FE4 These presenters have nothing to disclose Forum Excursion: The Gaylord Palms Hotel Eric Dickson and Christina Gunther-Murphy IHI Liaison: Carolyn Morgan December 7, 2015 Objectives Identify strategies to increase joy in the work place that can be applied in your environment Recognize and analyze key concepts of employee motivation and staff engagement. Develop ideas for increasing staff satisfaction in their work environment Learn how to run a snorkel exercise in your own organization
Today s Agenda 8:00-8:30am 8:30-9:45am Breakfast Welcome and Introductions 10:00-12:00 Tour of Gaylord Palms 12:00-1:00pm 1:00-2:00pm 2:00-4:00pm Lunch Tour of Gaylord Palms (continued) Debrief and Snorkel Introductions Get in groups of three or four with people you don t already know Introduce yourself and spend a minute or two talking about something that brings you joy at work At the sound of the alarm, find another group you don t know and repeat Share with the larger group some of the interesting things you heard
Astute Observation Is Important The results of our medical investigation seem to suggest that you have an axe in your head.
Find the Similarities Some Principles of Observation Introduce yourself to the people you are observing Discovery shopping v. mystery shopping Focus on listening Don't make meaning Record your observations Make notes and be specific Ask before taking pictures of people
9 IHI s Early Theory on Joy at Work IHI Fiscal Year 2016 Priorities 100 Million People Living Healthier Lives Systems of Safety Optimized Access and Flow for Right Care, Right Place, Right Time Maternal and Infant Health Joy in Work
Joy in Work Hierarchy Sustaining and Growing Joy in Work Maintaining Resilience Creating an Engaged Workforce Healthy, Safe, and Just Culture, Health and Wellbeing Worker Safety, Free from Fear Joy in Work Hierarchy 12
A Framew ork for Creating a Joyful Workforce Drivers 29 July 2015 A Healthy, Happy, and Resilient Workforce, Fully Engaged in Organization- Wide Goals Leaders at all levels both model and promote pride and joy in work Excellent Care and Outcome Improvement are part of ev eryday work for ev eryone Ev eryone works as a v alued member of a Team Operates systematic approach for a joyful workforce that assures includes standard work for leaders Communicates the direct connection between org goals and the work Role Model, teach, and mentor essential leading and managing behavior, transparency and actions to produce a just culture. Managers trained and capable of driving daily improvement Daily huddles on work and use of learning boards and improvement tools Interprofessional education and team training, including onthe job improvement skills Regular use of methods to reduce work inefficiencies Everyone is in a team or dyad Clear assignments and roles Daily huddles and focus on daily improvement Balance workload, people work at the top of their license Cohesion and belonging: Games, social functions, and wellness activities Individualsare welcomed, supported, and equipped to be capable and effective Assure each person links work to something that ignites their passion Warm Welcome, ongoing development Retention Engine Resilience Training Expanded Benefits, incl. tuition support, PTO bank Gaylord Tour
Afternoon Process HARVEST Create list of observations and thoughts from day You are here ORGANIZE & EXTRACT Develop actionable ideas from the thoughts and observations Prioritize and APPLY Prioritize actionable ideas and plan implementation Record Your Observations/Ideas Silently (privately) 10 Min Write dow n your thoughts and observations from the day, 1 per sticky note Aim for quantity, not quality Be creative use both sides of your brain As a group 10 min Rapidly share round robin style (1 person share sticky and put on flip chart, then next person shares one, etc.) Seek clarity, not agreement Add new ideas that pop-up as you listen to one another As a room 10 min Each team share a few ideas that rose to the top
Share Your Observations Listen To Me - Develop Me - Celebrate My Success Engaging Employees Through Unit Based Idea Systems Eric Dickson MD President and CEO UMass Memorial Health Care
19 Flow of Ideas From Frontline HOW TO OPEN THE VALVES?
Unit Based Idea System Patients People Innovation Financial Sustainability A place on every unit where the team comes together at an idea board, talks about performance (TNM), ideas for improving performance, track progress on ideas being implemented (PDSA) and celebrates success. The Best Place to Give Care The Best Place to Get Care Our Patients ED Borders AHRQ Mortality AQC Gate Scores HCAPS ACCESS Our Discoveries Number of Ideas Implemented Clinical Research Funding Our People Caregiver Satisfaction Our Long-Term Financial Health Days Cash on Hand Operating Margin
Low Impact High How Can We Improve Primary Care? Fresh Ideas Ideas Implemented Program Guidelines* Improves work force morale, safety, patient flow, patient satisfaction, quality or our financial performance, Low to no cost. Focused in your area. Can be Implemented in 30 days. Involves you in the solution. Our Patients Our People T Our innovations Our Future Implement Consider W ork in Progress To Do Doing Need Help Possible Kill T Low Difficulty High Inpatient Nursing Units 6 West 3 Lakeside Step Down 4 Admissions Unit 3 East & West 4 East & West 5 East
Patient idea board 28
Characteristic of Great Idea Systems Managed locally Ideas are visible for all to see Encourage group ideas (at huddles) Mechanism for prioritizing Track execution of idea Linked to specific goals (True North Metrics) System level support (innovation fund) Local and system level celebration Escalation system Spread system 29
Likelihood of Success Always be open to the ideas of the people doing the work Current State Idea systems now exist in 400 business units Over 25,000 front line staff ideas implemented All executives now huddle w eekly w ith front line staff in an area not under their control Idea of the w eek published across the system in Everyday Innovators Blog All new employees receive idea system training Monthly innovation celebrations across the system Yearly Champions of Excellence Celebration (~600 people) and $10,000 Innovators of the Year Aw ard given out by BOT $1 Million innovation fund created in FY 2015 Process has been defined and embraced by most including organized labor
Afternoon Process HARVEST Create list of observations and thoughts from day ORGANIZE & EXTRACT Develop actionable ideas from the thoughts and observations Prioritize and APPLY Prioritize actionable ideas and plan implementation You are here Ideas to Themes As a group, begin to group your post-it into high-level themes Use as many themes as are helpful; don t force post-its into themes
From Observations to Improvement Ideas On a sheet of paper right down specific actionable ideas you have for increasing employee satisfaction in your organization. For now keep them to yourself. Whose Shopping Cart Idea Did They Choose? http://vimeo.com/16456835
From Individual to Group Ideas Have each person share one idea and use the group to try and improve it. Afternoon Process HARVEST Create list of observations and thoughts from day ORGANIZE & EXTRACT Develop actionable ideas from the thoughts and observations Prioritize and APPLY Prioritize actionable ideas and plan implementation You are here
Low Impact High PICK Chart Easy Difficulty Hard What Other Participants Took Away Group interview s to let the cream rise to the top Learned you cannot change a person s attitude : I cannot tell you how much time I have wasted working with a couple of employees that had good technical work skills and expertise, but whose presence lowered everyone s morale and interf ered with overall productivity because of their attitude toward the job, organization and leadership. If I ever run across this problem again in the future, I will cut my loses sooner and move f orward. While I am not in a position to provide additional material perks, as does the Gaylord w ith laundry service and market place, they did reinforce my belief that recognition and respect are important day to day Many departments have implemented daily and/or shift huddles w hich has increased communication and morale I used the information for story telling about how we need to take care of employees in order for them to take care of patients Implemented star trainers in specific areas Identified blue versus red rules 40
Creativity Techniques Take your idea and Add constraints if you only had $10, if you only had 1 minute or 1 day, if you had a team of 1, 10, 100 Random word exercise pick a random word and see if it generates additional ideas on that topic Reverse or rearrange it sequence, layout, schedule, environment, priorities, people, goals, roles How might we? blue sky questions that allow us to imagine a different future How might we.? Ensure that the CEO knew the first names of all the front line staff? Make sure that all meetings started on time? Recognize staff more frequently?
Applying to Health Care What do we hope to accomplish? Think back to why you came on the excursion in the first place. How will we know a change is an improvement? To be determined later. What changes can we make that lead to an improvement? Select the themes and ideas that seem would help you accomplish your goals. Break
Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? Act Plan Study Do From: Associates in Process Improvement The PDSA Cycle Act What changes are to be made? Next cycle? Study Complete the analysis of the data Compare data to predictions Summarize w hat w as learned Plan Objective Questions and predictions (w hy) Plan to carry out the cycle (w ho, w hat, w here, w hen) Do Carry out the plan Document problems and unexpected observations Begin analysis of the data From: Associates in Process Improvement
Develop Your PDSA Follow the Model for Improvement Focus on the Plan and the Do What can you do by next Tuesday? Consult your neighbors Enjoy the rest of your time at the Forum! Questions? Please contact: Christina Gunther-Murphy cgunther-murphy@ihi.org Eric Dickson Eric.dickson@umassmemorial.org