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  • Hospital Impact - Examining patient satisfaction incentives through different lenses
    it is the art of conversation that goes away first in care when in fact it should all start there From Claire C patient support assistant the front line perspective We need to be mindful that a big part of patient satisfaction is understanding Why or Why not That takes time Take a moment sit down at the patient s level do not use medical jargon have the patient repeat back to you in his her own words what the plan of care is When we take the time to do this patients and healthcare professionals alike develop relationships of trust and understanding and patients learn that an antibiotic for the common cold can do more harm than good These and other comments frequently highlight the lack of time as a significant barrier to optimal care And yet we as healthcare leaders continue to band aid a broken system while never truly innovating the model to allow ample time and space for the patient and practitioner to develop an authentic relationship and trust for the patient to tell their whole story and to achieve understanding engagement and activation From Dike D M D through the lens of physician engagement and burnout The single largest negative influence on patient satisfaction is the level of stress and burnout in the provider they see on that particular visit With repeated surveys of physicians showing the average prevalence of burnout on any give office day at one in three All of this is possible however all but about 3 percent of organizations have given up on the possibility of creating a physician friendly workplace To truly improve patient experience outcomes and decrease cost of care as healthcare leaders we must position physicians and other clinicians for optimal health physically mentally emotionally and spiritually I cannot count the number of times I have heard a physician say they have lost their soul for healing or the number of former nurses who have shared they have left the healthcare workforce because of burn out Productivity measures continue to do great harm to our physicians our patients our communities and runs contrary to the great care great experience less cost we say we desire It is time to truly adapt and create healthy healthcare models The whole of this feedback highlights the multilevel multi view intellectual capital available to us to improve the broken healthcare system It also highlights the heart of many who care and desire to make a difference The current system does great harm as do many of the current solutions We can do far better Some questions for consideration What are the barriers in your organization to achieving these successes What are the root causes of these barriers How do you know Who are you engaging Are you engaging those on the frontlines Are you engaging patients and families Are you making progress Are you innovating Is the patient practitioner relationship at the heart of your solution How are you measuring I would

    Original URL path: http://www.hospitalimpact.org/index.php/2013/12/03/examining_patient_satisfaction_incentive (2016-02-10)
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  • Hospital Impact - Healthcare needs servant leaders for improvement, inspiration
    seen take risks ask for help own our mistakes learn from failure lean into joy and can we support the people around us in doing the same Brené Brown shared in the post Leadership Series Vulnerability and Inspired Leadership Now perhaps it was the time of year Thanksgiving but my conversation above was linked to some sad news that actually led to a place of gratitude and now the beginning of a New Year a vision for a new beginning In following up this conversation I reached out to my contact at the Joint Commission to schedule another call and learned that Jerod Loeb M D executive vice president of Healthcare Quality and Evaluation at the Joint Commission had passed away in October after courageously battling cancer for the past two years Loeb is another extraordinary brilliant leader He used his own experiences as a patient to further improve the quality of care provision He focused on improving patient safety set a vision for creating high reliability organizations HROs and much more I was blessed to have spoken with Jerod and his team on a few occasions and to have read much of his work noting every experience as inspiring As I mindfully considered my colleague Loeb and the leadership required to truly make a difference the following questions came to mind As a healthcare leader When was the last time I was courageous When was the last time I was vulnerable and shared this vulnerability with my team When was the last time my team saw my authentic self How have I celebrated my and my team s failures How have we together grown learned and improved care provision as another colleague calls it failing forward How have I taken risks in order to benefit those I am blessed to serve When was the last time I leaned into joy and brought joy to all those around me How have I led served and supported others to do the same When was the last time I truly inspired others to achieve the mission of my organization and to serve others with care compassion and love The U S healthcare system is profoundly broken and sorely needs the type of leader each of us can and should embody People like my colleague and Loeb have inspired me and I am so grateful Today I commit to serve and inspire others to carry on their message and to be a courageous servant leader Will you join me Thomas H Dahlborg M S M is chief financial officer and vice president of strategy for NICHQ National Institute for Children s Health Quality where he focuses on improving child health and well being Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to

    Original URL path: http://www.hospitalimpact.org/index.php/2014/02/05/healthcare_servant_leader_improvement_in (2016-02-10)
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  • Hospital Impact - Healthcare innovation lessons from the barbershop
    the PCMH itself is becoming the end goal rather than the improved health of our communities with PCMH serving as a tool More Believe it or not however the PCMH was not the most interesting aspect of the discussion Curiously what I found most intriguing that night was a detail shared quickly by a brilliant individual and then left behind as focus returned to the PCMH The detail Cardiovascular Disease Control Through Barbershops Design of a Nationwide Outreach Program a study published in the Journal of the National Medical Association With many African American men having uncontrolled high blood pressure which can lead to premature disability and death and also not going to the doctor s office for preventive care clinicians identified new venues to meet these men where they are in this case barbershops for effective monitoring of blood pressure and encouragement to get treatment Barbershops had been used in the past for community outreach but systematic assessment had historically been lacking The innovation led to increased treatment rates and improved blood pressure control in African American males with hypertension which would translate into significant cost savings as well It clearly was a tremendous innovation with significant impact that meets people where they are Researchers absolutely should study this innovation further and continue to adapt and leverage it to better the health of our communities And what else can we learn from this care innovation According to the Centers for Disease Control and Prevention B arber shops often draw large loyal followings and serve as a trusted venue for open discussions with influential peers on numerous topics including health Trust Open discussions Influential peers Yes the keys to optimizing the encounters within this innovation include trust open discussions and influential peers Trust open discussions and influential peers also are critical to optimizing encounters within the healthcare system As healthcare leaders it is our responsibility to embrace and create systems to exploit these same optimizers of impact trust open discussions influential peers if we truly want to optimize care Let s continue the wonderful community outreach innovations and at the same time let s bring the lessons learned from these innovations into the healthcare system maybe even into the patient centered medical home Thomas H Dahlborg M S M is chief financial officer and vice president of strategy for NICHQ National Institute for Children s Health Quality where he focuses on improving child health and well being Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can foster family centered care Pediatric ER seeks

    Original URL path: http://www.hospitalimpact.org/index.php/2014/01/01/title_116 (2016-02-10)
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  • Hospital Impact - The hidden costs of incentivizing patient satisfaction
    for improved patient satisfaction Shannon Brownlee has written extensively on the cost and dangers of overtreatment Overtreated debunks the idea that most of medicine is based in sound science and shows how our healthcare system delivers huge amounts of unnecessary care that is not only wasteful but can actually imperil the health of patients We can do far better When a physician or other clinician has limited time with a patient When there is little connection no relationship no trust When we as healthcare leaders create systems that do not allow the patient to tell their whole story to a physician they trust When we create models where a patient doesn t know who their doctor is and lacks an authentic relationship with their physician When we create models where teams have ever rotating physicians nurse practitioners physician assistants and other practitioners all in the name of creating a team based model see patient centered medical home When all of this happens then we are the ones who must look in the mirror and recognize we are placing our patients our families our communities in danger and wasting limited resources in doing so As healthcare leaders we need to create models where physicians and patients have the time to develop relationship and trust We must create a model where the patient s whole story is heard and understood We must create a safe place for the patient and physician to share in decision making and dialogue about treatment options In such a place when the patient asks the physician a question or for a specific treatment option the answer can be I don t believe that would be in your best interest here is why and here are other options that we should consider Let s discuss and together determine the best path to follow This discourse would lead to improved patient satisfaction because of the authentic relationship and trust and improved patient engagement not to mention increased physician satisfaction decreased cost of care decreased utilization better patient adherence and improved patient safety and outcomes If we want to improve patient satisfaction without the negative side effects then we must change the system If we want to change the culture of healthcare then we must change the model To honor our commitment to improving the health of our patients families and communities we must be mindful of the complexity of the system understand the unintended consequences and focus on those things that bring physicians and patients closer and rail against anything that hurts the physician patient relationship Thomas H Dahlborg M S M is chief financial officer and vice president of strategy for the National Initiative for Children s Healthcare Quality NICHQ where he focuses on improving child health and well being Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim

    Original URL path: http://www.hospitalimpact.org/index.php/2013/11/06/p4382 (2016-02-10)
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  • Hospital Impact - Using the RCA process to bring a patient's entire picture into focus
    time relationship trust and information to identify the root cause of a chronic illness How often are they positioned to truly collaborate with their peers and with their patients How often are they positioned to move away from a technical fix and toward positioning their patient for an adaptive change based on the root cause of the chronic health issue In 2007 David S Jones MD president of the Institute for Functional Medicine shared as part of his presentation on comprehensive care for complex chronic disease an amazing picture of what can happen when a root cause of a chronic illness is not identified In brief an individual who shows signs of depression sees a psychiatrist and receives a prescription for an SSRI selective serotonin reuptake inhibitors This patient also shows signs of hypertension visits an internist and receives a prescription for an ACE inhibitor angiotensin converting enzyme inhibitors This individual also suffers from osteoarthritis consults with an orthopaedic physician and receives a prescription for an NSAID nonsteroidal anti inflammatory drugs Oh and this individual is dealing with irritable bowel syndrome and gastroesophageal reflux disease and receives prescriptions from a gastroenterologist for Dicyclomine and an H2 Blocker respectively In this one example this patient has five diagnoses and is placed on five different prescription medications He s seeing four different physicians who are not positioned to truly collaborate with one another or with the patient At this point no root cause of these health challenges is identified And no one physician is well positioned to address the cause once it is determined As Dr Jones shares Each individual diagnosis becomes a distinct entity unto itself The patient s whole story never has a chance to be heard and understood in context There is no opportunity to identify and address the root cause of these issues the underlying mechanisms of disease If we are truly to improve healthcare in America and not just reform it we need to leverage the best practices of other industries to best position physicians to focus on true healing and patients to truly heal We need to identify and implement the best practices that will enhance and optimize the healing encounter Thomas H Dahlborg M S M is executive director of the physician practice True North Health Center where he focuses on improving growth while ensuring access for the uninsured and the elderly He has 21 years of experience creating competitive advantages analyzing customer expectations and developing and implementing focused and aligned strategic deployment plans Formerly he served as the chief business strategy officer at Network Health a comprehensive Medicaid health plan based in Cambridge Mass and was COO of the U S Family Health Plan at Martin s Point Health Care in Portland Maine 20 comments Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs

    Original URL path: http://www.hospitalimpact.org/index.php/2010/04/29/using_the_rca_process_to_bring_a_patient (2016-02-10)
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  • Hospital Impact
    hiring freeze so the relief you were expecting the opportunity to breathe and use the bathroom between patient visits will not be realized Now imagine you are again a clinician on the front lines of a large healthcare system and you have recently learned the level of stress associated with trying to ensure patient safety optimal outcomes and better patient experience while also meeting productivity quotas will worsen due to hiring freezes as well as the system offering early retirement incentives to hundreds of employees in an effort to improve the bottom line Read more Leave a comment Healing the healer in healthcare July 5th 2013 by Thomas Dahlborg I m a family doc in Eugene Ore where we ve lost three physicians in 18 months to suicide I was suicidal once Assembly line medicine was killing me Too many patients and not enough time sets us up for failure There are many studies highlighting the harm our broken healthcare system does to patients e g hospital errors occurring in one third of all hospital admissions medical mistakes contributing to up to 187 135 deaths and 6 1 million injuries an estimated annual cost of measurable preventable medical errors of 17 1 billion based on 2008 dollars But what about the harm caregivers face Read more Leave a comment Even more firsthand symptoms of a broken healthcare system May 8th 2013 by Thomas Dahlborg You are not going to be a professional baseball player Jimmy is a player on the high school recreational basketball team I coach and yes the orthopedic surgeon who reviewed Jimmy s MRI and who spent a total of 30 minutes over two visits tried to destroy this boy s dream unintentionally I hope to play professional baseball I learned of this healthcare encounter from Jimmy s mother and as she relayed these events to me I composed the following letter to this physician in my mind Read more Leave a comment Heed patient industry calls for compassionate care April 10th 2013 by Thomas Dahlborg Mr Roberts was in the hospital being prepped for an angiogram When Sally the hospital chaplain met with Mr Roberts he shared that his wife had passed away two months earlier he was struggling to cope and recently had a heart attack Sally was fully present and attentive to the patient she was supportive and listened and empathized with Mr Roberts struggles pain and fear And she asked whether he had shared this information with his doctor and learned he had not Shortly after this powerful sharing Mr Roberts doctor walked in and Sally asked the patient if he wanted to share their discussion with the doctor So Mr Roberts proceeded to tell his doctor about his wife passing away and his struggles and fear His doctor s response Sorry to hear that Mr Roberts So about your angiogram Read more Leave a comment Previous Page Next Page Enter your search terms Submit search form Web www hospitalimpact org Get Hospital

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=Thomas%20Dahlborg&page=1&disp=posts&paged=6 (2016-02-10)
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  • Hospital Impact - 10 considerations for a more innovative hospital culture
    or only individual creative thinkers those outliers with weird ideas that can turn into amazing innovations There s a great article in Forbes on this topic you can even take its Workplace Serendipity Quiz The thing to remember is that if you ask people to change you will need leaders idea generators implementers and effective teams to embrace the change Therein lies the challenge Who will own it You is probably the right answer Training works The research on this is quite compelling check out this article in MIT Sloan While built around the theme How to have influence rather than innovation it is a sound culture based approach to influencing people to move in new directions innovatively The more ideas you have the more likely you will have great ones you just don t know which ones they are This isn t a linear process ideas come together at the intersections Thus you need to have an idea room or an idea bank to get the juices flowing To learn more browse through the Medici Effect by Franz Johansson Where do you find those ideas Surprisingly the best places are right around you namely employees customers and your partners You just need to find a way to listen to their ideas and then organize them into an innovation process where they can be turned into meaningful solutions Convert ideas into effect innovations How can you know which ideas are worth developing into testable innovations and which to scrap Solution create a testing mindset Develop prototypes and then bring in customers to work on them Or take an innovation into the marketplace and evaluate its effectiveness From concept to implementation Now that you ve converted a new idea into a tested innovation and gotten positive results what next One option is to leave it with the development team Or you could bridge the gap between development and those who run the rest of the operation Both can work but be careful if both groups skills are different and don t transfer Onto the next big idea Humans generally celebrate success and then revert back to business as usual But the speed of change causes organizations to have a series of new ideas they convert into testable innovations concurrently not sequentially Celebrate Don t forget to build in the symbols and rituals that will recognize and reward the people in your organization who have contributed ideas effort patience and persistence People really do like hugs and they love to celebrate Use these to build the belief that they really can do it innovatively As you embark on your own innovative journey remember There really is a path from pain to change that can help you and your organization see feel and think in new ways Have fun Andrea J Simon Ph D is a former marketing branding and culture change senior vice president at Hurley Medical Center in Flint Michigan She also is president and CEO of Simon Associates Management Consultants

    Original URL path: http://www.hospitalimpact.org/index.php/2014/08/07/10_considerations_for_a_more_innovative (2016-02-10)
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  • Hospital Impact - Adapt hospital culture to changing times
    line for someone senior to make then waiting for the answers to trickle back down to them Plus physicians and nurses had less than collaborative relationships not an ideal situation and one that seemed ripe for culture change Our challenge quickly became apparent How could we get 2 500 plus physicians and employees to first understand their existing culture and second agree upon how it should be in the future As a cultural and corporate anthropologist I work with organizations that need or want to change their cultures The approach I use as I did with Hurley is grounded in the research and methods developed by Kim Cameron and Robert E Quinn at the University of Michigan For more than a decade they researched the many different types of cultural styles at play in companies and organizations They then grouped these styles into four quadrants differing by the degree to which companies were internally or externally focused and flexible or controlling The four types are described as follows Based on the Competing Values Framework developed by Robert E Quinn they developed a short but very powerful questionnaire to help companies assess their culture as they experience it today and as they prefer it in the future This tool is called the Organizational Culture Assessment Instrument OCAI OCAI creates a graph for each person expands it to each department and then the entire organization At Hurley almost 65 percent of the hospital including physicians and the board completed the OCAI The results looked a lot like this this is a sample and not the actual for the medical center For Hurley the hospital s culture was highly red controlling hierarchical and blue results driven What was missing across almost all departments and even among the trustees was a desire from the staff for more collaboration teamwork empowerment creativity or innovation This did not mean they would sidestep regulations or fail to deliver patient care effectively But doing it as it s always been done needed some serious rethinking There are always deep tensions at the heart of a culture change process People may not like the way it s always been done yet they hold on tight to what they know Habits are hard to break and the brain hates to change Therefore the process to undertake culture change must be highly collaborative and very much like a theatrical performance Even if people don t want to perform the play anymore everyone knows their roles Culture change is very much like learning a new role in a new performance Once the journey begins and a new script is learned it is harder to go back to the old which wasn t getting you to the future anyway So what will make a new way of doing things stick Strong leadership lots of small wins and constant encouragement Andrea J Simon Ph D is a former marketing branding and culture change senior vice president at Hurley Medical Center in Flint Michigan A

    Original URL path: http://www.hospitalimpact.org/index.php/2014/05/30/adapt_hospital_culture_to_changing_times_1 (2016-02-10)
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