Our vision for St. Charles Health System is bold, lofty, and motivating: Creating America’s healthiest community, together. Our board of directors recognizes that massive changes are on the horizon for the healthcare industry and created this vision to inspire every caregiver—from the C-suite to the birthing suite. This vision has become our energizing principle. With hospitals serving four communities that span three counties, our long-term goal is to capture the top three healthiest community rankings for Oregon, as measured by the Robert Woods Johnson Foundation.
Vision Charts a Course for Culture Transformation
At St. Charles, we are all caregivers. We believe that even if we aren’t directly serving a patient, we are serving someone who is. Our frontline caregivers find that government regulations, documentation, technology, and the sheer pace of their work make it far more difficult to find the time and opportunity to offer compassionate, healing, and patient-centered care.
Yet, invariably that is what attracted them to healthcare in the first place. As leaders, we are committed to re-ignite that spark and release caregiver strengths and energy in ways that fuel their engagement while driving organizational success.
We do this through several programs launched in recent years:
- The Leader Within
- Soul and Science of Caring
- Value Improvement Practice.
“The Leader Within” program is a six-week course designed for leaders at all levels. It will be featured in ATD’s Community Express: Healthcare Fast Track offering on Wednesday, May 25th at ATD 2016 Conference & Exposition. (For more information about this program, check out the blog post, “Cultural Evolution at St. Charles Health System.”)
In their recent blog, “Talent Development’s Role in Upgrading the Patient Experience,” Gabriela Ammatuna and Ryann Ellis report that only 44 percent of U.S. hospitals are investing in broad culture change efforts. St. Charles is among them. When our board announced our new vision and mission in 2013, we formally launched our cultural evolution. Caregivers across our system weighed in on the values they desired to help St. Charles become a high-performing health system.
Accountability, caring, and teamwork topped the list, and were subsequently endorsed by the board. Based on the Drivers of Performance Model that Ann Rhoades outlines in her book Built on Values (2011), we involved hundreds of caregivers across our system in developing behaviors to support each of our values. These elements provide concrete examples of how to treat one another, and in turn, our patients.
Tools Help Leaders Navigate Organizational Values
The Leadership and Culture department at St. Charles developed a variety of tools to keep our values top of mind and to provide multiple ways to drive them into our culture. Our Marketing and Communications team produced videos for each of our three values. The videos feature St. Charles caregivers and are an integral part of our new caregiver orientation.
Another example from our toolkit for leaders is Onboarding with ACT. Using a leader guide, all caregivers within a department meet together to plan how to onboard new team members. When new colleagues arrive for their first day, there may be banners welcoming them, flowers, a schedule for their first week and facility tours, all created by their teammates. To design this amazing first impression, the team asks itself the following questions:
- How can we help our new caregivers feel more accountable when they arrive?
- How can we show Caring?
- How can we help our new colleagues feel like part of our team?
Teams across the system from food services to facilities have also worked together to come up with their rules of engagement. These are linked to our values, and we call them ACT Agreements. Customized to their specific departmental work, these agreements capture behaviors everyone agrees to model. They commit to hold themselves and one another accountable to live by their agreements.
As health care reimbursement in Oregon and across the nation is moving from volume-based to value-based care, our teams are feeling the pressure mount. In a JAMA article dealing with self-care for physicians, Dr. Michael K. Kearney and co-authors describe symptoms and signs leading to burnout and compassion fatigue. They attribute a telling quotation to Dr. C, an oncologist, who states: “The stuff that burns me out has nothing to do with loss…. It’s fighting insurance companies.”
Engagement Drives Performance Improvement
As a part of our St. Charles cultural evolution, and in an effort to help our caregivers increase engagement, avoid burnout, and reconnect with the reason they entered health care in the first place, we offered an 18-month program entitled the Soul and Science of Caring. Two-day retreats were held every six months. Each retreat focused on one of our values. Tools or practices such as non-violent communication and situational awareness were introduced.
Between retreats, participants met monthly in small groups to dialogue about assigned readings and compare notes on their experiences using the practices. As part of each of the four retreats, we conducted well-being surveys and compared the results with those from control groups.
In addition, our new CEO joined St. Charles in December 2014. Upon his arrival, we embarked on our most ambitious initiative to date. We are transforming our culture through a massive commitment to process improvement. What better way to engage our frontline caregivers than to empower them to systematically improve our processes for the benefit of our patients?
While our vision and strategic direction come from the top, frontline caregivers are providing the solutions that are critical to success. As processes are simplified and become standard work, more time is available for patient-centered. By empowering and relying on our experts, the frontline, we are harnessing their power to fundamentally change how we do business, one department at a time.
Interested in learning more? Join us May 23 at ATD 2016 Conference & Exposition for our session Spark Their Hearts: A Roadmap to Re-Igniting Your Culture. We will share our cultural evolution roadmap along with strategies, processes, tools and discoveries that are systematically shifting our culture, allowing us to develop, inspire and re-ignite our caregivers.
