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Culture Club Retreat 2005

In an effort to launch a massive cultural change in hospitals across the mid-atlantic area, leaders from over 50 hospitals in the region gathered with a commitment to vastly improving the quality of care they deliver within their organizations. Hosted by the Delmarva Foundation, Medicare’s Quality Improvement Organization in Maryland and the District of Columbia, the Culture Club Retreat 2005 is the first step in a major initiative to fuel discussion between hospital leaders.

conference photo

Hospital leaders and care givers must change the way they think and operate on a daily basis in order to bring about this change. With emphasis on leadership-behavior, maintaining a patient-centered attitude and a commitment to taking immediate action, hospital leaders and care givers can focus on making institutions in our area safer and more efficient.

“This type of healthcare transformation is absolutely within our reach,” says Margaret Toth, MD, Chief Quality Officer, Delmarva Foundation. The first step in achieving this transformation is changing leadership-behavior and strategy. By developing a strong consensus for change, hospital leaders and healthcare providers can focus on simplifying, prioritizing, and aligning incentives. According to Gary Yates, MD, Chief Medical Officer, Sentara Healthcare, patient safety is directly related to maintaining clear processes and protocols of communication. Goals should be simple and direct and everyone must understand what they are supposed to be doing, including the patient. The greatest error prevention is, according to Yates, encouraging attention to details, questioning attitudes, strong patient handoffs, and coordinating physicians.

“The role of leadership is absolutely critical,” says Yates.

But leadership is not the only aspect of achieving cultural change within the healthcare system. Focusing, not on what the provider needs, but on what the patient needs, is the second key step. For the past year, providers at the Long Island Jewish Medical Center have been working to put patient needs first. In an effort to increase provider time at the bedside by 70% percent and decrease time spent on documentation by 50 percent, Barbara Popkin, MA, RN, and Catherine Mahoski, RNC, of Long Island Jewish Medical Center report that their plan, not only enhanced patient outcomes, but improved staff vitality.

Their proposal was simple: incorporate an enthusiastic team of new and experienced nurses who will accept, listen, trust, and support each other; focus on creating and maintaining at least one clear goal a day; post an appreciation board and a communication board for feedback and discussion; be flexible, willing to listen, and willing to change at a moment’s notice; explore and encourage a free flow of ideas from everyone, including the patient.

This shift in culture has only been in practice for one year, yet the providers at Long Island Jewish Medical have received tremendous feedback from patients and employees already. Recently, the hospital received a letter from a former nurse who wrote, “I’ve learned that the healing process does not fall on the responsibility of any one individual but the concentrated efforts of all employees. I believe this is the driving force behind the success of this hospital.”

There are small pockets of solutions everywhere. Instead of waiting for the perfect answer, hospital leaders should begin by testing possible solutions, encouraging feedback, and communicating with other hospitals in the area.

In the words of Jon C. Lloyd, MD, Pittsburg Project Coordinator, Center for Disease Control and Prevention, “I don’t think we can do this without being a community.”

C. Alison Murray

Graphic Facilitator Charts