Organizational CultureInfluence on Patient Experience

And Healthcare Innovation

Brandon Bacon

University of Utah

Patient Experience

PatientAnd

Family

Healthcare System

Environmental

Executive Management

Team/Unit

Individual

Interaction

Patient and Family Culture

Organization Culture

Patient ExperienceGood Experience Poor experiencePoor experience

Healthcare System

Patient and

Family

Culture Culture

Healthcare Improvement Methods

• Total Quality Management (TQM) • Continuous Quality Improvement (CQI)

Team Development Problem

DefinitionInitiative

DevelopmentConsensus Reached Implementation

Feedback

What’s missing?

• “…the difficulty in implementing successful total quality management (TQM) initiatives; four of five initiatives fail — despite the consensus that such efforts are essential to long-term organizational success.”– (emphasis added) Delmarva Foundation (Boan and Funderburk, 2003)

Problem Statement

Despite agreement that patient centered-innovation is an important part of improved healthcare, many initiatives are unsuccessful due to cultural implications rather than poor

idea generation.

Investigation of Organizational Culture

“The set of shared, taken-for-granted implicit assumptions that a group holds and that determines

how it perceives, thinks about, and reacts to its various environments.”

Investigation of Organizational Culture

• Culture can’t be dictated…

• …but it can be facilitated

Methods for changing Org.

Culture (E. H. Schein)

Formal Statements

-Mission, vision, values Design of

Physical space

Slogans, acronyms, language

Role modeling, training, teaching

Explicit Rewards

Storytelling Measured

activities and outcomes

Leadership reactions to

critical incidents

Workflow and Org. structure

Org. systems and

procedures

Criteria for recruitment

and selection

Innovation center

• A physical space for innovation

• Provides a “place” for ideas to go

• Integrates the idea of innovation into the culture of the organization

Innovation process

Develop Empathy

Idea Generation

(Prototypes)Implementation

Commercialization/

Feedback

Positive reinforcement

Inspiration Ideation Implementation

Phase I Phase II Phase III

IsolatedO

pen

Small Facility Large Facility

Continuum for Innovation Center Models

Improved

patient care

Change in organizational

culture

Facilitated innovation

Develop a center that enhances values

Organizational values defined and supported by executives

Impact of an Innovation Center

Influence of an innovation center on

culture

Formal Statements

-Mission, vision, values Design of

Physical space

Slogans, acronyms, language

Role modeling, training, teaching

Explicit Rewards

Storytelling Measured

activities and outcomes

Leadership reactions to

critical incidents

Workflow and Org. structure

Org. systems and

procedures

Criteria for recruitment

and selection

Don’t reinvent the Wheel…• Technology

– Department of Biomedical Engineering

• Design– Bench 2 Bedside

• Behavior– Simulation Learning Center

(Dept. of Nursing)

• Commercialization– Lassonde New Venture Development Center

• Culture– Behavior Standards and evaluations

http://how2droid2.blogspot.com/2011/01/collection-of-android-guides-and-best.html

Technology

Located throughout the University and Hospital

facilities. Involved in almost every technical

area of medicine.

http://www.ddmed.com/biomed.htmhttp://www.bioen.utah.edu/

Design

A medical device competition that brings medical,

engineering, science, and business

students together to develop and market a

medical device product

http://www.techventures.utah.edu/b2b.php

Commercialization

http://www.tco.utah.edu/

http://www.techventures.utah.edu/b2b.php

http://www.lassonde.utah.edu/

Opportunities to develop, patent,

license, and implement new technology and

process developments into

internal and external medical

services

Behavior

Simulation Learning Center

Center that allows nurses to practice basic

procedures. These centers can also be used to

prototype new procedures, care delivery methods, and patient room prototyping.

http://nursing.utah.edu/SLC/students_faculty.html

Culture

• Exceptional Patient Experience– Program that emphasizes quality

care• New Employee Orientation– Introduction to the

behavioral/culture expectations of the hospital

• Continuous employee evaluations– Quantitatively evaluate the actions

of healthcare personnel.

Innovation Center Structure

Technology Design

Culture Behavior

Commercialization

Patient

Can this work in Healthcare?

• Do Innovation centers enhance healthcare mission and goals?

• Do they impact the organizational cultural and empower personnel?

• Are they financially sustainable?

Case Study- Mayo Clinic

• “Like a giant incubator, the center offers a unique space within Mayo Clinic for nurturing new ideas, enabling them to grow, mature and evolve until they are ready for patients.”

Exam Room Redesign

Problem Patients were calling with many questions that had been answered during their appointments. Many of them were confused or unsure of their treatment plan. This caused clinic aids to spend a lot of time on the phone.

http://www.rmdtllc.net/pages/facilities.htmhttp://nexus.som.yale.edu/design-mayo/?q=node/99

Exam Room Redesign

http://nexus.som.yale.edu/design-mayo/?q=node/99

ProcessIntegrated group of doctors, designers, etc. observed doctor-patient interactions and found many meetings didn’t require exam room equipment.

http://www.coloncancerresource.com/image-files/colon-cancer-doctor-with-senior-patient.jpg

Exam Room Redesign

• Solution and Results– Designed a consultation

room similar to an office with a meeting table without any medical equipment

– “wildly successful…”– Patients retained more

information; decreased callbacks

– Better patient experience

http://nexus.som.yale.edu/design-mayo/?q=node/99

Case Study: Kaiser Permanente System-wide innovation center

• “a living laboratory where ideas are tested and solutions are developed in a hands-on, mocked-up clinical environment.”

• Developed in collaboration with IDEO• Any personnel within Kaiser can participate• Personnel involved include:

– Doctors– Nurses– Clinical Support staff– Members– Technologists– Engineers– Architects– Designers

Case Study- Kaiser Permanente• 37,000 sq. ft• Home environment• Outpatient clinic• Inpatient units:

– Med surg. Rooms– Critical care Patient room– Labor and Delivery Room– Operating Room– Emergency Department– Consult Room– Family waiting Room– Staff Unit/Nurse Work station

units

http://xnet.kp.org/innovationcenter/about/index.htm

Can this work in Healthcare?YES!

• Hospital’s mission and goals enhanced through patient centered activities

• Empowered culture that innovates within healthcare culture

• Financial Sustainability through development of new models, techniques, and technologies– Bottom line and commercialization

Conclusion

• Innovation centers are a method of facilitating a culture focused on patient-centered innovation.