Selected Podcast
From HRO to HERO: University of Maryland Upper Chesapeake Health's Journey to Date
In this panel discussion, Cassandra and David explain why University of Maryland Upper Chesapeake Health is adapting their own take on HRO; calling it HERO and what that means for people in the community.
Featuring:
David Branch | Cassandra Crowe-Jackson
David Branch is Vice President, Performance Improvement and Quality Management.Cassandra Crowe-Jackson is Vice President, Patient Experience.
Transcription:
Bill Klaproth (Host): So, what is the mission of Upper Chesapeake Health’s journey to date? We’re going to find out with Cassandra Crowe-Jackson, Vice President of Patient Experience and David Branch, Vice President Performance improvement and Quality Management.
This is the Hero Podcast from UM Upper Chesapeake Health. I’m Bill Klaproth. David, we’re going to start with you. Can you explain to us what is a high reliability organization or an HRO?
David Branch (Guest): Great question Bill. So, I will start from the beginning. The term high reliability organization is essentially a term that has been used quite often and typically associated with industries who have high risk in terms of the work environments that they support. And what you typically would hear is that the nuclear industry, aviation, military services so these are environments, you think about a nuclear plant that you need to be able to operate at a long extended period of time without having some sort of serious catastrophe or harm.
So, when we think about the term high reliability, it sits so appropriately with healthcare when you think about the complexity of what we do in terms of our service delivery and what we do for our patients. We want to be able to deliver our healthcare in such a way that it does not have catastrophic harm. And that harm for us, is in essence, a defect or death. We want to be able to not have errors and failures in terms of our delivery. So, as a healthcare industry, we are working towards becoming a high reliability industry.
Typically in the past with healthcare, it has been really guided through regulations and regulations and we’ve heard it even through joint commission, that regulations alone are not enough to transform us into a high reliability organization. The second component here is healthcare has really changed in terms of how in the value system that we have, typically in the past, the landscape has been driven by volume and what we’re seeing now is that the rise of consumerism within healthcare to not only deliver the volume but to deliver value.
And so, we’re looking at patients not just as patients any longer, but we are really looking at them as consumers and how do we drive greater value. And we really feel that becoming an HRO is in essence one of the key components towards us delivering value for our patients.
Host: That’s really good David. So, thank you for explaining what an HRO organization is. Interesting, nuclear, aviation, military, healthcare fits right in there when you are talking about high complex organizations. So, Cassandra tell us then what is Hero, H-E-R-O?
Cassandra Crowe-Jackson (Guest): So, HERO is taking the HRO concept and personalizing it for our organization with a high focus on engagement as the key element for what will get us to becoming an HRO. And we chose that because we wanted to show kind of appreciation for the culture of excellence that was part of the legacy of Upper Chesapeake. It really helped create Upper Chesapeake. And we needed to have that focus around engagement because one of the things we really want to stress is that engagement is our ability to connect and understand each other, our patients, they are our families and even our community.
So, we need that engagement to create shared meaning and value. And that’s when we will have the root of what we need to become an HRO. It will help us take some of the noise out of our environment, all the mixed messages and really foster the fact that the HERO journey is our journey. It is not a flavor of the month initiative. But it is who we are and how we will operate going forward.
Host: Really interesting. So, your take on HRO is HERO, H-E-R-O and the E stands for engage. So, David then, what are you doing to help Upper Chesapeake Health become that HERO?
David: Awesome. So, let’s discuss and think about the core components that we have that make up the HERO journey. The joint commission has three core components that it highlights as a high reliability organization and typically those are robust process improvement, we look at leadership commitment and then the patient and just culture. And what we felt to really drive our HERO journey, we expanded upon those.
So, there are really four core components to our HERO journey. First and foremost, is patient and family centered care. We have to start with our patients at the forefront and at the beginning. How we engage with our patients, how we are able to not just give care to them, but with them, how we are able to make them part of our overall care delivery and our plan. We’ve done a great job in terms of bringing in – we have a patient and family advisory council where we leverage our PFAs towards helping us with some of the solutions that we deploy.
Secondly is when we talk about this term continuous improvement, joint commission calls it robust process improvement. But really, we really want to develop this culture that says we can always be better. And it’s not just about being good, but it’s about being great and it’s about being excellent. So, how do we continue to look at the processes that we have and drive those towards better care and better delivery and better experience that we have.
The other component of continuous improvement is innovation. My thought process is there should not be a problem that the 3000 plus team members that we have can’t solve. But it’s how we leverage and how we drive a degree of innovation.
The next component is our safety culture. Ultimately, we want to be sure that we’re delivering safe care and one of the core components is creating this just culture. When you think about healthcare and the complexity of what we do, we have humans and we’re serving other humans and so, humans make errors. So, when those errors take place, how do we deal with them? How do we resolve it? And a just culture it says that it’s not going to be punitive when we make a mistake, but there’s a shared accountability between the individual and the organization that we want to do the right thing.
The other component is that we want to drive a shared and continuous learning. That we want to learn from our mistakes and continue to become and continue to be better. And then last, but certainly not the least; we thought about leadership commitment, but we wanted to expand on that and become even greater and we transformed, and we talked about transformational leadership. The goal towards zero error and zero harm aint an easy one. And as Cassandra highlighted, it’s not for the faint of heart, it’s not a flavor of the month. It will truly require a degree of transformational leadership that’s going to get us through this journey.
And so when we think about transformational leadership, we think about four core kind of attributes to that leader. One, the ability to be able to innovate and become an innovator. We think about Steve Jobs and we think about some of the great leaders who are able to create and turn ideas into great implementations.
The second is we think about influence. How do we take those great ideas and then influence the head and the heart of our team members. So where do we look at implementers. And that’s getting stuff done. Talk is cheap. But how we are able to take the ideas that we have and execute.
And then the last component of our transformational leader is that ability to inspire. This is a tough journey and so you have peaks and valleys when you are in that journey. And as you are going through that journey, how do you continue to inspire your team, continue to put that gas in their tank to continue to move along the journey that we have. So, that kind of creates a core component of what we’re trying to do as a HERO.
Host: Yeah, that’s really interesting David. And let me stick with you for one minute. When I heard you answering that, this really sounds like your vision statement. Is that right? This is what you want Upper Chesapeake Health to become. Is that true?
David: It is, and we think about this as that true north. Who is it that we’re trying to become and are inspiring to become as an organization? And Bill so we’re excited because we’re starting that journey. There are things that we’re currently already doing that has gotten us there. So, we aren’t starting from ground zero here.
When we think about how we operationalize this for the organization, we have four kind of core business imperatives or strategic objectives. And we want to deliver safe care, quality care, empathetic care and efficient care. And I think about some of the things that we currently have going on like related to safety.
We have a patient safety brief every day, leaders throughout the organization from 9:00 to 9:15 come together to talk about any sort of patient safety event or team member or patient experience event and it has helped to create a different degree of situational awareness within our organization. When we talk about quality, our goal towards zero; one of the things that we look at are hospital acquired infections. So, when one of our customers comes into our hospital with that; we’re able to ensure that there isn’t a defect in terms of their delivery, those HAIs, that CARDI, that CRAPSI that we could prevent that we are working towards being able to reduce those. And over the last couple of years, we’ve seen significant reduction in HAIs.
So, when we think about empathy. One of the strategies that we’ve begun to deploy is our ADET plus the promise that we have. And so when we think about what ADET stands for and how we engage with our patients or with our customers, our ability one, to have a degree of acknowledgement. When we walk into a room, do we just acknowledge and acknowledge the presence that we are there with our customers. Secondly, do we introduce ourselves? When you are thinking about you are in a hospital and that patient is seeing a variety of different care takers in and out of their rooms in terms of how it relates. And so the ability to introduce yourself, heh, I’m David Branch and I’m with leadership and this is what my job is. Secondly, we look at the D which is our duration. How long am I going to be there to set up an expectation over the next ten minutes, five minutes, here’s what I’m here to do and then explain. Explain why I’m in the room and what my objective is there and then lastly the component of thank you. Just we know that our patients don’t chose and want to be in our facilities most of the time and we recognize that. We want to thank them for the work and being able to choose us as their healthcare deliverer.
And then lastly, is the promise. If there was something throughout the experience that we’ve had that we have an opportunity to do service recovery and make their stay that much better, there’s a promise there that we’re going to take care of it and we want to ensure that we deliver on that promise for our patients.
Host: Very well put and this is really good for the staff to hear what you just articulated. Safety, quality, empathy, efficiency. This is a great vision statement to aspire to. So, Cassandra if you could tell us what is next then?
Cassandra: Well, what’s next is this really this first year is all about creating awareness. Creating awareness from our team member perspective even from our patients and families and our community in terms of what is HERO. What are we trying to do? And that will encompass our new mission which is we deliver an exceptional care experience; every person, every encounter, every day. So, that we get to our vision, our true north of creating the healthiest community in Maryland. And that will be done with us all focusing on our values which are excellence, integrity, teamwork, ownership, compassion and trust.
So, for us to get to that engaged environment; we need everyone to understand what those components are and more importantly what’s expected of me. What is my role in creating a HERO culture? And so, there will be a lot of focus around training and awareness and understanding of what we’ve also added is our must have behaviors. Very clearly articulated expectations that every team member, every provider, everyone who is part of Upper Chesapeake Health will be held accountable to. And those behaviors will become part of our evaluations, how we interview, how we hire, how we retain and that will be a huge shift for us in our culture.
But it’s important that we take that time to make sure everyone knows what’s expected so that we do ultimately create that healthy community. And to do that, we’ll need to do a lot of things differently. It will show up differently in how leaders lead and that will include a ton of training for our leaders. Training and development so that leaders understand their role in being transformational leaders. The type of leaders we’re going to need to get to this ultimate goal of zero harm.
We’ll be rounding differently. So, leaders will be out and about engaging with our team, much more frequently than we are currently doing. And we hope there that we build a trust and a collaborative environment that focuses on continuous improvement, ensuring that we have patient-family-centered care. And that we are always operating within a just culture. So, that we are driving on our journey a little bit quicker.
We will engage more with our frontline, so we’ll have a group that we partner with continuously called our HERO champions and that’s frontline driven engagement that helps us focus on those elements of safety, quality, empathy, and efficiency. And that’s really the first steps in our journey and I think that the key thing here is to emphasize this is a journey. We will not resolve being an HRO by the end of 2020 or fiscal 2020. This is the first steps in the journey. It will be a journey before we start seeing these values show up operationally so that everywhere we go, we’re seeing a consistent level.
But we know this and we’re patient with the journey.
Host: That makes a lot of sense. And communication is so important in a mission like this as you said, everyone needs to know what is expected of them. In fact, you said every experience, every encounter, everyday and that’s kind of a mantra that everyone can hold with them as they approach their daily responsibilities. So, as we wrap up, I’m going to ask each of you for your final thoughts. David, wrap this up for us in your thoughts.
David: I think Bill, I would end this by stating that this is just one step in the journey. I think our ability in leveraging podcasts and being able to from a 21st century communication, engage with our workforce across all generations and the millennials and our baby boomers in order to highlight and communicate this journey and so, I’m really excited about this being kind of the inauguration and the start for much more communication coming in the future from our CEO, Lyle Sheldon and just greater detail around what’s related to this journey and I think we are off to an awesome start.
Host: Very well said David and this podcast can help you deliver the important messages you need everyone to hear. Okay Cassandra, you are in the anchor chair, if you can please share your final thoughts on our topic today from HRO to HERO. University of Maryland Upper Chesapeake Health’s journey to date.
Cassandra: I am excited about the beginning of this journey. More than anything, I believe we are a community organization and we serve a very mighty purpose. And that really is about becoming the HEROs for our community. If we want the healthiest community, we have to be our HEROs. And that starts with all of us being engaged with what we’re trying to do on this journey and really understanding that we aren’t far off. We are doing good things already. We just have to be a little bit more precise sometimes. We have to engage differently with each other and with our patients. And we have to focus on those elements of safety, and of quality because that’s really what our community is needing. And our community is us. It is our family. It is our friends. And we owe it to Hartford County to all the communities that we serve to really create that zero harm HRO or HERO environment.
Host: The community is us. So, well said. Thank you, Cassandra and David. This is the HERO podcast from UM Upper Chesapeake Health a podcast for internal communications. Check back for our next episode soon. And thanks for listening.
Bill Klaproth (Host): So, what is the mission of Upper Chesapeake Health’s journey to date? We’re going to find out with Cassandra Crowe-Jackson, Vice President of Patient Experience and David Branch, Vice President Performance improvement and Quality Management.
This is the Hero Podcast from UM Upper Chesapeake Health. I’m Bill Klaproth. David, we’re going to start with you. Can you explain to us what is a high reliability organization or an HRO?
David Branch (Guest): Great question Bill. So, I will start from the beginning. The term high reliability organization is essentially a term that has been used quite often and typically associated with industries who have high risk in terms of the work environments that they support. And what you typically would hear is that the nuclear industry, aviation, military services so these are environments, you think about a nuclear plant that you need to be able to operate at a long extended period of time without having some sort of serious catastrophe or harm.
So, when we think about the term high reliability, it sits so appropriately with healthcare when you think about the complexity of what we do in terms of our service delivery and what we do for our patients. We want to be able to deliver our healthcare in such a way that it does not have catastrophic harm. And that harm for us, is in essence, a defect or death. We want to be able to not have errors and failures in terms of our delivery. So, as a healthcare industry, we are working towards becoming a high reliability industry.
Typically in the past with healthcare, it has been really guided through regulations and regulations and we’ve heard it even through joint commission, that regulations alone are not enough to transform us into a high reliability organization. The second component here is healthcare has really changed in terms of how in the value system that we have, typically in the past, the landscape has been driven by volume and what we’re seeing now is that the rise of consumerism within healthcare to not only deliver the volume but to deliver value.
And so, we’re looking at patients not just as patients any longer, but we are really looking at them as consumers and how do we drive greater value. And we really feel that becoming an HRO is in essence one of the key components towards us delivering value for our patients.
Host: That’s really good David. So, thank you for explaining what an HRO organization is. Interesting, nuclear, aviation, military, healthcare fits right in there when you are talking about high complex organizations. So, Cassandra tell us then what is Hero, H-E-R-O?
Cassandra Crowe-Jackson (Guest): So, HERO is taking the HRO concept and personalizing it for our organization with a high focus on engagement as the key element for what will get us to becoming an HRO. And we chose that because we wanted to show kind of appreciation for the culture of excellence that was part of the legacy of Upper Chesapeake. It really helped create Upper Chesapeake. And we needed to have that focus around engagement because one of the things we really want to stress is that engagement is our ability to connect and understand each other, our patients, they are our families and even our community.
So, we need that engagement to create shared meaning and value. And that’s when we will have the root of what we need to become an HRO. It will help us take some of the noise out of our environment, all the mixed messages and really foster the fact that the HERO journey is our journey. It is not a flavor of the month initiative. But it is who we are and how we will operate going forward.
Host: Really interesting. So, your take on HRO is HERO, H-E-R-O and the E stands for engage. So, David then, what are you doing to help Upper Chesapeake Health become that HERO?
David: Awesome. So, let’s discuss and think about the core components that we have that make up the HERO journey. The joint commission has three core components that it highlights as a high reliability organization and typically those are robust process improvement, we look at leadership commitment and then the patient and just culture. And what we felt to really drive our HERO journey, we expanded upon those.
So, there are really four core components to our HERO journey. First and foremost, is patient and family centered care. We have to start with our patients at the forefront and at the beginning. How we engage with our patients, how we are able to not just give care to them, but with them, how we are able to make them part of our overall care delivery and our plan. We’ve done a great job in terms of bringing in – we have a patient and family advisory council where we leverage our PFAs towards helping us with some of the solutions that we deploy.
Secondly is when we talk about this term continuous improvement, joint commission calls it robust process improvement. But really, we really want to develop this culture that says we can always be better. And it’s not just about being good, but it’s about being great and it’s about being excellent. So, how do we continue to look at the processes that we have and drive those towards better care and better delivery and better experience that we have.
The other component of continuous improvement is innovation. My thought process is there should not be a problem that the 3000 plus team members that we have can’t solve. But it’s how we leverage and how we drive a degree of innovation.
The next component is our safety culture. Ultimately, we want to be sure that we’re delivering safe care and one of the core components is creating this just culture. When you think about healthcare and the complexity of what we do, we have humans and we’re serving other humans and so, humans make errors. So, when those errors take place, how do we deal with them? How do we resolve it? And a just culture it says that it’s not going to be punitive when we make a mistake, but there’s a shared accountability between the individual and the organization that we want to do the right thing.
The other component is that we want to drive a shared and continuous learning. That we want to learn from our mistakes and continue to become and continue to be better. And then last, but certainly not the least; we thought about leadership commitment, but we wanted to expand on that and become even greater and we transformed, and we talked about transformational leadership. The goal towards zero error and zero harm aint an easy one. And as Cassandra highlighted, it’s not for the faint of heart, it’s not a flavor of the month. It will truly require a degree of transformational leadership that’s going to get us through this journey.
And so when we think about transformational leadership, we think about four core kind of attributes to that leader. One, the ability to be able to innovate and become an innovator. We think about Steve Jobs and we think about some of the great leaders who are able to create and turn ideas into great implementations.
The second is we think about influence. How do we take those great ideas and then influence the head and the heart of our team members. So where do we look at implementers. And that’s getting stuff done. Talk is cheap. But how we are able to take the ideas that we have and execute.
And then the last component of our transformational leader is that ability to inspire. This is a tough journey and so you have peaks and valleys when you are in that journey. And as you are going through that journey, how do you continue to inspire your team, continue to put that gas in their tank to continue to move along the journey that we have. So, that kind of creates a core component of what we’re trying to do as a HERO.
Host: Yeah, that’s really interesting David. And let me stick with you for one minute. When I heard you answering that, this really sounds like your vision statement. Is that right? This is what you want Upper Chesapeake Health to become. Is that true?
David: It is, and we think about this as that true north. Who is it that we’re trying to become and are inspiring to become as an organization? And Bill so we’re excited because we’re starting that journey. There are things that we’re currently already doing that has gotten us there. So, we aren’t starting from ground zero here.
When we think about how we operationalize this for the organization, we have four kind of core business imperatives or strategic objectives. And we want to deliver safe care, quality care, empathetic care and efficient care. And I think about some of the things that we currently have going on like related to safety.
We have a patient safety brief every day, leaders throughout the organization from 9:00 to 9:15 come together to talk about any sort of patient safety event or team member or patient experience event and it has helped to create a different degree of situational awareness within our organization. When we talk about quality, our goal towards zero; one of the things that we look at are hospital acquired infections. So, when one of our customers comes into our hospital with that; we’re able to ensure that there isn’t a defect in terms of their delivery, those HAIs, that CARDI, that CRAPSI that we could prevent that we are working towards being able to reduce those. And over the last couple of years, we’ve seen significant reduction in HAIs.
So, when we think about empathy. One of the strategies that we’ve begun to deploy is our ADET plus the promise that we have. And so when we think about what ADET stands for and how we engage with our patients or with our customers, our ability one, to have a degree of acknowledgement. When we walk into a room, do we just acknowledge and acknowledge the presence that we are there with our customers. Secondly, do we introduce ourselves? When you are thinking about you are in a hospital and that patient is seeing a variety of different care takers in and out of their rooms in terms of how it relates. And so the ability to introduce yourself, heh, I’m David Branch and I’m with leadership and this is what my job is. Secondly, we look at the D which is our duration. How long am I going to be there to set up an expectation over the next ten minutes, five minutes, here’s what I’m here to do and then explain. Explain why I’m in the room and what my objective is there and then lastly the component of thank you. Just we know that our patients don’t chose and want to be in our facilities most of the time and we recognize that. We want to thank them for the work and being able to choose us as their healthcare deliverer.
And then lastly, is the promise. If there was something throughout the experience that we’ve had that we have an opportunity to do service recovery and make their stay that much better, there’s a promise there that we’re going to take care of it and we want to ensure that we deliver on that promise for our patients.
Host: Very well put and this is really good for the staff to hear what you just articulated. Safety, quality, empathy, efficiency. This is a great vision statement to aspire to. So, Cassandra if you could tell us what is next then?
Cassandra: Well, what’s next is this really this first year is all about creating awareness. Creating awareness from our team member perspective even from our patients and families and our community in terms of what is HERO. What are we trying to do? And that will encompass our new mission which is we deliver an exceptional care experience; every person, every encounter, every day. So, that we get to our vision, our true north of creating the healthiest community in Maryland. And that will be done with us all focusing on our values which are excellence, integrity, teamwork, ownership, compassion and trust.
So, for us to get to that engaged environment; we need everyone to understand what those components are and more importantly what’s expected of me. What is my role in creating a HERO culture? And so, there will be a lot of focus around training and awareness and understanding of what we’ve also added is our must have behaviors. Very clearly articulated expectations that every team member, every provider, everyone who is part of Upper Chesapeake Health will be held accountable to. And those behaviors will become part of our evaluations, how we interview, how we hire, how we retain and that will be a huge shift for us in our culture.
But it’s important that we take that time to make sure everyone knows what’s expected so that we do ultimately create that healthy community. And to do that, we’ll need to do a lot of things differently. It will show up differently in how leaders lead and that will include a ton of training for our leaders. Training and development so that leaders understand their role in being transformational leaders. The type of leaders we’re going to need to get to this ultimate goal of zero harm.
We’ll be rounding differently. So, leaders will be out and about engaging with our team, much more frequently than we are currently doing. And we hope there that we build a trust and a collaborative environment that focuses on continuous improvement, ensuring that we have patient-family-centered care. And that we are always operating within a just culture. So, that we are driving on our journey a little bit quicker.
We will engage more with our frontline, so we’ll have a group that we partner with continuously called our HERO champions and that’s frontline driven engagement that helps us focus on those elements of safety, quality, empathy, and efficiency. And that’s really the first steps in our journey and I think that the key thing here is to emphasize this is a journey. We will not resolve being an HRO by the end of 2020 or fiscal 2020. This is the first steps in the journey. It will be a journey before we start seeing these values show up operationally so that everywhere we go, we’re seeing a consistent level.
But we know this and we’re patient with the journey.
Host: That makes a lot of sense. And communication is so important in a mission like this as you said, everyone needs to know what is expected of them. In fact, you said every experience, every encounter, everyday and that’s kind of a mantra that everyone can hold with them as they approach their daily responsibilities. So, as we wrap up, I’m going to ask each of you for your final thoughts. David, wrap this up for us in your thoughts.
David: I think Bill, I would end this by stating that this is just one step in the journey. I think our ability in leveraging podcasts and being able to from a 21st century communication, engage with our workforce across all generations and the millennials and our baby boomers in order to highlight and communicate this journey and so, I’m really excited about this being kind of the inauguration and the start for much more communication coming in the future from our CEO, Lyle Sheldon and just greater detail around what’s related to this journey and I think we are off to an awesome start.
Host: Very well said David and this podcast can help you deliver the important messages you need everyone to hear. Okay Cassandra, you are in the anchor chair, if you can please share your final thoughts on our topic today from HRO to HERO. University of Maryland Upper Chesapeake Health’s journey to date.
Cassandra: I am excited about the beginning of this journey. More than anything, I believe we are a community organization and we serve a very mighty purpose. And that really is about becoming the HEROs for our community. If we want the healthiest community, we have to be our HEROs. And that starts with all of us being engaged with what we’re trying to do on this journey and really understanding that we aren’t far off. We are doing good things already. We just have to be a little bit more precise sometimes. We have to engage differently with each other and with our patients. And we have to focus on those elements of safety, and of quality because that’s really what our community is needing. And our community is us. It is our family. It is our friends. And we owe it to Hartford County to all the communities that we serve to really create that zero harm HRO or HERO environment.
Host: The community is us. So, well said. Thank you, Cassandra and David. This is the HERO podcast from UM Upper Chesapeake Health a podcast for internal communications. Check back for our next episode soon. And thanks for listening.