundreds of coaching engagements, is that coaching engagements rarely fall into the neat categories of these 4 phases. One reason is that learning is a messy process. The process is ongoing, iterative, client-focused, both an “artful craft” requiring practice, and a scientific management consulting process requiring expertise. The action learning process implies that coaches and leaders jointly learn what works, and why it works, so that the leader can do more of that behavior.
That said, the process of organizational development can be described in these 4 phases. (Source: Gallant & Rios, 2014).
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The start-up phase requires candid assessment of what is working, what is not working, and what is needed. The selection of a coach or consultant is crucial. Leaders should not select someone they like as a potential confidante or best friend. Leaders should select the most expert consultant who can help them master a new behavior. For instance, if a leader needs a woman who speaks Spanish to help prepare for relocation to Mexico City, then I am not qualified. The goal of this start-up phase is to define boundaries of the engagement, and to mutually agree on those boundaries in a written contract.
The diagnosis phase includes learning what the leader thinks about their reputation, brand, strengths, and weaknesses. That self-assessment often conflicts with data gathered from others. Techniques include surveys, interviews, assessments, observations, and video. The word “diagnosis” is not accurate, because it implies a gap or deficiency that is static and needs correction. I prefer the words “development” or “focus” or “assessment” because they accurately describe the ongoing quality of coaching engagements that reinforce the strengths of leaders.
The intervention phase is the core of any coaching engagement. The process includes ongoing assessment of the client’s agenda, review of behaviors, feedback, and constructive actions. There is both art and science involved in coaching. The art requires constant attention to the leader’s words and actions, following intuition, and what I call “dancing with curiosity.” The science requires ongoing consideration of recent research in evidence-based behavior or world-class tactics that may be useful to the leader.
The transition phase occurs at the end of every coaching session, in monthly written summaries, after any feedback session or observation, quarterly frequency reviews, and opening and closing meetings with the leader, HR business partner, direct manager, and the coach. Those 4-way meetings insure that behavioral outcomes have been exceeded. As a 4th step in this model, the transition phase reminds all stakeholders that coaching has a beginning and an end. There are some “executive coaches” who boastfully declare that they have provided value to a leader for years. I sincerely hope that they regularly review the behavioral outcomes and business needs so that each phase of that engagement is closed. If not, they may be describing a dependent relationship that has little to do with a leader’s need for behavioral change.
This neat model with 4 phases may be useful for those who like structure. Accountants and engineers and some HR managers may find them useful.
One final thought: if the client needs a more fluid model, then these 4 steps can be twisted into a circle or a spiral.
Call us if you need to assess step 1 above, the start-up phase.
If we cannot help you, then we will refer you to someone who can do so.
Reference:
Gallant, S. & Rios, D. (2014). The organization development (OD) consulting process. In B.R. Jones & M, Brazzel (Eds.), The NTL handbook of organization development and change (2nd ed.) (pp. 153-174). San Francisco, CA: Wiley.
Every U.S. citizen has a vested interest and an opinion about the quality and effectiveness of healthcare delivery, a $3.8 trillion industry with rapidly escalating costs.
The fastest-growing industry in healthcare is telemedicine, which is now used in over 50% of the hospitals in the U.S. to promote remote access to healthcare. Examples range from tele-surgery to tele-emergency care to tele-psychiatry. The reasons for telemedicine abound. It allows specialized care to be distributed from a central hub to a rural location or an underserved population, efficiently and at lower costs. For instance, in 2012, the Veterans Administration (VA) documented over 1.5 million telehealth sessions, for over 35% of veterans.
Problem statement and opportunity
The primary problem with telemedicine is low user adoption rates because many people resist organizational change. The result is massive waste that can be reduced. Telemedicine technology and processes exist. However, organizational readiness for telemedicine results from two variables: 1) ability to change, and 2) motivation to change. The innovation diffusion curve (see Figure 1) demonstrates an immediate opportunity for telemedicine initiatives to move from the early adopter phase to the majorities.
Organizational readiness for telemedicine can be measured. The key variables for organizational readiness include 1) executive sponsors who champion the ability and need to change, 2) buying agents convinced by case studies or ROI data of the economic value for the change, and 3) consumers driven by a compelling need for effective, inexpensive health care outcomes. The need for organizational leadership innovations in telemedicine programs is immediate.
Figure 1: The innovation diffusion curve (in Rogers (2003) Diffusions of Innovation)
Unique opportunity: Tennessee
Although resistance to telemedicine is a global problem, we have a unique opportunity to provide a solution from Tennessee. Described as the “Global Center of Healthcare,” Nashville, TN has over 400 healthcare companies, spawned from Healthcare Corporation of America (HCA). On January 1, 2015, Tennessee became the 21st state to enact “telemedicine parity” legislation requiring that insurers reimburse licensed health care providers for services delivered remotely just as they would for in-person visits. On February 15, 2015 Tennessee added law stating that telehealth providers will be held to the same level of care as direct care providers (SB 1223). That law “opened the door” for telemedicine services to be delivered remotely, at lower cost, to rural minorities in Tennessee. We are in the right time at the right place to lead innovation in telemedicine.
Sadly, there is resistance to telemedicine from consumers and administrators who do not trust the government, or the technology, or the financial benefits. A telemedicine visit may cost $50 and take 10 minutes (e.g. MD Live, Teladoc); an ER visit may cost $150 and take 3 hours; a hospital visit may cost $15,000 and take 3 days. Telemedicine has demonstrated a 10X cost savings. Unless, of course, there is organizational resistance to change, in which case telemedicine is a waste of time and resources.
One administrator said, “We have 3 telemedicine kiosks sitting in a storage room, hidden by sheets. The vendor who provided them no longer exists. The technology may be extraordinary, but I cannot get my physicians and nurses to use it.” His experience represents hundreds of wasteful healthcare initiatives.
What can you do to increase adoption of telemedicine?
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