In a recent webinar for our ActionCue clients, Prista’s panel of experts answered questions about healthcare innovation and the role of leadership in creating action that improves patient safety and quality.
As President and Founder of Prista, Don Jarrell brings more than 30 years of technology experience in products management, application design, technology strategy and intellectual property management licensing. Don has provided the vision for Prista and for the ActionCue application.
Billie Anne Schoppman is a Registered Nurse and CPHQ (Certified Professional in Healthcare Quality) with more than 30 years of experience in the healthcare industry. As the Chief Mission Officer at Prista, she brings her passion to create the most efficient environment for improvement.
Dr. Jake Redden is a member of Prista’s Advisory Board with expertise in patient safety, healthcare quality, human factors, crew resource management, and safety culture, and is certified in healthcare quality and patient safety.
Don Jarrell: I wouldn’t want to be a healthcare CEO these days. The pressure is enormous and it’s coming from every sort of angle, internally and externally. We respect that and want to address the areas of greatest concern for hospital executives, particularly CEOs.
Quality doesn’t occupy the same space as when it was simply delegated to a mid-level team member and not given much attention. Thanks to the pay-for-performance landscape—with macro NIPS, ACOs and everything else—you’re either going to get penalized for bad quality or safety issues, or you’re going to miss out on incremental income if your quality and safety, and performance track records don’t reflect the right things.
There’s a direct link between quality, safety and your financial considerations, as well as your regulatory issues, because when licensure is on the line, you want to live up to all of those standards. However, many C-level executives spend most of their time trying to actually run the operation and struggle to find time to address other crucial issues.
By taking good care of the quality, safety and improvement process, we are essentially taking some of the pain away from the C-levels so they can spend more of their time looking at those other areas. The quality and safety efficiencies we focus on also have a favorable impact on all of these other areas.
By getting an efficient, comprehensive look at their quality and safety situation, C-levels and the individuals who report directly to them can immediately link that to what their organization is doing. That makes the entire executive review process, given the sort of CEO’s mindset or perspective, much more efficient.
Dr. Jake Redden: Nothing replaces the foundational understanding of patients’ safety within the total leadership curriculum. That is the reason almost all hospital CEO jobs require an MHA or graduate degree. Most leadership courses are not going to take you much further than answering the “why” question or trying to help build a platform which leadership can act upon.
Leadership classes and seminars will not tell you what has to be done every day in your hospital. Building a culture of quality and leaning towards a higher liability organization of care delivery takes everyone working together, with real time insight and meaningful feedback on how their efforts are contributing to the improvement of patient care throughout the entire hospital.
One of the suggestions from the National Patient Safety Foundation last month was to insure that technology is safe and optimized for patient safety. This certainly applies to medical monitoring, decision support software and electronic medical records, but it also applies to the tools that senior leaders are using to monitor and improve the safety landscape for hospitals.
By now, almost all executives realize unintended consequences related to implementing any new technology happen almost every time. Implementing a new technology inadvertently changes the way people work and reduces new and unanticipated problems that we’ve got to deal with.
Our executives are quick to acknowledge this realization and deal with adjustments out on the floor with our patient flows. However, we are bad with making those adjustments to our own personal work processes that can result in maximizing the benefits of any new technology and what it’s supposed to provide us as a decision maker.
As executives, we have to dedicate time every week to review reports and patient safety indicators that are unique to our organizations. We have to let our frontline experts make the improvement, but we also have to be there to provide support.
More importantly, leadership needs to provide the accountability to insure that improvement efforts and innovation are occurring at every single opportunity, big or small. Every unsafe condition, outdated care process, or safety report that gets completed should have a senior leader devoting protected time to the right oversight of patient safety, and driving innovative change and solid improvements.
Don Jarrell: From an outside analyst view, people use the term culture of quality a lot, but in a presentation I did for ASHRM, I talked about what it really means to have an operative culture of quality. It’s not the slogans, the posters on the wall or the methodology that’s named. It’s really how people feel about the culture of quality.
To put it another way, it’s that voice we hope is inside everyone’s head on the clinical staff repeating over and over, “This is how we do our work.” If you really want to hook into that in a way that is sustained, it can’t be just a speech the CEO gives. The continuity of leadership and leader participation is important, but to really get it to continually present for the users and clinical staff, you need to make it a part of their daily work.
That’s why we focus on actually giving organizations a workbench and a working platform for their collaboration, reporting and investigation, so we can change their behaviors directly as they work toward the goal of quality and safety.
Actually addressing the work rather than the mind has been a strong teaching method of behavioral psychologists for a long time. They typically contend that you don’t change attitude to change thinking and actions, you change actions to change thinking and attitude. We come in with a very behaviorist approach to changing the working environment by changing the working platform.
Billie Anne Schoppman: It’s tough to find one thing, but mine is action. We need to take action now to make a positive impact on our organizations. There’s always change in healthcare. Now is the time. Innovation is the new strategy.
Everywhere you look, whether it’s online or with evidence-based data, the movement is toward innovation. Why? Because we are doing operations well. You want to be efficient? That’s great. You want to be predictable? That’s good. But we want growth. We want to meet the demands of the future. We want to prove our value to the community and to our customers. That’s innovation.
We have processes that have been in place for years. Let’s allow people in the organization to be creative, because if they are, they will take risks, which will lead to actions that drive change. That’s the one thing that can have the most positive impact on organizations right now. Take a risk, be an entrepreneur and take action.
Dr. Jake Redden: I always help organizations fix things more effectively the first time. When the frontline staff sees a level of consistent engagement from the executive team, it increases support from other frontline employees. We see the enthusiasm and overall improved safety culture grow.
Consistency is where we fail. We start out with a lot of enthusiasm in the C-suite, but by the third month, we’ve stopped having our regular, protected time check-in meetings, and we’re bypassing stuff. It ends up looking like a lot of lip service to those frontlines, so executives have to be available and present, and expect improvement.
Accountability is where their money comes from on those frontlines. They’ve got to not only trust, but verify as well. They’ve got to go out and make sure that we actually fixed the things that were reported last month in order to do that consistently, every single day, and every single opportunity, big or small.
We hope you will read our final installation in the series about Healthcare Innovation, Leadership and Action, coming soon. Reach out to us via email or on social media if you have questions or comments, and let us know what challenges you’re facing and how ActionCue CI can make a difference for your patients.