Leadership Learning and Action Network: Employee Engagement, 2

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1 Leadership Learning and Action Network: Employee Engagement, 2 July 12, 2017 Michael Pugh, MPH President, MdP Associates Senior Faculty, Institute for Healthcare Improvement

2 Michael Pugh, MPH Michael D. Pugh, MPH, President, MdP Associates, has more than 30 years of CEO experience in hospitals, health care systems, managed care and health information technology companies. He is a consultant to senior leaders of health care delivery organizations, payer organizations and government agencies on issues of quality, performance, strategy and governance. Mr. Pugh serves as Senior Faculty at the Institute for Healthcare Improvement and co-authored two Institute for Healthcare Improvement white papers, High-Impact Leadership and Seven Leadership Leverage Points for Organization-Level Improvement in Health Care. He is an adjunct faculty member at the University of Colorado at Denver School of Business and an instructor in the Master of Science in Health Care Delivery Leadership Program at the Icahn School of Medicine at Mt. Sinai in New York. Mr. Pugh has served on the boards of the American Hospital Association, the AHA Health Forum, the Colorado Hospital Association, and The Joint Commission. 2

3 Are your boards actively used by the entire team? 3

4 Who are the "engaged staff? Staff who: Are interested in making care better for patients Take pride in their work Like to learn new approaches and try new things Practice mindfulness Display empathy for patients and others Like technical challenges Understand the value of teams and teamwork Are willing to pitch in Are willing to share their ideas and suggestions 4

5 So why are staff not more engaged Fear Chaotic work Over-burdened Burnout Boredom Poor management and leadership Communication Interpersonal skills Poor time management Lack of empathy Lack of standardization Lack of direction and purpose 5

6 Employee Engagement and the Science of Improvement Psychology of People Intrinsic motivation vs Extrinsic motivators Mental Models how we think about our staff Deming said, Drive out fear Maslow s Hierarchy of Needs Theory of Profound Knowledge 1. Appreciation for a System 2. Understanding Variation 3. Theory of Knowledge 4. Psychology 6

7 IHS Leadership Change Approach Engaging Employees in Improvement Work Note: The IHS Leadership Change Approach is based on the Institute for Healthcare Improvement Leadership Framework 1 1. Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; (Available at ihi.org), p.18

8 High-Impact Leadership Behaviors What Leaders Do to Make a Difference 8 Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. Cambridge, MA: Institute for Healthcare Improvement; Available on

9 Engaging Employees is About Culture shape culture one behavior at a time Edgar Schein Humble Inquiry: the gentle art of asking instead of telling (2013) 9

10 Strategies for Shaping Culture Be present where work is performed Be an authentic presence have an understanding of how work should be performed and the challenges Focus on removing wasted efforts and barriers that make it difficult for staff to perform their work Be an advocate for your team Lead by example, not just direction Daily team huddles and multiteam safety huddles Include staff in target and goal setting on safety or improvement goals Actively solicit staff ideas and opinions Pursue a fair and just approach when error occurs Promote transparency Set high standards for safety and performance Set high standards for personal and team accountability 10

11 Staff Engagement: How will you know? Are your visible boards messy with staff notes and annotations? Are you getting measurable results on your improvement and safety efforts? Is there an increase in staff suggestions/comments? Are staff becoming more open/assertive/positive in offering ideas? Is there a shift in topics from staff concerns to concerns for patients? Are staff offering suggestions about how to better standardize work? Is there a positive change in the patient experience response scores/results? 11

12 Are your boards actively used by the entire team? 12

13 Strategies for Building Will Appeal to both Mind and Heart Storytelling both good and bad Celebrate success frequently Be transparent about goals, barriers and progress Use visible boards Always stop at the boards when rounding and talk with employees about what is on the boards Talk to patients and share what you learn Engage staff in choosing projects and goals Properly use group tools and methods on improvement teams Small tests of change Clear, measurable aims how much by when Teach just-in-time improvement tools when necessary Data collection as part of daily work Check sheets and other simple real time data collection tools 13

14 Engagement in Daily Work Used with Permission of Dr. Steve Swensen, Mayo Clinic 14

15 Developing Decision Making Capacity, Part 1 August 2, p.m. (EDT) Noon (CDT) 11 a.m. (MDT) 10 a.m. (PDT/MST) Duration: 1.5 hours Presenter: Clifford L. Norman, Associates in Process Improvement Mr. Norman will provide IHS hospital leadership with mentorship and capacity building around decision making, including: An introduction to Profound Knowledge Using data for decision making Decision making in an environment of overload

16 Questions This material, prepared by Michael Pugh, MPH, and HealthInsight, is provided by HealthInsight, the Medicare Quality Innovation Network Quality Improvement Organization for Nevada, New Mexico, Oregon and Utah, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-AIAN-17-77