Viewing entries tagged
engagement

what if corporate personality tools were used in medicine?

Treat me how I want to be treated at that moment without knowing me or how I feel. Seems like a reasonable request, right? Maybe not so much. And still, it’s what our modern —indeed overdue —conversation about patient-centered care demands. Patients and providers are clamoring for better partnerships; they desire to communicate effectively, to understand one another. But we don’t really have great tools and processes in place to support fast, low-effort assessments of learning styles and communication preferences.

Are you visual or aural? Do you need control or want to be directed? Does the nature of a situation affect how you might answer that question? Do you want reenforcement, an opportunity to teach back, an opportunity to question? Do you need time to reflect, or do you make quick decisions? And how many of even clearly know these things about ourselves in our daily lives, let alone when we are dealing with our health and wellbeing.

Imagine this scene: you arrive at your annual physical. Except for the occasional cold, you really only see your physician once a year. How well do you really know each other? You are highly visual and prefer diagrams to lengthy documents. You also like to have all the facts and tend to worry when you feel under informed. You are ok to let someone else plan things, so long as you know the plan. Your physician, in her spare time, is an amature writer. She would much prefer writing to talking, and is often reserved during your interactions. She is of a generation where her training reinforced a paternalistic, I know best style of practice.

You have 25–30 minutes together for your visit. Most of that time is spent doing a physical exam and updating your history. But your physician finds something unexpected, a lump. “Get an MRI and I’ll call you soon when we know more…”

Do things break down?

Do you leave feeling informed or terrified or somewhere in between? Could you describe to your spouse what happened, where the lump is and what it might be?

The challenge with treat me how I want to be treated at that moment without knowing me or how I feel is the unfair burden it places on both parties. How, in a time-restricted environment are two parties supposed to quickly get to know one another’s styles and preferences in a way some spouses even spend years working towards? And, for patients and physicians who have a long-standing relationship, wouldn’t an aid at least help remind you of the other person’s prefernces, so you don’t have to rely on memory or assumptions?

When I worked for a large multi-state health system, we used a commercial tool called Personalsys. Everyone in a management role took an online personality preference test. The computer spit out a brief narrative and color-coded chart. As will not be a surprise to those who have worked with me, I tend to be highly energized by ideas and creative brainstorming and am less driven by deadlines than others (something I’ve had to build systems to help support). Many of my healthcare finance coworkers, at the risk of generalizing, were, conversely, highly structured. They like plans and deadlines and clear objectives. If we had a meeting, someone would see my chart and the spikes in my green creative areas, where they might have spikes in their red structure areas. “Ohhh you’re one of those aren’t you? All creative and loosey-goosey…” And we’d laugh and poke fun at each other’s personality traits and preferences. “yeah, well I bet you’re all tightly wound and obsessed with numbers…”

Personalysis

In reality, the framed charts behind everyone’s desks became a bit of an inside gag. The insecure among the lot would cast their doubts on the efficacy of the hippie tools and new age management practices. But even the doubters knew there was some benefit to understanding how their colleagues work and think. You could walk into someone’s office, and know within seconds how they like to interact and work with other people, and in turn what you might expect from them.

There are other examples of these types of tools which are being deployed increasingly in large corporate settings. The DISC assessment, for instance, looks at how a person feels about control using the vernacular of dominance, inducement, submission and compliance. And what discussion of personality inventories would be complete without a mention of my personal favorite, the Myers-Briggs Type Indicator (I’m an ENFP for the inquiring minds out there)?

DISC

Visual and narrative aids like Personalysis or the DISC assessment, are not commonly a part of patient-provider interactions. But why shouldn’t they be used? Imagine if every patient had a card with a visual indicator on one side, in a short narrative about their preferences and styles on the other. What if every doctor had a similar tool framed on the wall of their exam room and office? Patient styles and preferences would be stored in medical records and patients could learn about their physicians’ styles online before visits.

Now imagine this scene: you arrive at the emergency room with chest pains and shortness of breath. You are scared, but not in dire straits. You are taken back, immediately, into an exam bay. A physician comes in, sees your chart and knows right away that you like to be in control of situations. You are aural and work better with big pictures than minutia. How might their communication style change to meet your needs, where you are, at that exact moment? Perhaps, in stead of patting you on the shoulder and saying “you are going to be fine dear…” they might instead offer “Ok, we’re going to move quickly, my concern is a blockage, so we’re going to get you to the cath lab, you’ll remain conscious, this is a great team who has done more of these than anyone else in town, after the cath, we’ll know more. Is that plan ok with you?”

To be fair, I suspect the later example is more typical of modern physician communication styles than my patronizing former example. But there is still room for a tool to help aid the process.

We need something quick, easy to understand and effective. It should be a two-way tool, allowing both patients and providers to quickly understand each other and meet in the middle. If this idea of participatory shared decision making is to work, it’s going to need some aids. The good news is some examples already exist. The folks at Diagram Office, a New York-based design firm have created some fantastic conversation aids around shared decision making.

Diagrams OpenIDEO submission

I’m still looking for a solution which fits upstream of decision making. I’m suggesting something which exists as the very first step between a patient and provider, before a word is ever spoken.

Anyone have a prototype?

From Elsewhere: The Bossless Office

Bossless Office (Photo: Illustration by Marc Boutavant)

…“Management is a term to me that feels very twentieth century, … That 100-year chunk of time when the world was very industrialized, and a company would make something that could be stamped out 10 million times and figured out a way to ship it easily, you needed the hierarchy for that. I think this century is more about building intelligent teams.”

—Simon Anderson, CEO of DreamHost

One of my biggest concerns about the future of healthcare is the industry’s attractiveness to bright young people. Let’s face it, unless you are doig cutting edge clinical work, there’s not a lot in healthcare which compares to Google’s sushi bars, segways and wifi-blanketed busses.

The hospital workplace is still one of the most conservative environments in corporate america. Dark suits, wood paneled board rooms and hierarchy are the norms. I haven’t spoken to many college-aged young adults who are anxious to flock to that kind of workplace.

Enter the Bossless Office. A feature this week in New York Magazine looks at an emerging trend in management, or the lack of it.

There’s a lot to like about this idea and its application to the healthcare environment. Could it help entice more of the start-up, rapid pace, rapid reward crowd? I think so.

This structure—largely flat and very flexible—is especially appealing to those new to the workforce, twenty-somethings who tend to approach work differently from their parents. “The way workers are motivated is changing,” says Anderson of DreamHost. “Twenty years ago, it was about higher pay. Now it’s more about finding your work meaningful and interesting.” As more and more millennials enter positions of power in the business world, Anderson believes we will soon reach a point where hierarchy itself is “passé.”

Power to the People [Part 2] – Exposure Therapy

Part 2 of a 34-part seriesThe next level of growth for healthcare social media, must come from within the organization and involve all employees in the effort.

The previous post in this series reviewed the first year of healthcare social media and noted the correlation between engaged employees and customer service. I’ve predicted that in the coming year we’ll see progressive organizations extending the use of social tools to their employees; thereby creating a culture of information exchange and online service. Achieving a socially connected employee base at a healthcare provider is not without challenges, although it may be easier than some would suggest.

Action conquers fear

We have no reluctance about hiring someone to register a patient or letting nurses tend to patients. Healthcare providers, as Lee Aase of the Mayo Clinic has quipped, are accustomed to embracing cutting edge advances in medicine but ironically slow to adopt new business practices. And so, it should come as no surprise that many hospital systems balk at the idea of allowing a nurse or registrar represent their brand online. Many concerns can be easily relieved by exposure to social media tools and education about their use.

Compliance and regulatory issues usually top the list of concerns and rightfully so. A well-intentioned caregiver posting a patient’s picture could unwittingly generate serious legal problems for a provider. Similarly, I would not suggest completely dismissing issues relative to branding. Again, a well-intentioned employee could post offensive or misleading information.

But there are also concerns that rest on a much less solid foundation. Here, I’m referring to the red herrings of productivity, viruses (or other technological malfeasance), and inflammatory discourse. I suggest these concerns can be allayed by  what psychologists call exposure therapy.

The tools that organizations are scared to give their employees  can, in fact, be the way to overcome fears – real and imagined. It is time to begin using social media internally, within provider organizations. Doing so will help assuage naysayers and allow organizations to cultivate online ambassadors.

Connecting the dots by connecting employees

Out-of-the-gate it may not make sense to extend Twitter to 5,000 employees. However, a simple forum site, accessible only internally, may be a gentle introduction for both the organization and its employees. Consider augmenting the intranet site with a forum. Make the rules clear and accessible -- no foul language, no insults, and no patient information. This is not a unique idea.

Paul Levy, the widely-read CEO blogger from Beth Israel Deaconess Medical Center in Boston set up forums when facing a difficult financial position last year. He explained that layoffs seemed inevitable, but offered an online, intranet for employees to discuss other options. It worked. Employees collaborated openly and created ways to reduce costs and save jobs. Concerns about inflammatory language proved unfounded, the conversation was civil and professional. Levy is a seasoned leader who knows criticism is often a suggestion in disguise; he’s fearless about letting employees speak freely.

If forums are the first steps, a more feature-rich social platform may follow. Multi-user content management systems like open source Word Press MU or commercial Microsoft SharePoint can be used to build powerful internal social networks. As a colleague puts it: "I can log into Facebook and see what everyone I know is up to in broad strokes, and it only takes minutes a day. Why can't we do that across our organization?"

Imagine logging into an intranet and discovering what’s going on in finance, surgical services, registration, administration, and infection control,-- all from short status updates. Wouldn’t knowing where the company as a team was headed be useful?

These kinds of controlled, internal social efforts also help employees better understand what leadership looks like. Leaders,  coached by those who understand social networks and organizational development, can model leadership by their participation in online communities. Most companies already have online training tools, so including Social Media Communications 101 is an easy drop-in that will lead to an internally connected and engaged workforce.

Next time, a deeper look at the the tools to build an internal social network...

Power to the People [Part 1] - HCSM turns 1

Part 1 of a 3 part series The next level of growth In healthcare’s use of social media, must come from    the within the organization by involving all employees in the effort. Preface

For many healthcare provider organizations, social media has become an extension of external marketing efforts.  And while  big external wins, like viral videos or news coverage of tweets can help create internal momentum, too often these actions are little more than glorified sales pitches. To truly be successful in the use of social media, providers need to begin thinking about engaging their employees in the social conversation and. creating a team of online ambassadors who serve each other and their customers more effectively. In the case of healthcare, it means engaging the  entire staff of caregivers in the conversation about bettering the patient experience.

The story so far If seven human years equal a dog year, how would we calculate an internet year?

Only twelve to sixteen months have passed since early adopters got serious about social media in the healthcare industry. A lot has happened during that short period of time. Just recently the #HCSM twitter chat celebrated its first birthday. According to Ed Bennett’s Found in Cache, over 500 hospitals now have some kind of social web presence.  We’ve seen surgeries tweeted, the Pink Glove Dance go viral, doctors tweeting, and iPhone applications for hospitals. So what does the coming year look like for healthcare social media?

Most, if not all,  healthcare providers  share the collective goal of improving patient experience. Sometimes, this is expressed as clinical excellence; sometimes as increased efficiency. Regardless of wording, having an entire organization discussing this type of improvement can strengthen a provider’s ability to deliver care. Just as there is a correlation between engaged employees and good service, so too is there a connection between connected employees and empowerment.

During the past two years at the hospital where I am employed, we have seen how increased employee engagement has  improved everything from patient satisfaction to clinical outcomes.

Well cared for, happy employees serve customers with an exuberance that comes from a sense of pride that cannot be induced by coaching alone. The exuberance and best in class service I have observed  across multiple service industries is a result of establishing and sustaining a company’ culture of serving customers with pride, anticipating patient needs, and caring about positive outcomes. This type of culture is rooted in engaged employees who believe in the organization’s mission. And just as service emerges from a culture of engaged employees, social media must emerge from engaged participants.

Prediction This next year for healthcare social media will be an opportunity for progressive providers to grow in amazing ways. I say this is the year that organizations that truly embrace openness and transparency will move to the forefront. Social tools have a role inside of organizations. When they’re used to help flatten the org chart and promote discourse, the entire enterprise benefits and convey an important ethic that branding alone cannot match. The path has been paved in this last year. The very social tools that we have been using externally have an immense power when they are applied internally. More on that thought soon...

____

This post is shared with much gratitude to Meredith Gould for her editorial guidance