A friend sent the following link to the post, 7 Cultural Concepts We Don’t Have in the US, over the holidays this year and it was a nice break from my regular reading. The author, Starre Varten, highlights seven cultural concepts originating in other locales around the world, such as “Kaizen” from Japan, which many in healthcare have already adopted with resounding results. I especially liked the Danes practice of “hygge”, or the idea of togetherness, coziness as a mental state versus physical one. She describes “hygge” as being akin to family and friends, gathered around the warm crackle of a fireplace enjoying good food and drink together as the first winter snow falls outside. Denmark is repeatedly rated as one of the happiest countries despite the long, cold winters they endure. Given the extent and brutality of our last two US winters, I would be more than willing to adopt hygge as a core part of my own culture!
Varten also reminds readers:
Culture is ours to do with as we choose, and that means that we can add, subtract, or edit celebrations or holidays as we see fit — because you and me and everyone reading this makes up our culture, and it is defined by us, for us, after all.
Culture change is admittedly not an easy or quick event, especially within healthcare. It takes time and commitment, and sometimes a game-altering nudge to the status quo! Changing the narrative and creating a new picture of an ideal healthcare environment is one place to begin–and while it may seem foreign at first, the benefits can very often outweigh any risk. There is a growing group of healthcare change agents embracing the uncertainty of change–certain that by taking the leap to innovate healthcare–patient and provider alike will be the beneficiary. This group is behind USA Change Day (@USAChangeDay), which is built off the pioneering work of the National Health Service (NHS). The NHS launched Change Day in 2013, and Helen Bevan (@helenbevan) has been a lead healthcare change agent in the UK, putting a refreshing and inspiring spin on something that began as a grassroots campaign, started by a small team and which has now taken flight. From the USA Change Day website:
…Its mission was simple—to challenge everybody within the organization to pledge just one thing that they would commit to doing in the next year to improve healthcare. This small initiative turned into a huge success, and now we’ve brought the movement to the United States of America.
You can follow their efforts @USAChangeDay, or better yet, join the cause!
What will you commit to doing in the next year to improve healthcare?
To all those looking to lead healthcare differently–
- …to include and honor the voice of patients
- …to ensure healthcare professionals are allowed to be open and honest with patients, and one another
- …to honor a culture of safety above all else, and;
- …to adopt wearables and other new technology that allow patients to better monitor and manage their own health
–here’s to the crazy ones.
And finally, another great “Jobism” from his oft quoted graduation speech at Stanford University, three years before his death:
“Stay hungry. Stay foolish.”
I recently watched the film, Jobs, a biopic based on the life of Steve Jobs, Apple Computer Cofounder, Chairman and CEO. Jobs and partner, Steve Wozniak, started the legendary company in his garage in 1976 in what ultimately resulted in one of, if not, the greatest changes to the landscape of personal computing and digital content development to date. Jobs’ vision and passion for creating technology that would extend the vision and passion of every one of us, never wavered even though he was challenged countless times by doubters with limited vision themselves.
So the story goes, Jobs was told by his Board, “people aren’t going to want a personal computer,” and he ultimately was fired from his own company in 1985, and then later rehired in what many call one of the greatest company turnarounds. Throughout the ups and downs of his career, Jobs remained passionate about the need to deliver the highest quality technology products directly to consumers, putting the ability to create just about anything in the homes of users. Thanks to Jobs passion, stubbornness and entrepreneurial spirit we now have the iMac, iPod, iPad, iTunes, iPhone…the list goes on…and ways in which consumers use each device continues to expand in direct proportion to the freedom given to the imagination.
Healthcare is adopting the devices created by Jobs and his Apple teams at the frontline of care in many places–places where visionary healthcare leadership is too passionate to hear the fearful naysayers that impede the progress we all know also prevents zero preventable harm and returns joy and meaning to the healthcare workplace. In the following clip from the Jobs film, actor Ashton Kutcher delivers the inspirational lines below. Whether Jobs actually said these exact words or not, he has said much that echoes similar sentiment. Those working to influence much needed change in healthcare can draw strength from the dialogue when faced with doubters of our own. To find like-minded healthcare colleagues, be sure to check out ChangeDayUSA!
You got to have a problem you want to solve, a wrong that you want to right. And it’s got to be something you are passionate about, otherwise you won’t have the perseverance to see it through…And in your life, you only get to do so many things, and right now, we’ve chosen to do this. So let’s make it great.
“If transparency were a medication, it would be a blockbuster, with billions of dollars in sales and accolades the world over. While it is crucial to be mindful of the obstacles to transparency and the tensions—and the fact that many stakeholders benefit from our current largely nontransparent system—our review convinces us that a health care system that embraces transparency across the four domains will be one that produces safer care, better outcomes, and more trust among all of the involved parties. Notwithstanding the potential rewards, making this happen will depend on powerful, courageous leadership and an underlying culture of safety.”
The previous paragraph comes from the fifth and final National Patient Safety Foundation’s Lucian Leape Institute (LLI) White Paper entitled, “Shining a Light: Safer Health Care through Transparency”. Each of the five white papers address key issues that healthcare stakeholders will need to successfully manage if healthcare is to achieve zero preventable harm. I was honored to be part of the panel that helped create this paper and the 39 recommendations for greater transparency throughout healthcare.
Defining transparency as “the free, uninhibited flow of information that is open to the scrutiny of others”, the paper provides recommendations in four different domains of transparency:
- Transparency between clinicians and patients (illustrated by disclosure after medical errors)
- Transparency among clinicians themselves (illustrated by peer review and other mechanisms to share information within health care delivery organizations)
- Transparency of health care organizations with one another (illustrated by regional or national collaboratives)
- Transparency of both clinicians and organizations with the public (illustrated by public reporting of quality and safety data)
I encourage everyone to visit the LLI website and download the White Paper (click here for a copy). Increased transparency is critical to any Patient Safety mission. Greater transparency throughout the system is not only ethically correct, but will lead to improved outcomes, fewer errors, more satisfied patients, and lower costs.
Those where the words shared by former President Bill Clinton as he helped kick-off the 2015 Patient Safety, Science and Technology Summit this past weekend (http://patientsafetymovement.org/). The former president has been a keynote speaker at all three annual Summits and sees the Patient Safety Movement’s mission similar to the Clinton Foundation Global Initiatives Program (GIP).
Working with former President Clinton, Joe Kiani adopted a similar “commitment” model used by Clinton’s collaborative GIP in selecting preventable medical harm and setting a goal of Zero Preventable Deaths by 2020 (0X2020). There has been a lot of great work by many patient safety advocates since the release of the IOM report on preventable medical harm fifteen years ago. The Patient Safety Movement is another example of people wanting to make a difference and help reduce risk in healthcare. We hear “it takes a village” and Joe Kiani continues to bring more people wanting to make a difference into the “safety village”.
This year, Joe worked his magic and was also able to bring Vice President Joe Biden into the safety village. The Vice President was wonderful – he spoke passionately and eloquently about the safety crisis. He admitted that two years ago when he agreed to meet with Joe, he knew little about the preventable medical error crisis but quickly changed his 30 minute meeting with Joe into a two-hour tutorial on the issue. Like many others, he has become an engaged partner and re-arranged his very busy schedule so he could attend, address the crowd and hear about the great work going on by many.
In a short time, the Patient Safety Movement has brought high-ranking “partners” into the safety village, added tremendous value to the mission, and brought significant attention to the great work done by many others over the past fifteen years.
As former President Clinton said, we need to embrace more “people who are dying to be asked to make a difference”. It does take a village…and we need to continue to grow our safety village.
Of all the books on my nightstand, Timothy Wilson’s, Redirect: Changing the Stories We Live By, has quickly risen to the top of the stack. An easy-to-read, research supported, “how to” on the tools we can use to craft personal narratives that change behavior is music to an already adopted choir. What we have accomplished intuitively with good catch stories, and sharing of patient and provider stories in the healthcare workplace crafted to influence culture change to date, now has a loosely related scientific explanation as to why it may be working. All along, these stories have been providing the “story-prompts” Wilson speaks of–also known as alternative ways of viewing the tough, lesser talked about events that occur in a healthcare setting. Applying Wilson’s research on narrative to healthcare culture, the repercussions of patient harm which often includes healthcare professional feelings of guilt or depression compounded by the lack of a just culture from which to manage both can now be the “old” story, and we can eagerly rewrite exactly what we want our future healthcare culture to look like. We can create a better way of managing both patient and provider when things don’t go as planned by writing the new narrative, along with the roadmap to achieve our new healthcare worldview.
It was the recent NY Times Well Blog post, Writing Your Way to Happiness, by Tara Parker-Pope summarizing Wilson’s Redirect, that prompted me to sit down at the keyboard, as she writes:
The scientific research on the benefits of so-called expressive writing is surprisingly vast. Studies have shown that writing about oneself and personal experiences can improve mood disorders, help reduce symptoms among cancer patients, improve a person’s health after a heart attack, reduce doctor visits and even boost memory…
The concept is based on the idea that we all have a personal narrative that shapes our view of the world and ourselves. But sometimes our inner voice doesn’t get it completely right. Some researchers believe that by writing and then editing our own stories, we can change our perceptions of ourselves and identify obstacles that stand in the way of better health…
What is surprising to me is that this fact is surprising to so many. In third grade, thanks to the educational genius of Robin Fogarty PhD, an elementary school teacher at the time and now educational consultant, my classmates and I learned early on the power of daily journaling, or documenting the personal narrative. Wilson takes this healthy release one step further, and teaches those who want to change behavior to create a new personal narrative that matches the desired story of our lives. It’s not just writing the outcome either, but also a well-crafted tale of how to get there. His book provides real tools that can be applied to personal or professional life, as well as to encourage the lasting change needed in healthcare. And, his work reinforces the numerous posts on the power of storytelling here on ETY, as well as in the recently released eBook, Using Stories to Influence Change in Healthcare Culture.
For those who enjoy video versus an inviting tome, check out Wilson’s lecture below on the same topic!
The deadline to apply for 2015 sessions of The Academy for Emerging Leaders in Patient Safety: The Telluride Experience has been extended to February 15th! Medical students, nursing students with less than 10 years experience, and resident physicians can apply online at The Telluride Experience website by clicking here. Dates and locations include:
- In Telluride, CO: For Health Science Students-June 7th-11th and for Resident Physicians-June 12th-16th.
- In Napa, CA: For Health Science Students-July 26th-30th.
- At Turf Valley Resort in Ellicott City, MD: A combined session for Resident Physicians and Health Science Students-July 8th-12th.
Students who are accepted receive a full scholarship covering room, board, transportation voucher & all educational costs. Resident physicians accepted to attend should be sponsored by their program. Expected faculty for 2015 include healthcare and patient advocate thought leaders:
- Founder–David Mayer, MD
- Curriculum Director–Anne Gunderson, PhD
- Aviation Consultant and Author–John Nance
- Leadership Coach and Author–Paul Levy
- Founder, Josie King Foundation–Sorrel King
- Director, Foundations of Doctoring Program at University of Colorado–Wendy Madigowsky, MD
- Healthcare Advocate and Author–Rosemary Gibson
- President, Mothers Against Medical Error–Helen Haskell
- Founder, Citizens for Patient Safety–Patty Skolnik
- Director of Undergraduate Education, Clinical Excellence Commission–Kim Oates, MD
- And more…
Join us in our 11th year and become part of a preeminent and growing alumni network while developing the skills and knowledge to be a patient safety leader of tomorrow!