By Rhonda Stewart, Virginia Mason Institute Faculty
For leaders who want to make progress in improvements across an organization, the challenge can seem insurmountable. How can you get executives, providers and staff to adopt a mindset of continuous improvement? How do you even get started?
A good place to begin is to reflect on your organization’s culture. What would it take for you to have a culture that puts the patient first? Are you thinking it would be too hard on your organization to make the necessary changes? Are you feeling powerless to bring about a meaningful change that would make a difference? Let’s look at some key aspects of a culture that is truly patient-focused.
- In patient-centered organizations, staff members speak up about their own near misses. In these organizations self-reporting is essential because it can expose gaps in the process where patient safety might be jeopardized. In fact, leaders encourage self-reporting because it can instigate an investigation of the process and the formation of an improvement event to protect patients.
- Staff members speak up about others’ mistakes. Staff feel empowered—and eventually compelled—to speak up. This is true for any employee in the organization. Those who speak up for patient safety are met with support, not retribution.
- Staff members talk to each other to uncover and resolve problems. They don’t point fingers; they don’t say to another team member, for instance, “You always bring me the patient too early.” They say, “When the patient is brought to me, I’m not ready to provide care and then the patient has to wait. What can we do as a team to make this process seamless for the patient?” Leaders support this teamwork.
- The idea generators in your organization are staff members. In organizations that are not patient-focused, staff members won’t regularly think of ideas—or speak up about them—to improve patient safety or the patient experience. They just do the best they can with the processes they were trained to use. In these organizations, leaders want satisfied patients, but they don’t ask their staff to be a part of improving the system of delivering care. In patient-focused organizations like Virginia Mason, however, leaders ask staff members to come up with ideas to improve patient care, and then the staff members own those ideas and work independently or with a team to test them and bring them to life.
- Within departments, work processes function similarly for all the department’s providers. In organizations that are not patient-focused, the bigger picture is lost, and medical assistants throughout the organizations say, “My provider does things differently.” Patient-focused organizations are willing to challenge the status quo to make things better for patients across the organization. They know that when variation is reduced, the service becomes not only consistent and more predictable, but also feels safer from the patient perspective.
- Staff members listen to other perspectives and are willing to integrate them into their own thinking. They’re willing to shadow other staff members and work collaboratively to make the new process function well for the whole team. They know that health care that is truly patient-focused involves collaboration with many staff members involved in the patient visit to make patient care seamless and make it truly safe.
- Teams make their work visible, transparent. They have production boards showcasing their health care processes so other teams can spot defects that may impact patient satisfaction. Teams know that working well with other teams is essential to an organization that wants to improve the patient care process.
Being patient-focused means that your organization works constantly to do what is best for the patient—to improve patient safety and the patient experience. It means understanding what is not value-added in patient care and working relentlessly to make the patient experience better. To leaders who say, “Where do I begin changing something like culture?” I would say, “Look at one of these key concepts. What can you do to promote this in your organizations?” Small steps in transforming your culture can make a difference—for you, your staff and, most significantly, your patients.
Learn more about leading differently to bring about change in your organization in our course Engaging Staff in Daily Improvement.
Rhonda Stewart, who is certified in the Virginia Mason Production System, has led improvement events throughout ambulatory, specialty and hospital value streams, including the PACU/Recovery areas. In her former role as Virginia Mason’s director of finance, she led improvement events in accounting, analytics, billing, payroll and supply chain.