Building a Culture of Ownership in Healthcare:

Transcription

1 Building a Culture of Ownership in Healthcare: The Invisible Architecture of Core Values, Attitude, and Self-Empowerment Dr. Bob Dent, DNP, MBA, RN, NEA-BC, CENP, FACHE Senior Vice President, Chief Operating and Chief Nursing Officer, Midland Memorial Hospital Adjunct Faculty, University of Texas of the Permian Basin Adjunct Faculty, Texas Tech University Health Sciences Center School of Nursing President-Elect, American Organization of Nurse Executives

2 Learning Outcomes 1. Describe the healthcare crisis within of incivility, bullying, and toxic emotional negativity in the workplace and the way it contributes to stress, burnout, and compassion fatigue. 2. Describe the elements of the Invisible Architecture of core values, organizational culture and workplace attitude. 3. Practical values-based leadership applications to foster and sustain a culture of ownership. 2

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11 What was the effect of this new building on outcomes? 11

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13 Invisible Architecture? 13

14 Toxic Emotional Negativity 14

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16 Names Used to Describe Phenomenon Incivility Intra-staff Aggression Intra-staff Hostility Lateral Violence Bullying Mahr,

17 Incivility can take the form of rude and discourteous actions, of gossiping and spreading rumors, and of refusing to assist a coworker. All of these are an affront to the dignity of the coworker and violate professional standards of respect. ANA Position Statement on Incivility, Bullying, and Workplace Violence (2015) 17

18 Many Faces of TEN Overt (Done Openly) Name-calling Fault-Finding Criticism Intimidation Gossip Shouting Blaming Covert (Not Openly Acknowledged) Ignoring Refusing to help Unfair assignments Sabotage Exclusion Broken Confidences Failure to respect privacy 19 Mahr, 2016

19 22,000,000 negative workers in the United States 20

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22 $500,000,000,000 wasted in negative energy and employee disengagement 23

23 Theoretical Model of Horizontal Violence (TEN) Oppression (TEN) Process Key: + Positive Relationship Negative Relationship Internalized Dominant Values Horizontal Violence Peer Communication Patient Safety 24 Mahr, 2016; Purpora, 2010

24 Communication Breakdown: Leading Cause of Sentinel Events Human Factors (ex: staff supervision issues) 2. Leadership 3. Communication 25 The Joint Commission, April 2015 retrieved from

25 Medical Errors: Significant Cause of Death Medical Errors: 8 th leading cause of death 26

26 Negative Impact of HV (TEN) on Organizations Work Culture Patient Safety Cost Commitment Collegiality Support Satisfaction Learned Behavior Late Interventions Incomplete Interventions Errors Absenteeism Workforce Rehires Nursing Shortage Mahr, 2016; 27

27 Negative Effects of HV (TEN) on Nurses Impaired Relationships Hypertension Depression Fatigue PTSD Irritability Panic Attacks Dissatisfaction Burnout % resign 1 in 3 leave nursing Diminished Confidence Substance Abuse Mahr, 2016 Vessey, 2009 Townsend, 2012 Longo,

28 This is The Healthcare Crisis Within! 29

29 Determinants of Best Places to Work Pride Connection Trust 30

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31 From Accountability. 32

32 Accountability Is Not Enough! 33

33 Accountability implies irresponsibility 34

34 Accountability can be exhausting! 35

35 Accountability focuses on rules, not on values 36

36 Accountability is always after the fact and often demotivating 37

37 Accountability provides an incentive to cheat 38

38 Accountability never takes an organization from good to great 39

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40 to Ownership! 41

41 Ownership IS the secret sauce! 42

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43 Mission, Vision, and Core Values 44

44 CORE VALUES Who you are What you stand for What you won t stand for 45

45 Be yourself unless you re a jerk. Integrated DNA Technologies,

46 Give a damn. Southlake Regional Health Centre,

47 Our culture is based on the Christian faith and that staff and physicians are encouraged to pray with patients Craig Lindsey, Chief Nursing Officer Park Ridge Health, North Carolina Interaction of Personal and Organizational Values 48

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50 Workplace culture is important to the job satisfaction of all employees. For all generations, the highest indicator of satisfaction is to feel valued on the job. AARP: Leading a Multigenerational Workforce Young People: They re People, Too 51

51 No Opting Out One toxically negative person can drag down morale and productivity of an entire work unit. 52

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54 Attitude is a choice! 55

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56 Bring your whole self to work; not only your knowledge and expertise, but also your values. Stay true to who you are and have the courage of your convictions. If you do, you will become an authentic and courageous leader something intensely needed at this time in healthcare. And you will have the power to change your workplace and the community around you. Mary Brainerd, President and CEO, HealthPartners 57

57 The call to end this silent epidemic in our profession has been heard loud and clear. It is time we turn our caring behaviors more fully toward our colleagues and those we work with and demand a stop to any form of violence that occurs in any setting Dr. Cole Edmonson, Chief Nursing Officer Texas Health Presbyterian Hospital, Dallas, Texas 58

58 A silent epidemic A great threat to patient safety An ugly secret in the most caring of professions These are just a few of the ways that incivility and bullying have been referred to in the literature over the last 10 years. Edmonson, Bolick and Lee: A Moral Imperative for Nurse Leaders: Addressing Incivility and Bullying in Health Care, Nurse Leader, February 2017

59 Eight Essential Characteristics of a Culture of Ownership Joe Tye, The Florence Prescription 60

60 Commitment To the mission, vision, and core values of the organization 61

61 Engagement With patients, coworkers, and with the work itself 62

62 Passion Enthusiasm, positive attitude, and joy reflected in everyday actions 63

63 Initiative A Proceed Until Apprehended mindset 64

64 Stewardship Caring for yourself, your organization, and your world 65

65 Belonging Making everyone feel like a partner and not just a hired hand 66

66 Fellowship Fostering a support group culture of respect and caring 67

67 Pride In the organization, in the profession, in the work, and in yourself 68

68 Be Emotionally Positive 69

69 Be Fully Engaged 70

70 Be Self Empowered 71

71 People will be and do their best with the tools they have. As a leader, we need to make sure they have the tools! Leadership 72

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74 Daily Leadership Huddle 75

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78 Sacred 60: Leadership Rounds

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84 Leadership Job #1 Shifting the shape of your Attitude Bell Curve 97

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87 And now for the results at MMH 100

88 Patient Satisfaction: 90 th percentile in Emergency Department All other departments continue improvement But that s not all! 101

89 22% reduction in CLABSI 64% reduction in CAUTI 38% reduction in ventilator related events 32% reduction overall nursing turnover 43% reduction in first two year s Nurse Satisfaction Improvements w/ Emergency Department: Top 10 th percentile 102

90 The transformation I have witnessed the last few years has been inspirational for me. Dr. Sari Nabulsi, MD Private Practice Pediatrician and Past Chief of Staff 103

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92 Midland s Year of Values Robert Wood Johnson Foundation s: Culture of Health Study 3 rd ANCC Pathway to Excellence Submission & ANCC Magnet Submission 105

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94 TBSSSNDQ 107

95 To be published by Sigma Theta Tau International on March 14,

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98 Bob Dent, DNP, MBA, RN, NEA-BC, CENP, FACHE Midland Memorial Hospital 400 Rosalind Redfern Grover Parkway Midland, Texas (office) (mobile) LinkedIn: bobdent Facebook Page: DrBobDent Blog: 111

99 References Gordon, J (2007). The Energy Bus. John Wiley & Sons, Inc. Hoboken, New Jersey. Tye, J. & Dent, B (2017) Building a Culture of Ownership in Healthcare. The Invisible Architecture of Attitudes, Values, and Self-Empowerment. Sigma Theta Tau International. Tye, J. & Dent, B (2016). The Pickle Pledge Tye, J. The Florence Prescription. Mahr, Nicole (2016). Identifying Factors Associated with Horizontal Violence. ANCC Magnet Presentation