Culture of Excellence RAYMOND

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Culture of Excellence RAYMOND

  1. 1. Patricia L Raymond MD FACP FACG Rx for Sanity, Norfolk VA RxForSanity.com
  2. 2. www.RxForSanity.com
  3. 3. www.RxForSanity.com
  4. 4. ~ A cocktail napkin RxForSanity.com
  5. 5. ~ Gail SheehyLearners agreement RxForSanity.com
  6. 6. www.RxForSanity.com
  7. 7. ~Mark Twainwww.RxForSanity.com
  8. 8. www.RxForSanity.c om
  9. 9. RxForSanity.com
  10. 10.  RxForSanity.com
  11. 11.  Fun is good “…in our haste to seek the American dream, we‟ve sucked the fun, passion, and creativity out of the workplace.” ◦ Instant replay ◦ Disco inferno night ◦ Lowest attendance record ◦ Labor day www.RxForSanity.com
  12. 12.  Melissa McCants, College of Charleston Athletic Department (& former Veeck employee) Mark off a large athletic field in squares, raffle 300 spaces for $100 each, and bring in a cow. Wherever the „chip‟ fell determined the winner. Gallon of “Holy Cow” ice cream to owners of squares visited at least 15 minutes All-you-can-eat oyster roast $25 After $10,000 prize for bingo, netted $30,000 for scholarship fund www.RxForSanity.com
  13. 13. Cow BingoCollege of Charleston Athletic Department300 spaces for $100 each, $10k prizeGallon of ice cream if cow lingers 15 minutes www.RxForSanity.com
  14. 14. Let go, lean,& laugh www.RxForSanity.com
  15. 15. RxForSanity.com
  16. 16.  Fun is good (in healthcare too) Fun/satisfaction in medicine=transition to health From patients to partners ◦ Patient Ed and Assignments  Stool diary ◦ Snaps for good efforts for health www.RxForSanity.com
  17. 17. You treat a disease, you win, you lose. You treat a person, I guarantee you, youll win,no matter what the outcome. ~Hunter Patch Adams RxForSanity.com
  18. 18. RxForSanity.com
  19. 19. www.RxForSanity.com
  20. 20. Did I bring joy?Did I find joy? Egypt afterlife RxForSanity.com
  21. 21. www.RxForSanity.com
  22. 22. www.RxForSanity.com
  23. 23. www.RxForSanity.com
  24. 24. www.RxForSanity.com
  25. 25. www.RxForSanity.com
  26. 26. www.RxForSanity.com
  27. 27.  Disease of the month Body art- sharpies, bottom décor Ownership of their health- Nona‟s book Cartoon book Butt Meddler, butt-ons, joke books RxForSanity.com
  28. 28. RxForSanity.com
  29. 29.  Did you bring joy? Did you find joy Fun is good Genuine curiosity RxForSanity.com
  30. 30. RxForSanity.com
  31. 31.  RxForSanity.com
  32. 32. RxForSanity.com
  33. 33.  Hunker Down The more I ignore things, the bigger they get. RxForSanity.com
  34. 34. www.RxForSanity.com
  35. 35.  Heart broken Butt kicked Ego bruised Stabbed in the back Crushed Stepped on Left hanging RxForSanity.com
  36. 36. “…bullying significantlylowered workplace morale, created poor working relationships, and resulted in a poor working environment.”
  37. 37.  2100+ MD & RN executives ◦ 67% nurses ◦ 68.9% hospital setting 97% “experience behavior problems with docs and nurses” ◦ 12% note increase in last 3 years Problems occur: ◦ Daily 9.5% ◦ Weekly 30% ◦ Monthly 25.6%
  38. 38. YellingDegrading comments & insults Cursing Refusing to work together Refusing to speak to each other Spreading malicious rumors Inappropriate joking Trying to get someone disciplined unjustly Trying to get someone fired unjustly Throwing objects
  39. 39. www.RxForSanity.com
  40. 40. Who most often exhibits behavior problems?Doctors 45.4%Nurses 6.8%A pretty even mix ofdoctors and nurses 47.9%
  41. 41. www.RxForSanity.com
  42. 42. Bullying behavior in medicine Attack upon competence & reputation Personal attack Attack through work tasks Hutchinson, Nurse Researcher 2008
  43. 43.  My reputation was damaged by false allegations My achievements and contributions were ignored My abilities were questioned I was given work above skill level and refused help I was denied development opportunities
  44. 44.  I was ignored I was belittled in front of others I was watched and followed I was blamed I was publicly humiliated I was threatened
  45. 45.  My work was excessively scrutinized I was allocated the heaviest workload My work was organized to inconvenience me I was given demeaning work below my skill level
  46. 46.  My work life was made difficult I was excluded from receiving information My work was organized to isolate me
  47. 47. ~Anonymouswww.RxForSanity.com
  48. 48.  VHA Survey ◦ 2562 respondents, 1615 nurses ◦ 37% “Nurses are leaving the hospital as a result of disruptive behavior”  If +, average number of nurses 2.5/year Rosenstein The Physician Executive; 2002
  49. 49.  Knaus 1986 Ann Int Medicine ◦ 5030 patients in 13 ICUs  Differences in death rates related to interaction and communication between nurses and MDs Shortell 1994 Medical Care ◦ 17,440 patients in 42 ICUs  Group culture, leadership, communication, coordination, c onflict management abilities  Lower risk-adjusted length of hospital stay  Lower nurse turnover  Higher technical quality of care www.RxForSanity.com
  50. 50.  The worst behavior problems aren‟t the most „show-y‟ ◦ “It‟s the everyday lack of respect and communication that most adversely affects patient care and staff morale”  Fear of questioning attitude ◦ Better teamwork leads to fewer OR errors  OR is most common site for adverse events to occur  47.7% -50.3% of AEs for surgical patients Johnson PEJ; 2009; Catchpole Ann Surg 2008
  51. 51.  VHA Survey: 102 hospitals, Jan 2004- March 2007 ◦ 4530 participants, 2846 nurses 67% agreed disruptive behavior was linked with adverse events ◦ 71% medical errors ◦ 27% patient mortality Rosenstein Jt Comm J Qual Patient Saf 2008
  52. 52. News Report:www.RxForSanity.com
  53. 53. www.RxForSanity.com
  54. 54. www.RxForSanity.com
  55. 55.  Insistent Persistent Consistent If it doesn‟t work… www.RxForSanity.com
  56. 56. -Oscar Wilde 1854-1900www.RxForSanity.com
  57. 57. www.RxForSanity.com
  58. 58. ~Jack Canfieldwww.RxForSanity.com
  59. 59. ~Tiger FormTai Chi, Nam Hoa Temple RxForSanity.com
  60. 60. Potential Pictogram RxForSanity.com
  61. 61. ~Susan Elizabeth Phillips, Breathing Room RxForSanity.com
  62. 62. -Did your sphincters tighten? -Keep trying to see conflict asblessing, potential, opportunity RxForSanity.com
  63. 63. -Ones you initiate-Ones that are thrust upon you RxForSanity.com
  64. 64. RxForSanity.com
  65. 65.  First, get centered Second, establish who you are wiling to be in the moment ◦ Select three, and if you can get the other party to commit to three…) RxForSanity.com
  66. 66.  Alert  Generous Appreciative  Gentle Attentive  Grateful Clear  Joyous Compassionate  Kind Courageous  Loving Creative  Open Empowering  Present Enthusiastic  Receptive Flexible  Supportive Focused  Truthful  Vulnerable RxForSanity.com
  67. 67. ~ Beverly Sills RxForSanity.com
  68. 68.  Cultivate non-resistance ◦ Martial arts, yielding ◦ Don‟t tense up! Resistance is futile. Non-resistance is fertile. RxForSanity.com
  69. 69.  Cultivate non-resistance ◦ Martial arts, yielding ◦ Don‟t tense up! Only two sentences for you: Tell me more. then What do you need? ~or~ What‟s missing for you? RxForSanity.com
  70. 70. “attend to them with the ear of your heart…” ~Prologue, Rules of St. Benedict RxForSanity.com
  71. 71. ~ Ruth Gordon RxForSanity.com
  72. 72. ~Ralph Waldo Emerson RxForSanity.com
  73. 73. RxForSanity.com
  74. 74.  RxForSanity.com
  75. 75. RxForSanity.com
  76. 76. Just like everybody else.pairshare
  77. 77. www.RxForSanity.com
  78. 78. www.RxForSanity.com
  79. 79. RxForSanity.com
  80. 80. RxForSanity.com
  81. 81.  1920‟s study at Hawthorne plant, Cicero Il. Increased lighting, shorter workdays, other worker friendly fixes to improve productivity Boosted performance noted, but due to changes in social environment, not physical. Increased attention led to happier and more effective employees. www.RxForSanity.com
  82. 82.  Gallop Organization 1998 Extensive interviews with highly productive workers ◦ 5.4 million employees at 474 organizations Developed 12 statements to measure happiness with work=“engagement” Sept ‟04: 29% engaged, 55% not engaged, 16% actively disengaged www.RxForSanity.com
  83. 83. RxForSanity.com
  84. 84.  Do you know what is expected of you at work? Do you have the materials and equipment you need to do your work right? At work, do you have the opportunity to do what you do best every day? In the last seven days, have you received recognition or praise for doing good work? Does your supervisor, or someone at work, seem to care about you as a person? Is there someone at work who encourages your development? www.RxForSanity.com
  85. 85. RxForSanity.com
  86. 86.  At work, do your opinions seem to count? Does the mission/purpose of your company make you feel your job is important? Are your fellow employees committed to doing quality work? Do you have a best friend at work? In the last six months, has someone at work talked to you about your progress? In the last year, have you had opportunities at work to learn and grow? www.RxForSanity.com
  87. 87. www.RxForSanity.com
  88. 88. RxForSanity.com
  89. 89.  360 degree feedback 1. Truth lunch:  Employee gets $25 to take manager to lunch at location of their choice outside hospital for straight talk and honest feedback 2. Twelve coupons for “Listening Time”  20 minutes to talk to you about anything www.RxForSanity.com
  90. 90. www.RxForSanity.com
  91. 91. RxForSanity.com
  92. 92.  Guidelines for your area ◦On time ◦Respect ◦Assistance ◦Lunch relief ◦Uniform selection ◦Come to leadership with BOTH a problem AND a solution. www.RxForSanity.com
  93. 93. www.RxForSanity.com
  94. 94. www.RxForSanity.com
  95. 95. www.RxForSanity.com
  96. 96. www.RxForSanity.com
  97. 97.  If you had a magic wand, and could wave it over your staff/patients/colleagues and get them to do any one thing differently, what would you choose and why? If the people in your office were singing a blues song about their job, what would they be singing about EXACTLY? RxForSanity.com
  98. 98. J. Haidt, UVawww.RxForSanity.com
  99. 99. www.RxForSanity.com
  100. 100.  “Make a Change” “Pass it on” The “put-down, put-up bean jar” exercise Are your staff suffering from O.R.? ◦ “Bell-Ringers” “Give Up the Chip” www.RxForSanity.com
  101. 101.  Recognize Positive Behaviors ◦ NorthShore Regional Medical Center, Slidell Lo. ◦ Vote for awards for MDs with positive behaviors and attitudes ◦ Congeniality, most compassionate, best dictation, best teacher, best penmanship, best bedside manner, best phone etiquette Begin an epidemic of elevation in your office or unit! www.RxForSanity.com
  102. 102. How would you describe the working environment in this unit?How are staff recognized?Is innovation valued here? If so, give me an example of how. www.RxForSanity.com
  103. 103. www.RxForSanity.com
  104. 104. No matter how big or warm or soft your bed is, you still have to get out of it. ~Grace Slick Opportunity Hit List: Grow, stretch, & learn Internal job fairs Grow your own staff: CE eligible classes Give good feedback, weekly or monthly ◦ Set written goals and deadlines www.RxForSanity.com
  105. 105. 1. Build a flexible staff Cross trained Part time  Half shifts and 4-10 hr days2. Address concerns re physical nature of job Zero lift policy www.RxForSanity.com
  106. 106. www.RxForSanity.com
  107. 107.  Newsletters Thank you cards Display accomplishments in unit Spotlight and encourage their volunteerism “Caught Doing Good” www.RxForSanity.com
  108. 108. RxForSanity.com
  109. 109.  Nomination by other staff Nominee must be caught going beyond job description Outcome of action had positive result in patient care The result must further one of the hospitals mission statements www.RxForSanity.com
  110. 110.  Improved working relationships amongst staff and between staff and patients ◦ Enhanced job satisfaction and reduced turnover of both nurses and MDs ◦ Reduced LOS and costs of health care ◦ Better patient outcomes ◦ And…it‟s more fun to be at work! www.RxForSanity.com
  111. 111. Do theNEXT thing. ~Betty Luse RxForSanity.com
  112. 112. RxForSanity.com
  113. 113. RxForSanity.com
  114. 114. SSDT RxForSanity.com
  115. 115. ~ A cocktail napkin RxForSanity.com
  116. 116. RxForSanity.com
  117. 117. RxForSanity.com

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