One person can make a difference, and everyone should try.

Donna Sollenberger, EVP & CEO, UTMB Health SystemBefore I share the patient letter I recently received, I wanted to begin with a story. Written by Loren Eiseley, I thought it was a great example of how each of you, through your everyday service and care of our patients and their loved ones, make a big difference. Although you may not always immediately see or hear about how the work you did impacted someone else’s life, your efforts often carry a significance far greater to others than you may realize.

“Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out “Good morning! May I ask what it is that you are doing?”

The young man paused, looked up, and replied “Throwing starfish into the ocean.”

“I must ask, then, why are you throwing starfish into the ocean?” asked the somewhat startled wise man.

To this, the young man replied, “The sun is up and the tide is going out. If I don’t throw them in, they’ll die.”

Upon hearing this, the wise man commented, “But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can’t possibly make a difference!”

At this, the young man bent down, picked up yet another starfish, and threw it into the ocean. As it met the water, he said, “It made a difference for that one.”

Each day, when you do something special for a single patient, for all of our patients as a whole, or even in support of a colleague, it matters. The letter that follows, which was written by a patient’s wife, provides a powerful example of how one of our employees, Care Manager Mary Jacinto, made this sort of tremendous difference in a family’s life.

As you know, a key strategy of UTMB’s Best Care initiative is to manage our patients’ care, not only while they are in the hospital, but also after they are discharged. For many patients, this is to help prevent readmission (for example, the care manager may follow up to make sure the patient is taking their prescribed medications); for others, the goal is to help patients transition to another level of care or to help them find the resources they need to continue their care plan once they’re home. This letter tells the story of how, through Mary’s actions, she helped save a patient’s life:

“We want you to know how Mary Jacinto helped save my husband’s life. Back in September 2015, Michael [patient’s name is used with permission] got sick and was admitted to UTMB Galveston. Michael had cirrhosis with ascites, an enlarged spleen, an aortic aneurysm, hepatitis C and chronic obstructive pulmonary disease (COPD). After Michael was discharged, this is where Mary came into our lives as Michael’s Care Management Nurse.

We didn’t have insurance and little money. Mary got Michael lined up with the Freeport Clinic, so he could get the medical attention he needed. He wasn’t getting better and needed further medical attention. Mary used her resources and got Michael set up as a casebook study at UTMB.

In May 2016, we found out Michael had liver cancer and without a transplant, he only had a year to live. We still did not have insurance. I had tried several times to get insurance and wasn’t successful. Mary took the time to sit with me, and we did a conference call with the Health Market Place. We got insurance, effective June 1, 2016.

Then, Mary got Michael set up with the Liver Transplant Clinic. On August 8, 2016, Michael got a liver transplant at UTMB Galveston. He is doing fine and is very thankful to be alive. Because of Mary’s persistence, perseverance and caring ways, Michael is alive today! She is a very special person! We call her our angel! We want Mary to get the recognition she deserves.”

This is just one example, but this sort of amazing care takes place every day at UTMB. I can go on and on with examples of how individuals and teams across UTMB contribute to Best Care. In fact, just the other day, after a power outage in League City, individuals from Clinical Equipment Services, Nursing Services and many other areas discovered and preempted a potential patient safety issue with back-up batteries and emergency power. They then immediately took action to resolve the problem in a single evening. Some of the individuals who helped weren’t even on schedule that night, or they came in early the next morning to ensure everything had been addressed. To me, this sort of teamwork is outstanding and it proves that often, it is not one person or one action that makes the difference; it is the collective efforts of many who are working together toward a common goal.

As we continue the Best Care initiative and receive feedback from groups across the organization, leadership has learned that many people still aren’t sure how they impact Best Care. Although Best Care is largely focused on some areas for improvement that are difficult to impact for those who do not deliver direct patient care, I want to emphasize that each of you plays a very important role to the overall Best Care initiative. When it comes to helping patients navigate the health care system, ensuring they have a positive experience, or making sure needed supplies are delivered and facilities are operational, through your collective service, you make an impact.

Never doubt that one person’s efforts can make a difference. It did for Michael and will for so many others.


November 11 is Veteran’s Day.

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Success is the sum of small efforts…

Donna Sollenberger, EVP & CEO, UTMB Health SystemThe famous artist Michelangelo once received a visit from a friend as he worked diligently on a sculpture. After a brief chat, the friend left but returned later to find Michelangelo working on the same statue. Thinking the statue was nearly completed on his last visit and seeing no visible change, he exclaimed, “You haven’t been working all this time on that same statue, have you?”

“Indeed I have,” the sculptor replied. “I’ve been retouching the facial features, refining the leg muscles, polishing the torso; I’ve softened the presentation of some areas and enhanced the eye’s expression.”

“But all those things are insignificant,” responded the visitor. “They are mere trifles.”

“That may be,” replied Michelangelo, “but trifles make perfection, and perfection is no trifle.”

Even today, painter, sculptor, architect and poet Michelangelo is still widely regarded as the most famous artist of the Italian Renaissance. Among his works are the “David” and “Pieta” statues and the Sistine Chapel frescoes. His work demonstrated a blend of psychological insight, physical realism and intensity never before seen.

The moral of the story? People and organizations who pay attention to the “little things” produce excellence in larger matters. As American entrepreneur, businessman and founder of the Marriott Corporation J. Willard Marriot said, “It’s the little things that make the big things possible. Only close attention to the fine details of any operation makes the operation first class.”

UTMB’s Best Care initiative is composed of many “moving parts”. There are a number of focused efforts in each area in which we are working to make significant improvements: reducing our observed mortality rate, improving effectiveness (doing or using the right things to achieve the desired patient outcome and best experience of care) and increasing efficiency (doing or using the right things to achieve the desired patient outcome and best experience of care). There is a tremendous amount of work in progress, and I am truly excited about the collaboration and teamwork taking place to make Best Care a reality.

Many of you are a part of the teams conducting this focused work, but everyone in every role at UTMB Health contributes to making our organization the best place to receive care and to have an excellent patient experience. I know you are all dedicated to this endeavor and have a desire to stay informed of our progress and the projects underway. That’s why this week, I would like to give you an update on some of the work that is taking place, as well as the work that will be conducted in the time to come.

Reducing UTMB’s Mortality Rate

At UTMB, all patient deaths are reviewed within 48 hours of the event, as generated in the Epic electronic medical record (EMR). Each death is then classified based on how likely the patient’s death was to occur—some patient’s illnesses are severe and they were expected to pass away, while other patients who passed away were not expected to. This is why detailed and specific clinical documentation is important when it comes to predicting mortality, because it illustrates how sick our patients are and it helps identify any additional illnesses or complications that may make care delivery more complicated. To aid in this documentation effort, an enhancement known as a “smart phrase” will be made in the EMR is forthcoming.

Another way we have improved our mortality rate—and more importantly, improved end-of-life situations for patients and their families—is to consult with patients and their families when the patient is expected to pass about moving into hospice care. This helps give them a choice about how to spend their last days and honors the patients’ preferences. So far, we have been able to transition 14 patients into comfortable end-of-life care. These efforts will continue and remain ongoing in the future.

Diagnosing, Treating and Preventing Sepsis

Sepsis is a leading cause of mortality. It is a bloodstream infection that results in tissue damage and organ failure. Sometimes patients arrive in the hospital with sepsis; at other times, they can develop it after a surgery (if this occurs, it is considered a patient safety event).

Recent work to improve our performance in this measure has focused largely on placing a workflow in the electronic medical record (EMR) to help providers follow the evidence-based care recommended for testing and treatment of sepsis. A report has also been developed to help monitor all patients with sepsis on their problem list—this helps ensure that if sepsis is initially documented as “suspected” or “probable”, it is eventually also documented as “confirmed” or “ruled out” and the final diagnosis is clearly documented.

Clinical documentation guidelines for the diagnosis, documentation and coding of sepsis and septic shock have now been posted to the Best Care website, and clinical documentation specialists and inpatient coders continue working closely with physicians on this area for improvement.

Clinical Documentation Improvement

After physicians document the care they provide in the medical record, it is later translated into codes which are used not only to determine the cost of care and reimbursements, but to help illustrate how sick patients are and to track disease trends. The documentation/coding process is fairly technical and detailed, but one important factor is to identify not only the primary diagnosis, but also identify and document any complications or co-morbidities (aka, secondary, co-existing illnesses). It is also important to note whether or not the secondary illness was considered “major” (meaning it required more resources to treat and was at the highest level of severity) or “simple” (meaning the condition resulted in some increased resources, but at a much lower rate).

When ICD-10 was implemented in October 2015, it changed how some conditions and procedures were classified. That is one reason why specificity of clinical documentation was strongly emphasized. However, it was predicted that on a national level, some services that are considered “procedural-heavy”, like general surgery, general medicine and cardiac services would be more susceptible to the impact of this shift than other areas of care.

At UTMB, clinical documentation improvement is focused in all services, but project teams are also particularly focused on Cardiology. To help providers make the best possible diagnosis choices, Department Chair Dr. Ken Fujise has requested that a template be developed for use in the EMR, and this work is in progress.

Effectiveness and Efficiency

Building on work already accomplished, Orthopaedics continues work to reduce patient length of stay and preventable 30-day readmissions through revised order sets (order sets are standardized lists of orders for specific diagnoses that help physicians follow evidence-based guidelines for care), conducting risk assessment for patients (that is, understanding what might put a patient at risk for readmission), and improved patient education and physical therapy training. Sometimes, a patient may need advanced care after a surgery, such as a knee replacement, but their condition isn’t serious enough to actually be admitted. By placing them in observation instead, which is a less expensive care environment, a 30-day readmission can be avoided.

Other areas of focus that are helping to improve the data for our readmission rate overall is ensuring that elective surgeries are clearly distinguished from non-elective surgeries and that inpatient procedures are accurately coded as planned or unplanned.

Last but not least, throughout the inpatient arena, patient care teams continue conducting progression of care rounds and using the “8 Ps” (an assessment of preventable risk factors for readmission). Teams also continue conducting and documenting “Teach Back”, which helps ensure that patients understand their condition and how to care for themselves at home. Care managers remain focused on following up with patients after they are discharged to ensure they are following their plan of care. Particular attention is being given to caring for hospital-dependent patients.

“Success is the sum of small efforts – repeated day in and day out.”

As you can see, there is a lot of work going on! Although I mentioned a couple of weeks ago that we slipped in our rankings in the most recent Vizient Quality & Accountability Study, all of the amazing work I described above was not included in the data submitted for that study’s time period. Therefore, I am confident that if we continue these efforts and maintain a steadfast focus on Best Care, including maintaining our performance in patient-centeredness and equity of care, we will be successful in our endeavor to become a top 20 academic medical center in the next study.

Thank you all for your diligence and hard work! And remember, it’s the things we work hard for that have the greatest worth. We have a tremendous opportunity to prove that UTMB Health is the best place to receive patient care!

Quote attributed to Robert Collier

Remember Why You Started

Donna Sollenberger, EVP & CEO, UTMB Health SystemHave you ever worked really hard to improve at something, only to find that after dedicating a lot of time and attention to it, you did not get better? Or worse yet, that you didn’t even do as well as when you started? Did you give up, or did you make adjustments and work even harder?

When I was in my early 20’s, I decided I would take up golfing. Many of my friends played, and I thought it would be a good skill to have, especially if I were going into business. Everyone in business plays golf, right?

The first thing I set out to do was purchase a set of golf clubs. I am left-handed, so borrowing clubs was out of the question, and no one I knew had left-handed clubs that I could borrow. I had even tried playing a round of golf using right-handed clubs, but wow, was that a mistake! I didn’t even get through three holes before I realized it simply wasn’t going to work.

So, I set out in search of some left-handed golf clubs. I had been saving up for a new car, but I decided since my car was running fine, I would use the money to buy my clubs instead. I would love to say that they helped my performance, but they did not.

Despite family members who tried to teach me and despite the lessons I paid for with more of my car savings, nothing helped. In my entire life, I have played nine holes of golf twice. I am sure it was entertaining to those accompanying me—I would miss the ball and hit the grass with the club, knocking up a chunk of earth, or I would swing repeatedly at the air while trying to tee off. Then, it would take me about 10 strokes just to get to the green. While I was a pretty good putter, it did not make up for the rest of my performance.

Ultimately, I decided that golf was not my game; so, I invested my time in playing other sports I was good at like volleyball, softball and bowling. (I ended up being pretty good at bowling!) However, I have often wondered how good I could have become at golfing if giving up hadn’t been an option. I guess I will never know…

This experience made me think about Best Care. Last week, we received our results from Vizient for the quality and safety data we submitted in parts of 2015 and 2016. While we are still generally in the top 20 for equity and patient-centeredness, and we are almost at the top 20 for patient-safety, we have fallen in our overall ranks for mortality, efficiency, and effectiveness. As a result, our overall score fell from being 58th to 76th out of a little more than 100 academic medical centers. While we are still in the three-star category, our results within that range slipped.

What happened? There are several things to point out:

  • The 12 months of data we submitted did not include most of the last four months of effort we have given to the Best Care initiative. This means that some of the great progress we have made so far was not captured in this set of data. This was particularly evident in the category of mortality; for example, we know we have made considerable progress by converting patients who were expected to pass away to hospice care at the right time.
  • As we had already anticipated, several items were also added to the survey this year which affected the scores. For example, length of stay (LOS) was previously calculated according to the date of inpatient admission and the date of discharge. Now, patients who are being observed but are later officially admitted are also included in this count, and the time they spent in observation is included in their length of stay, thus increasing UTMB’s overall length of stay performance.
  • We have identified issues that are creating the need to keep patients in observation, such as limited availability of some weekend services in the hospital (other than what is needed for emergency services). The Health System has started working with affected departments to help improve patient access for those services on a routine basis.
  • It should be noted that several services have improved their performance by reducing their length of stay, as well as the direct cost of care for the patient. So, there was some positive news in the latest results.

We will be looking very closely at the data this week and developing the additional action plans we need to meet our Best Care goals, but we need everyone to stay focused on what we need to do in our individual roles—and most importantly as part of our teams—in order to be successful.

They say, “When you think about quitting, remember why you started.” Unlike my decision to give up on golfing, quitting Best Care is not an option for us. We have to double down on our efforts—we owe it to our patients and their families and we owe it to ourselves to show the world that the care and service delivered at UTMB is the very best. When the Vizient Quality & Accountability Study comes out next fall, and we are in the top 20, our efforts to “Be the Best” will not end. Maintaining that position will be as challenging as achieving it. It is hard work to always deliver Best Care, but it is also highly rewarding.

I am convinced with the many good people we have working together on Best Care, that we will achieve our goals. Thank you for all of your contributions to and work on behalf of our patients to assure that they receive Best Care – every patient, every time.

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If it doesn’t challenge you, it doesn’t change you.

Donna Sollenberger, EVP & CEO, UTMB Health SystemI read online that viewership of the 2016 Rio Olympics is down. That was news to me, since I have been glued to the television during all of the swimming, diving and gymnastics events. I don’t read the spoiler alerts on the news and in social media, because I want to watch each event with nervous anticipation and hopefulness. I love to be surprised by the results!

As you know, swimming is a favorite sport of mine – more so lately because my grandson, Jack, participates in the sport. In my last two Friday Flash reports, I told the story of his most recent meet, as I watched him swim in adversity and finish his first race with his goggles lodged between his nose and mouth; then, I had a chance to see him finish in fifth place for his 100-meter backstroke event. He had told me all about his strategy to improve his time, and in his last race, the 200-meter freestyle, I learned even more about Jack as he once again put his strategy to work—he shaved a full 15 seconds off his personal best time and finished in fourth place!

Last week, I used Jack’s story to talk about our own strategy for success when it comes to Best Care. Our vision is to not only deliver the safest care to every patient, every time, but we are also challenging ourselves to rank among the top 20 academic medical centers for quality and patient safety*. This week, something happened to reassure me that we can and will meet this very aggressive goal.

As a participant in the Medicaid program, which provides medical coverage for more than 4 million low-income Texans, UTMB takes part in its pay-for-performance program. Simply put, the program has two basic elements upon which we are rated: potentially preventable readmissions (PPR) and potentially preventable complications (PPC).

The penalties are not insignificant. When the program began three years ago, UTMB had $3.5 million of its Medicaid payments withheld due to unplanned readmissions and complications. We were astonished. But, as we looked into the data, it became clear that a good deal of the reimbursements were withheld not because of the quality of the care provided, but rather because our documentation and coding was not sufficient; therefore, it did not accurately reflect the degree of our patients’ illnesses or the specificity of their complications. In response, we set out on a mission to improve our documentation and coding, as well as to review every unplanned readmission.

The results the following year were incredible—instead of the $3.5 million figure being withheld, we had reduced the amount to a $2.5 million—all from readmissions. Following this significant improvement, we planned to further reduce this amount in FY16 by at least another million by sustaining our gains in reducing readmissions and focusing on preventing complications.

Because our Medicaid population is heavily represented by mothers and children, we talked to the department leaders, we rolled up our sleeves and reviewed OB charts with identified complications, brought in experts in the 3M PPR and PPC algorithms, and shared findings and recommendations with faculty and residents, informing them of the implications for their ongoing documentation.  As a result of that work, a physician leader reviewed each case forwarded by hospital coders. The physician then communicated clarifications to the individuals involved in that patient’s care and medical record, and provided any overall messaging that would be useful in guiding the entire department.

While documentation and coding were certainly high contributors to the outcomes, there were also some process changes that helped us turn the information into actions that improved our overall care. The team engaged partners in Information Services to make changes in the Epic EMR infrastructure that would better facilitate the identification of the complexity and co-morbidity of OB patients, and to guide the assignment of observation status as appropriate (thereby avoiding an inpatient readmission).

The result? This week, we received our report from Medicaid outlining our results for the 2015 performance period, which go into effect September 1, 2016. We had zero deductions for unplanned readmissions and zero deductions for unplanned complications of care. That’s right—we exceeded our plan, and we did not incur ANY of the potential $2.5 million penalty!

This outcome reinforced several things for me:

  • We need a plan that we follow without exception.
  • We need people to be engaged in this effort to help us identify problem areas, develop solutions to those problem areas, and be willing to assist in teaching and educating our providers and staff to help us achieve our goal.
  • We can achieve lofty, seemingly impossible goals, if we have a plan, execute it and stay singularly focused on achieving it.

While I would like to think that the large amount we retained will help our budget next year, we also learned that some of our funding from other various sources will be reduced more than we had anticipated. So while the latter is disheartening, it is another reason why we are so focused on Best Care—safer care is not only better for our patients, but it costs less, too.

If we remain focused on meeting the performance benchmarks for academic medical centers, increase our efficiency, reduce variation in care, and improve our quality, everyone wins. We lower our costs, see greater reimbursement, and most importantly, our patients get the best possible care—this is our ultimate goal.

We have a tremendous opportunity to showcase our talent and expertise through this endeavor. Thank you all for everything you are doing to help UTMB Health achieve Best Care for all of its patients!

*As measured by the Vizient Quality & Accountability Study.

A challenge only becomes an obstacle when you bow to it.

Donna Sollenberger, EVP & CEO, UTMB Health SystemThis week, I was reminded of a time in the past when I worked on a leadership team that did not function as well as it could have. We were a diverse group of people from many different backgrounds with a wide array of professional expertise. Individually, we were all really good at what we did, and we all accomplished a lot within the departments we directed. As a leadership team, we even had a pretty clear idea of what our individual responsibilities were; however, we did not work well together to accomplish our shared goal.

We all knew what we were working toward, but we became frustrated when we did not progress quickly enough to the end result. So, we each started doing our own thing, according to our own leadership styles. Pretty soon, everyone was confused because there was so much duplicative work. No one seemed to know what the other was doing, and as a consequence, teams across the organization didn’t know what they needed to do to contribute to the goal or who was supposed to be doing what. I knew in my heart that the employees’ frustration was justified. So, I made a decision—I could allow this lack of coordination to continue, or I could try reshaping the team so that we worked together more effectively. I decided to do the latter.

As the team worked hard to come to an agreement, we conducted an exercise that involved completing a questionnaire to help identify our preferred working styles. It also honed in on how we each responded to stress in the workplace. Many of you have probably taken similar questionnaires, and you were categorized as a combination of letters or a certain color, like yellow, blue, green or red, which defined how you normally acted, as well as how you acted under stress. For example, if you were categorized as yellow, it meant you were generally process driven—a sequential thinker. If you were categorized as blue, it meant you were a “people person” who generally tried to understand everyone’s point of view and tried to get people to work together. Green meant you were a planner and strategist who was easily bored with details. If you were red, you were a detail-oriented person.

When our team shared their predominant color for our normal work mode, we had a great blend of the colors—something all teams should have. We had a people person, a planner, the process-oriented person, and detail-oriented team members. But what happened when we were under stress was really interesting. We were all in the red category. This meant that under stress, we all approached our work from the same point of view, and we didn’t have the important input from the sequential thinkers, the planners or the outgoing people with strong communication skills.

To really emphasize to our group how the organization was affected when this happened, I put tape on the floor so that we had four clear quadrants. I then asked everyone to stand in their respective color quadrant, exactly as the survey tool had placed us in “normal mode”. The closer someone was to the center, the more they reflected traits from multiple quadrants; the further away one was, the more strongly they reflected a single working style.

Under normal circumstances, we were all pretty well distribute across the colors. But when I asked everyone to occupy their stress quadrant in the exact placement the survey depicted, the result explained everything—we were all deep into the red, trying to occupy each other’s space. No wonder the employees said they were confused! In stress mode, our leadership team each tried to take charge, and to the organization, this seemed as if no one was in charge.

Why do I tell you think story? If we are going to achieve Best Care, we need everyone in the organization to contribute their unique talents and working styles to the team. Whether you are mostly a planner, a people person, a strategist or an operational process person, we need all of you contributing to reaching Best Care by August 31, 2017.

So what can you do?

  • Make sure that you understand your primary role on the team – whether you are on a patient care team or an operational team. Your position description provides guidance on your job, but what is your role on the care team? If you are not sure, your manager or leader should help you better understand your role and the contribution you can make to Best Care.
  • If you are a manager or leader, your job is to have clarity about how your area can most effectively contribute to Best Care, and then make sure that everyone knows they are on the team and what their role should be.

It is so important that we try to stay in our “normal” mode at work, because if we are operating under stress, we may not be able to contribute to our teams in a positive way, or we may create a situation where our environment could potentially become unsafe. Dr. Gary Grody defined stress this way: “Stress is defined as an inability, or the perception that you are unable, to take control of your life. If you feel in control, even if you’re not but you perceive you are, you won’t feel the stress.”

We all have high hopes for what UTMB Health can achieve over the next year as we work toward our goal of Best Care. We are already beginning to emerge as a leading academic medical center in many ways—we have experienced unprecedented growth and are performing better than most in many areas. Now, to deliver the Best Care to every patients, every time, we must remain focused on what we want to happen as an organization.

We will be rapidly moving toward our goal, so let’s remember to continue working together steadily as a team toward the goal, even in the face of challenges or frustration. Zig Ziglar says, “When obstacles arise, you change your direction to reach your goal; you do not change your decision to get there.” We must identify the areas in which we can make a change and come up with creative solutions to move the needle. We have an opportunity to become a model healthcare organization, and teamwork, focus and effective communication will be critical to improving the health and well being of all we serve!

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Accountability is the glue that ties commitment to the result.

Donna Sollenberger, EVP & CEO, UTMB Health SystemOn Wednesday, I had the pleasure of speaking at a Lunch & Learn for Health System leadership about the importance of accountability for both individuals and members of leadership. I am sharing it today via the Health System Intranet for you to review. Whether you are a manager, director or individual staff member, there are worthwhile reminders in the presentation for all of us.

After the presentation, I began thinking about how important the principle of accountability will be to achieving our goal of Best Care this year. You will recall that Best Care is an initiative we are implementing in response to University of Texas System Chancellor William McRaven’s challenge that UTMB rank in the top 20 of academic medical centers by August 31, 2017 (as measured by the Vizient* Quality & Accountability Study).

In Stephen Covey’s book “The 4 Disciplines of Execution,” he contrasts an organization that thinks conventionally with one that thinks in terms of both individual and collective accountability. In the organization with conventional thinking, team accountability is always top down: “We meet with the boss periodically and s/he lets us know how we’re doing and what we should focus on next.” In the organization used for contrast, the individuals on the team collectively share accountability for achieving goals and results: “We make commitments and then we’re accountable to the boss; but more importantly, we are accountable to each other for following through.”

A culture of accountability is crucial to achieving goals, particularly when the storms of change and multiple priorities are whirling around us. Often in these types of environments, teams end up breaking apart because individuals decide to go off on their own to “just get it done”. The goal becomes increasingly difficult to achieve if, within the whirlwind, we are also trying to change the behaviors of a lot of people.

With this in mind, I started thinking about how much we have going on right now. We are really going to need to buckle down, prioritize our work, and maintain a steadfast focus on achieving Best Care, especially because reaching this goal will require changing the behaviors of many people and teams. Failure to achieve Best Care is not an option, because it is the right thing to do for our patients!

everstThe work that we must do to deliver on our promise of Best Care reminds me of the book, “Into Thin Air,” which tells the story of two teams of climbers who attempted to get to the summit of Mount Everest. The first team included the author of the book, Jon Krakauer. He wrote about the numerous adversities his team encountered as they tried to reach the summit. As blizzards, high winds and altitude sickness began to affect the team, certain members decided to split off on their own in an attempt to get to the top. Although each climber had the same goal, by setting out on their own, they abandoned the team and discarded discipline and accountability to each other. The results were disastrous as the weather conditions proved too much for eight of the climbers who ultimately lost their lives.

The second team of climbers included a blind climber, Erik Weihenmayer. If the group succeeded, Erik would become the first blind person to reach the top of Mt. Everest. The biggest difference between this group and first is that at the end of each day, they huddled together in what they called a “tent meeting” to talk about what they had accomplished and what they had learned. The team used the meetings to review their strategy, make needed adjustments in their approach to the climb, and define each member’s role. They also decided who on the team would go ahead to clear the path and secure the ropes so that Erik could climb.

Erik characterized the teamwork this way: “Our team stuck together and took care of each other, which gave me the courage to finish.” The result? On May 25, 2001, the team reached their goal, and Erik Weihenmayer became the first blind person to stand on the summit of Mt. Everest.

There are so many lessons to be learned from this story, but here are some of the critical ones that we will need to implement to ensure we achieve Best Care:

  • Form teams that have specific goals for achieving Best Care.
  • Make certain that the team has their specific goal, target and deadline assigned and understood.
  • Encourage the team to engage in developing the plan to achieve the goal.
  • Make sure that everyone on the team understands their role, including the role of the leader.
  • Hold each other accountable for making contributions to the team. Speak up in a kind and understanding way to help a team member who is not fulfilling their role on the team—encourage them, but also be firm about the fact that everyone on the team has to do their part in order to deliver Best Care to every patient, every time.
  • Meet regularly and make adjustments along the way.
  • Celebrate milestones and congratulate individuals who demonstrate exceptional effort along the way.
  • Most importantly, ensure that the patient and their loved ones are at the center of all decisions. This is not about “us” or “me”. It is about doing what is best and right for the patient.

Accountability is critical to any organization’s success. Even if we have all the goals, priorities and metrics set, without accountable leaders, teams and individuals, we cannot achieve our goal. If we commit to these actions, on August 31, 2017, we will have achieved our goal of Best Care.

*Vizient was formerly known as UHC.

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