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Clinical Implications of a
      Shift in a Health Care
     Organization’s Culture
Presented By:
Quintin Dukes, MSHA
Date: September 25, 2012
Evidence of a Dysfunctional
     Work Environment
 Signs of a Dysfunctional            Results:
    Work Environment        •Infrastructural
•Poor Communication         Fragmentation

•Too Many Bosses            •Creation of silos

•Over-Control               •Lack of coordination

•No Feedback                •Poor community image

•Fear
Motivation for an Action Plan
               • America's strength is not
                 our diversity; our
                 strength is our ability to
                 unite people of different
                 backgrounds around
                 common principles. A
                 common language is
                 necessary to reach that
                 goal.”
                             -Ernest Istook
Istook’s Application to Health
            Care
• After the passage of the Patient Protection and Affordable Care Act
  (PPACA).
   • Diversity became a popularized health care buzzword, but many
     health organizations misinterpreted the implications of diversity and
     it’s expected outcomes.
   • Putting up a sign in various languages is not diversity.
   • An organization must “Walk the walk, and talk the talk.”
• Diversity is a learning tool that should be used to educate health
  care staff on the different cultures of patients that they will be
  treating.
• In coordination with Inclusion and Leadership this will improve the
  delivery of patient-centered care, coordination of care, and a
  patient’s treatment adherence.
• An organizational shift must occur in order to adopt and effectively
  implement initiatives such as diversity.
An Organizational shift in
           Culture
• Why shift an organization’s culture?
  • Linked to performance.
• In health care, poor performance is linked to lower
  productivity, poor quality of care, and fiscal waste.
• Lower productivity= medical errors and patient deaths.
• Poor medical service= poor community image.
• Fiscal waste= inability to produce a margin (No margin, no
  mission).
Various Organizational
             Cultures
• First, assess your current organizational culture and it’s
  efficacy in continuously achieving your organization’s mission.
  • Collaborate or Clan Culture
     • An open and friendly place to work where people share a lot of
       themselves.
  • Create Culture
     • A dynamic, entrepreneurial, and creative place to work.
  • Control or Hierarchical Culture
     • Rules and procedures govern behavior.
  • Compete Culture
     • A results-driven organization focused on job completion .
Components to Shifting an
    Organization’s Culture
• Components needed:
  • Inclusion = Teamwork
  • Leadership= Servant-leadership
  • Diversity

• All three components must work together to be effective.
• Anticipated Outcomes:
  • Employee cohesion.
  • Culturally diverse employees.
  • Facilitation of communication from top-to-bottom and vice-
    versa.
  • Better delivery of patient-centered care, coordination, and
    treatment adherence.
  • Decrease in re-hospitalizations, patient deaths, and accrual of
    bad debt.
Unconventional Action Plan
• Anticipated Time Frame: 5 years
• Staffing Ratio: 2:100 (FTE HR
  staff: employees)- larger orgs.

• Year 1: Non-management staff
    establish committees for inclusion,
    leadership, and diversity .
•   Year 2: HR leaders integrating senior
    management.
•   Year 3: Begin to implement feasible
    organizational shifts.
•   Year 4-5: Post-Intervention metrics
    will measure:
•   Employee equity , patient
    satisfaction, employee retention,
    productivity, and organizational ROI.
Questions

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Clinical Implications Of A Shift In A Health Care Organization

  • 1. Clinical Implications of a Shift in a Health Care Organization’s Culture Presented By: Quintin Dukes, MSHA Date: September 25, 2012
  • 2. Evidence of a Dysfunctional Work Environment Signs of a Dysfunctional Results: Work Environment •Infrastructural •Poor Communication Fragmentation •Too Many Bosses •Creation of silos •Over-Control •Lack of coordination •No Feedback •Poor community image •Fear
  • 3. Motivation for an Action Plan • America's strength is not our diversity; our strength is our ability to unite people of different backgrounds around common principles. A common language is necessary to reach that goal.” -Ernest Istook
  • 4. Istook’s Application to Health Care • After the passage of the Patient Protection and Affordable Care Act (PPACA). • Diversity became a popularized health care buzzword, but many health organizations misinterpreted the implications of diversity and it’s expected outcomes. • Putting up a sign in various languages is not diversity. • An organization must “Walk the walk, and talk the talk.” • Diversity is a learning tool that should be used to educate health care staff on the different cultures of patients that they will be treating. • In coordination with Inclusion and Leadership this will improve the delivery of patient-centered care, coordination of care, and a patient’s treatment adherence. • An organizational shift must occur in order to adopt and effectively implement initiatives such as diversity.
  • 5. An Organizational shift in Culture • Why shift an organization’s culture? • Linked to performance. • In health care, poor performance is linked to lower productivity, poor quality of care, and fiscal waste. • Lower productivity= medical errors and patient deaths. • Poor medical service= poor community image. • Fiscal waste= inability to produce a margin (No margin, no mission).
  • 6. Various Organizational Cultures • First, assess your current organizational culture and it’s efficacy in continuously achieving your organization’s mission. • Collaborate or Clan Culture • An open and friendly place to work where people share a lot of themselves. • Create Culture • A dynamic, entrepreneurial, and creative place to work. • Control or Hierarchical Culture • Rules and procedures govern behavior. • Compete Culture • A results-driven organization focused on job completion .
  • 7. Components to Shifting an Organization’s Culture • Components needed: • Inclusion = Teamwork • Leadership= Servant-leadership • Diversity • All three components must work together to be effective. • Anticipated Outcomes: • Employee cohesion. • Culturally diverse employees. • Facilitation of communication from top-to-bottom and vice- versa. • Better delivery of patient-centered care, coordination, and treatment adherence. • Decrease in re-hospitalizations, patient deaths, and accrual of bad debt.
  • 8. Unconventional Action Plan • Anticipated Time Frame: 5 years • Staffing Ratio: 2:100 (FTE HR staff: employees)- larger orgs. • Year 1: Non-management staff establish committees for inclusion, leadership, and diversity . • Year 2: HR leaders integrating senior management. • Year 3: Begin to implement feasible organizational shifts. • Year 4-5: Post-Intervention metrics will measure: • Employee equity , patient satisfaction, employee retention, productivity, and organizational ROI.