Although my studies years ago touched on systems thinking, the more I read, the more I am intrigued about the multitude of ways that systems thinking can make a difference optimizing healing healthcare. When I was first entering the healthcare industry, one of the strangest things to me was the concept of competition between hospitals and healthcare systems that I observed and felt. A hospital or other healthcare organization’s core mission is to optimize the health of the people they are entrusted to serve and the community in which it is located. Therefore, with multiple hospitals located in a region, it would seem to make sense that shared mission and purpose would be a higher and more noble purpose than competition that pits hospitals one against another.
I’ve learned since that hospitals and health systems are collaborating more and more on a variety of shared challenges: decreasing infections, improving patient safety, etc. And, still, there is still competition that could be better directed at improving the health and wellness of communities served.
In my reading and understanding of John Wenger’s blog “It’s not a behavioural problem: it’s the system” I believe he would advise: “What we need if we want organisational transformation, if we want more effective organisations, if we want people to find the work they do meaningful: we need to work with the whole system.”
I completely agree with Anthony Cirillo who wrote in his most recent About.com blog published today: “Healthcare has to heal itself before it can heal others.” It seems to me that systems thinking is critically important in the process of optimizing healing healthcare.
What do you think?
Don’t ask a systems thinker for advice on managing performance or staff engagement. They will probably say something pretty fruity and you’ll wind up frustrated by how fervently they trash conventional wisdom on the subject. Of course performance, engagement, recruitment, they’re all connected, so your systems thinking friend will sound like a fruit loop because they’ll see the whole picture and proceed to suggest that you are asking the wrong questions, when all you wanted to know is “how to get people to do stuff”. You go to them as a sounding board because there is something you like about the way they think; when you’ve talked previously, they come up with ideas that seem counter-intuitive at first, but are actually surprisingly on the money. However, when it comes to a sticky situation you are actually dealing with, you don’t want to hear them bang on about the system, the…
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In this article by Bruce Temkin, he highlights what Aristotle called “practical wisdom,” which refers to “the combination of moral will and moral skill.” Temkin highlights an example cited by Barry Schwartz in his TED speech “Our Loss of Wisdom” about hospital janitors who cater to patient, family, and visitor needs and believe doing so is as essential to their job as what’s on their job description.
“Practical wisdom” is absolutely critical in the work of optimizing healing healthcare. For a similar example of such an amazing patient/family experience in a hospital made possible by a maintenance man full of “practical wisdom,” see my upcoming blog that will be published the week of December 3rd by Hospital Impact, a blog written by and for hospital executives, physicians and other healthcare thought leaders.
I recently watched a video of a TED speech by Barry Schwartz, the author of the seminal book The Paradox of Choice. His TED talk was called Our Loss of Wisdom. Wow! It’s a powerful speech.
Schwartz references what Aritstotle called “practical wisdom,” the combination of moral will and moral skill. He uses anecdotes about janitors at a hospital who alter their prescribed work routines in order to cater to the needs of patients and visitors. His key point is that these janitors believe that human interactions involving kindness, care and empathy are an essential part of their job, even though their job descriptions don’t mention anything about how they should treat other people. According to Schwartz:
“These janitors have the moral will to do right by other people. And beyond this, they have the moral skill to figure out what “doing right” means…. A wise person knows when…
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Carolyn Thomas, in her blog “Study: ‘91% discharged from hospital without care plan’,” not only shares the problems she encountered after leaving the 24-hour care of a hospital following her heart attack but also some disturbing, sad, and mind-blowing statistics about the many others who unfortunately share her experience day-in and day-out.
For the sake of optimizing healing healthcare and the patient experience, Thomas concludes her blog with an excellent and thorough list of recommendations for patients so that they are prepared for the transition from hospital to home and are positioned for success in following their plan of care to optimizing their health and well-being.
When I was discharged from hospital following my heart attack, I was wheelchaired down to the front door, patted on the head, and waved off with just a follow-up appointment with a cardiologist in six weeks’ time. I carried home with me my appointment card, a prescription for a fistful of new daily cardiac medications, a one-page photocopy on post-op wound care, a couple of pamphlets on cardiac rehab and heart-healthy eating, and a Heart and Stroke Foundation booklet called Recovery Road. But nowhere in this small stack of old growth forests was there anything about me.
Me personally. Me, Carolyn Thomas, the shocked and frightened and overwhelmed heart attack survivor.
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In the blog “Ashley Furness: The Secret to Ritz-Carlton’s Customer Service Mojo,” Furness outlines a few core elements to Ritz-Carlton’s success revealed by Diana Oreck, VP of the Ritz-Carlton Leadership Training Center, in an interview.
In a future blog of mine, I will highlight the core elements outlined by Oreck when it comes to optimizing healing healthcare and the patient experience.
A special thanks to Bill Quiseng for bringing this blog to my attention!
Prior to my present position as resort manager for Marriott’s Ko Olina Beach Club, I served as the charter general manager for The Henry – Autograph Collection (Autograph Collection is Marriott International’s exclusive portfolio of independent hotels) when it was reflagged after 21 years as the Ritz-Carlton Dearborn, MI (Ritz-Carlton is a wholly owned subsidiary of Marriott International). Almost all the associates were former Ritz-Carlton “Ladies and Gentlemen”. Last year The Henry was recognized as one of Marriott International’s Hotels of the Year. I am convinced that while they are now The Henry associates they still would bleed Ritz-Carlton blue. And if you’ve every stayed in a Ritz-Carlton hotel you know there is something extraordinary about the refined delivery of customer service by its associates. So when fellow customer service blogger Ashley Furness offered to share an interview she conducted with Diana Oreck, vice president of the Ritz-Carlton Leadership Training…
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Rod Butcher’s blog “Is your Customer Experience a Victorian penny dreadful or the greatest story ever told” uses a very creative metaphor to describe what it might be like for customers as they interact with companies.
I particularly enjoy the simplicity of the metaphor and Butcher’s implied definition of customer experience as the total accumulation of all experiences the customer has with a company that “builds and builds over time.”
Butcher’s description of the customer experience makes me think of the definition of patient experience from The Beryl Institute: “The sum of all interactions, shaped by an organization’s culture, that influence patient perceptions, across the continuum of care.”
Too often, companies — and I will shine the light on hospitals and healthcare organizations — still operate as if the customer (patient) experience is a series of isolated episodes and interactions instead of a carefully orchestrated and interwoven tale and story. Butcher invites the reader to be intentional and purposeful — to consider “how each interaction SHOULD add to the customer’s (patient’s) overall perception, and narrative.”
In the end, optimizing healing healthcare is a purposeful, integrated, and macro approach that “writes” an exceptional and healing experience in which the patient FEELS like (and is) the “star” — not a “victim.” And, when this occurs, both author (the healthcare organization) and protagonist (patient) applaud and await the next chapter in the story called “Healing.”
I hope you, too, enjoy Butcher’s blog!
I remember reading a great paper from a few years ago in the Journal of Service Research, called “Service Design for Experience Centric Services” that talks about the
similarities between customer experience and plays, novels and films. The main point being to think about and design customer experience as ‘theatre’, and consider the dramatic flow and progression (the start, middle and end) of the customer journey as interactions occur.
This makes a lot of sense when you think about disciplines like customer journey mapping; the paper says we typically tend to remember the high and low points, and the ending, how you feel at the interaction’s conclusion. I would emphasise the word, ‘feel’ here, because it is our emotional response to customer experiences that will stay long with us after the mechanics – the nuts and bolts – of an interaction are long forgotten.
The sad fact is that doing…
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In order to optimize healing healthcare, deep listening that leads to understanding is an absolutely critical skill and competency. Recently, I have heard story after story (including some from my mom) of patients warning their nurse or phlebotomist that they are a “hard stick.” What that ultimately means is that the patient may be seeking a smaller needle for a successful blood draw or, in my mom’s case, a draw lower on her arm and closer to her wrist where her veins tend to roll less. More often than not, the response from the clinician is the following or similar, “I will be extra careful; I am very good at this” and the result is predictable — a blown vein, pain, and frustration on the part of the patient who concludes, “I told you so but you didn’t listen!”
The patient experience is founded in trust and a sense of partnership between caregiver and the one who entrusts him or herself into another’s care. Failing to incorporate the patient’s experience and overriding their input, suggestions, and caveats increases anxiety, diminishes trust, calls respect into question, and is felt as dismissive and even paternalistic — qualities and realities that fly in the face of optimizing healing healthcare.
In this blog by Robert Whipple, he offers some practical steps that anyone — including nurses, phlebotomists, and anyone caring for others — can use to hear, listen and move toward understanding.
We have all experienced the phenomenon where we have tried to explain something to an individual who appears to be paying full attention. The individual was alert and nodded many times giving the impression of understanding. Later on we found that the individual internalized almost none of the information we were trying to convey. This article explains why this happens and offers some antidotes.
To internalize a message, one must not only pay attention, but the information must sink into the brain enough for recall and action. Listening can be happening even though there is little comprehension. A typical example of this occurs when dealing with two people who have different primary languages.
I noticed this phenomenon often when working with technical people in Asia. They were able to understand English, so we used that for communication. They would nod and give verbal cues (like “uh huh”) when I talked…
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