The most successful hospitals not only focus on patient safety and positive outcomes, they also create a collective winning mindset within the organization. When a positive and open culture is created, great things happen and everyone benefits, especially patients. Two leaders—one in the Navy and one at a top-five hospital system—had simple but effective ways to create a culture that drove success. They understood they could not change the individuals or the physical environment, so they focused on what they could change: culture and attitudes.
Captain D. Michael Abrashoff’s book, It’s Your Ship, is a surprisingly apt read for hospital administrators that want to improve outcomes. When Captain Abrashoff took the helm of the USS Benfold, it was the worst-performing ship in the Navy. Though it was loaded with the most advanced technology, the crew did not fully understand their mission. But instead of scrutinizing his team, Abrashoff took a different approach. While analyzing each process on the ship, he asked, “Is there a better way to do what you do?”
The approach paid off as he started making small changes to practices based upon this feedback. Soon, more suggestions came in, and new approaches and protocols were established. The crew felt like they were part of the management process and were eager to learn more skills. In response, Abrashoff started duplicate training to ensure at least two people always knew each job task and received continual training. Part of being a team is filling in for other members when needed with no loss of skill set.
When a leader demonstrates that employee input is important and incorporates suggestions, attitudes change. According to Abrashoff, “Some leaders feel that by keeping people in the dark, they maintain a measure of control. But that is a leader’s folly and an organization’s failure. Secrecy spawns isolation, not success.” Aboard a ship are sailors from every type of background and education—and a hospital’s staff is similarly diverse. Making sure everyone feels they are part of the team and have a voice is the key to pushing success to excellence.
The Cleveland Clinic, like other prominent healthcare systems, embraces change to optimize patient outcomes. Former CEO Toby Cosgrove, MD, understood leading was not about him, but about empowering the entire team to achieve superior results. Like Abrashoff, Cosgrove created a culture that allowed everyone to be set up for success—with the patient as the focus.
This culture is evident when boarding any of the numerous shuttles between buildings on the main Cleveland campus. Shuttle drivers are compassionate, educated on each building, and proactive about reducing the stress of their passengers. Customer-focused training is not a niche area for the Cleveland Clinic; everyone is trained, and everyone knows the importance of empathy.
In contrast, hospitals without a strong culture of success and training often have deficiencies that can lead to accidents. For instance, hospital technicians, when asked how they were trained to perform their required tasks, frequently respond that either coworkers or their predecessor provided the training. Standardized training on specific equipment or cleaning techniques are scattered, and retraining is often never provided. This educational weakness may result in multiple infections or deaths due to improper practice—incidents that can be prevented.
A breach in infection control practices facilitates transmission of infection from patients to healthcare workers, fellow patients, and the surrounding environment. Therefore, it is imperative for all healthcare workers to understand and properly practice infection control guidelines. Consider the role of contractors and maintenance technicians at most hospitals. While a majority of healthcare systems struggle with trying something new to address the training of all outside vendors that work in a hospital, the Cleveland Clinic jumped on an alternative delivery method for its training—a cloud-based education platform that is available 24/7 from any smart device, complete with testing to verify learning. Not only did this training help reduce harmful mistakes, it also added positive momentum within the health system’s culture.
Healthcare administrators must ensure that their infection control program is implemented, that training and education are properly administered, and that feedback from their “crew” is collected and acted upon. The combination of providing employees with effective knowledge while empowering teams to remain focused and motivated is how excellence can be achieved.