Friday, July 8, 2011

New Year, New Vision, A Need for More and Faster Improvement

The New Year is always a good time to reflect on what you have accomplished and what you strive to do better. With July 1 being the start of GBMC’s fiscal year, it’s important to look back on last year’s goals – We had a good year, we remain financially strong, we hit some goals right on, yet there are other goals that still need more of our focus. It’s a new year with a new strategy, new operating plan and goals designed to address this important question - Are we getting closer to our vision of treating everybody, every time with the care we would want for our own loved ones?
It’s clear to me that in order to achieve this vision, we have to get better at executing change – change through the eyes of our patients. We place a great deal of emphasis on patient satisfaction scores, and over the past year we’ve made some progress thanks to measures put into place to improve our patients’ experiences…but we need to make the breakthrough changes that will really matter most. So to start, our goals this year about improving the patient experience will be more focused on the most meaningful things to patients, questions like “Was I included in decisions around my care?” And we know that to best understand and appreciate the experience we cannot lose sight of what it is like to be a patient in a hospital.
So, in developing the patient experience and satisfaction goals for this year, we did something a little different. Unlike last year where the senior management team drove the goals, this year we asked the Quality Committee of our Board of Directors to take the lead on creating our goals. A sub-committee was formed that included a number of our physicians and nurses who brought an important perspective to the table as they developed the clinical outcomes and patient experience goals. These providers at the bedside know and understand what the patients need and how to make their experience better.
Our goals this year are again in four areas:
  - Better health outcomes
  - Better [patient] satisfaction with the care experience
  - Less waste and lower costs
  - More joy for those providing the care [employee and physician satisfaction]
This year, we need to get more ownership of our goals by every member of the GBMC family. We must have everyone in action. To this end, the Senior Management Team is working with their people to develop departmental and unit level goals that will drive attainment of the system goals.  
Everyone at GBMC has the ability to create positive change through the eyes of our patients.  But we have to take action, because if it’s just talk and nothing changes, then we will never get closer to our vision.
So I need you – our staff on the front lines of patient care – to tell me:
How can we improve our care even faster than we have in the past?
What do you need and what can I do to help you create better health, and better care, with more staff joy at lower cost?
Please share your thoughts by commenting below…I look forward to the dialogue!


  1. Dr. Chessare - One of the books I'm reading right now is, "The Age of Speed: Learning to Thrive in a More-Faster-Now World" by Vince Poscente. It is by no means exclusively about healthcare, but has some interesting points about the time/speed-focused world we live in and really looks at speed as one of the developing currencies in business. It's pretty interesting so far and rather challenging to the "old way of doing things".

    Tim Saunders

  2. It is common knowledge around GBMC that if someone has a good idea, it will probably take a year (minimum)to be put into practice. There has to be meetings, committees, sub-committees, surveys, actions plans, and other random silliness first. There is still a hesitation to speak up for change. I have been to too many meetings where this is obvious. The feeling is that our opinions are solicited but when all is said and done, we're just going to keep on doing what we've been doing. I am completely serious when I say that if someone presents a suggestion, someone else will say "we tried that 20 years ago and it didn't work." So we can never do anything differently, or retry something, ever again? We are not cutting edge and speed is definitely not our forte.

  3. Tim, thanks very much for the tip on the book. I am going to get it and read it.

    Anonymous, I can't say that I agree that "if someone has a good idea, it will probably take a year to be put into practice". I am currently "rounding" with the staff on Unit 35 and they are changing many things as a Team to make it better for their patients and themselves. At GBMA, in our primary care offices, since January, almost everything has changed including the electronic record. Gilchrist Hospice Care and Gilchrist Greater Living have just won the Circle of Life Award from the American Hospital Association, in large part because of how good they have become at making meaningful change to make it better for our patients and their families.

    Many people are stopping me and asking me if we are changing too fast.

    I do agree that the larger an organization is, the more people need to be involved to make a good change and to make it stick. The smaller an organization, the fewer the number of people who need to be involved and the quicker you can make change stick.

    Anonymous, perhaps you are frustrated by the slowness in a change that you are trying to make. Would you like to share it with us?

  4. Here is one example: WingSpan. The evaluations are too long to be meaningful. We managers are never done. When you have a staff of 50+, you are never finished with evals. Some of the criteria are such that employees in certain jobs would never be able to attain an exceeds; i.e., the examples shown are above and beyond their scope of duty. I have a feeling that many employees give themselves "meets" just so they can get through the 12-14 pages of their eval. We have expressed our frustration since WingSpan made its debut, to no avail.

  5. Anonymous:

    I am sorry that you feel that WingSpan problems are not being corrected. I hope that you are one of the many managers who attended one of the four focus groups that Patricia Larkin, Compensation Analyst, and I held a few months ago. During those sessions, we received feedback from a variety of managers and the core problems that needed to be addresses were the length of the forms and how specific they are to each job.

    Since those focus groups, Patricia and I have been working diligently to rewrite forms to be more specific to each job and shorten the forms. This is something that unfortunately will not be able to put into effect until the 2012 forms, but the feedback has been taken into consideration. This process is extremely time consuming as there are over 700 specific jobs that receive appraisals each year and a staff of two working to fix the system.

    I understand that you have been frustrated with WingSpan since its debut, and as the people who took over administration of the system we are doing our best to correct any problems that the managers are having. I hope that if you have any future issues with the system, you will contact Patricia or myself so that we can work to correct the problems.

    Thank you,

    Liz Arkuszeski
    Compensation Specialist

  6. Tim, I read Vince Poscente's, The Age of Speed last week. Thanks for the tip. It is critical for us to remove wasteful steps, practices, and all forms of waiting to improve our care.

    Anonymous, I too think that our evaluations can be improved. I am happy that Liz and Patricia are working on this. Thanks for your patience.

  7. This is a good submission to address the difficulties "When Forms Take Over" and managers lose sight of the reason why they evaluate in the first place. Meaningful conversation with the aim toward professional development gives the best chance for a meaningful evaluation and engaged employee.


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