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BUILDING A CULTURE OF
OWNERSHIP IN HEALTHCARE
with theValue of Specialty Nursing
Certification
Bob Dent DNP, MBA, RN, NEA-BC, CENP, FACHE, FAAN, FAONE
Senior Vice President, Chief Operating and Chief Nursing Officer, Midland Memorial Hospital
Adjunct Faculty, University of Texas of the Permian Basin School of Nursing
& Texas Tech University Health Sciences Center School of Nursing
2019 Immediate Past President, American Organization of Nurse Executives
2
Learning Outcomes
1. Describe “the healthcare crisis within” of incivility, bullying, and toxic
emotional negativity in the workplace and the way it contributes to
stress, burnout, and compassion fatigue.
2. Describe the three essential elements needed to move from a culture of
accountability to a culture of ownership.
3. Discuss the value of specialty nursing certification in a culture of
professional ownership.
3
Building a Culture of Ownership in Healthcare
The Invisible Architecture of Core Values, Attitude, and Self-Empowerment
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Invisible Architecture?
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6
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Lateral
Violence
Bullying
Intra-staffffffffAggression
Intra-staffffffffHostility
Incivility
Names Used to Describe Phenomenon
8
Mahr, 2016
9
Incivility can take the form of rude and discourteous actions, of gossiping and spreading rumors, and of refusing to assist a coworker. All of these are an affront to the dignity of the coworker and violate professional standards of respect.
ANA Position Statement on Incivility, Bullying, and Workplace Violence (2015)
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Many Faces of TENTENTENTEN
Name-callingFault-Finding
Criticism
Intimidation
Gossip
Shouting
Blaming
IgnoringRefusing to help
Unfair assignments
Sabotage
Exclusion
Broken Confidences
Failure to respect privacy
11
Overt (Done Openly)Covert (Not Openly
Acknowledged)
Mahr, 2016
22,000,000
negative workers in the United States
12
Theoretical Model of Horizontal Violence (TEN)(TEN)(TEN)(TEN)
Process
16
Oppression
(TEN)
Internalized
Dominant
Values
Horizontal
Violence
Peer
Communication
Patient
Safety
Key:
+ Positive Relationship
− Negative Relationship
Mahr, 2016;
Purpora, 2010
“
”
Danny Meyer, owner of twenty-seven restaurants in New York City, preaches civility and tolerates nothing less. If bad behavior from an employee at any level isn’t corrected quickly, they’re gone. Meyer is convinced that customers can taste
incivility. Even exceptional chefs don’t last in Meyer’s restaurants if they’re disrespectful to other employees.
Christine Porath, Professor, McDonough School of Business, Georgetown University
Mastering Civility: A Manifesto for the Workplace
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Source: Quartz, September 15, 2017. The silent killer of workplace happiness, productivity, and health is a lack of basic civility
CommunicaCommunicaCommunicaCommunicatititition Breakdown: on Breakdown: on Breakdown: on Breakdown:
Leading Cause of SenLeading Cause of SenLeading Cause of SenLeading Cause of Sentitititinel Eventsnel Eventsnel Eventsnel Events ---- 2014201420142014
18The Joint Commission, April 2015 retrieved from
www.jointcomission.org/assets/1/23/jconline_April)_29_15.pdf
1. Human Factors (ex: staff supervision issues)
2. Leadership
3. Communication
Medical Errors: Significant Cause of Death
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Medical Errors: 8th leading cause of death
Negative Impact of HV (TEN)(TEN)(TEN)(TEN) on Organizations
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Work Culture
•Commitment
•Collegiality
•Support
•Satisfaction
•Learned Behavior
Patient Safety
•Late Interventions
•Incomplete Interventions
•Errors
Cost
•Absenteeism
•Workforce Rehires
•Nursing Shortage
Mahr, 2016;
56-78.5%
resign
1 in 3 leave
nursingBurnout
Dissatisfaction
Irritability
Impaired Relationships
Fatigue
Hypertension
PTSD
Depression
Panic Attacks
Diminished
Confidence
Substance Abuse
Negative Effects of HV (TEN)(TEN)(TEN)(TEN) on Nurses
21
Vessey, 2009
Townsend, 2012
Longo, 2013
Mahr, 2016
22
BUILDING ABUILDING ABUILDING ABUILDING ACULTURECULTURECULTURECULTURE
OF OWNERSHIPOF OWNERSHIPOF OWNERSHIPOF OWNERSHIPIN HEALTHCAREIN HEALTHCAREIN HEALTHCAREIN HEALTHCARE
The Invisible Architecture ofCore Values, Attitude, and
Self-Empowerment
23
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From Accountability ….
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Accountability Is Not Enough!
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Accountability implies irresponsibility
27
Accountability can be exhausting!
28
Accountability focuses on rules, not on values
29
Accountability is always after the fact and often demotivating
30
Accountability provides an incentive to cheat
31
Accountability never takes an organization from good to
great
32
33
Mission, Vision, and
Core ValuesCore ValuesCore ValuesCore Values
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CORE VALUES
38
Be yourself…
Integrated DNA Technologies, 201639
unless you’re a jerk.
Give a damn.Southlake Regional Health Centre, 2012
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41
Our culture is based on the Christian faith and that staff and physicians are
encouraged to pray with patients …
Craig Lindsey, Chief Nursing Officer
Park Ridge Health, North Carolina
Interaction of Personal and Organizational Values
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43
“Culture is a peoples adaptation to an
environment”
Dr. Jean-Jacques Decoster
Cultural Anthropologist
44
45
Workplace culture is important to the job satisfaction of all employees. For all generations, the highest indicator of the highest indicator of the highest indicator of the highest indicator of
satisfaction is to feel valued satisfaction is to feel valued satisfaction is to feel valued satisfaction is to feel valued on the job.
AARP: Leading a Multigenerational Workforce
Young People: They’re People, Too
46
How would you describe your culture in just 6 words?
47
““Cursed with Cancer,Cursed with Cancer,
Blessed with FriendsBlessed with Friends””
9 year old Hannah Davies 9 year old Hannah Davies
Southwest Airlines Motto
Servant’s Heart, Warrior Spirit, Fun-Loving Attitude
The Real Marine CorpsThe Real Marine CorpsThe Few, the Proud, The Few, the Proud, the Brave*the Brave** And you* And you’’re not one of themre not one of them
So, what is your 6-Word Culture Story?
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52
No Opting Out
53
One toxically negative person can drag down morale
and productivity of an entire work unit.
54
Bring your whole self to work; not only your knowledge and expertise, but also your values. Stay true to who you are and have the courage of your convictions. If you do, you will become an If you do, you will become an If you do, you will become an If you do, you will become an authentic and courageous leaderauthentic and courageous leaderauthentic and courageous leaderauthentic and courageous leader — something intensely needed at this time in healthcare. And you will have the power to change your workplace and the community around you.
Mary Brainerd, President and CEO, HealthPartners
58
The call to end this silent epidemic in our profession has been heard loud and clear. It is time we turn our
caring behaviors more fully toward our colleagues and those we work with and demand a stop to any
form of violence that occurs in any setting
Dr. Cole Edmonson, Chief Nursing Officer
Texas Health Presbyterian Hospital, Dallas, Texas
www.stopbullyingtoolkit.org
59
How do we create healthier and more
positive work environments?
60
Blueprinting a Culture of Ownership
61
People will be and do their best with the tools they
have.
As a leader, we need to make sure they have the
tools!
62
Three Essential Elements of a Culture of Ownership
63
… in our profession!
67
… Fully Engaged
68
A Leadership A Leadership A Leadership A Leadership PhilosophyPhilosophyPhilosophyPhilosophy
69
Text BOB to 66866 For my Leadership
Philosophy and continuing
the conversation!
Leadership Job #1
Shifting the shape of your Attitude & Ownership Bell Curve
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What is the Value of Nursing Specialty Certification?
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76
77
Nursing Specialty Certification and Patient Outcomes: What
We Know in Acute Care Hospitals and Future Directions
by Diane K. Boyle, PhD, RN, FAAN, September 2017
Findings:
Studies have found relationships between higher rates of
nursing specialty certification and lower rates of total patient
falls, pressure injuries, selected hospital-acquired infections,
failure to rescue, and death.
78
Core Action Value 4: Core Action Value 4: Core Action Value 4: Core Action Value 4: Core Action Value 4: Core Action Value 4: Core Action Value 4: Core Action Value 4: CourageCourageCourageCourageCourageCourageCourageCourage
Core Action Value 5: Core Action Value 5: Core Action Value 5: Core Action Value 5: Core Action Value 5: Core Action Value 5: Core Action Value 5: Core Action Value 5: PerseverancePerseverancePerseverancePerseverancePerseverancePerseverancePerseverancePerseverance
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TBSSSNDQ
82
Bob Dent, DNP, MBA, RN, NEA-BC, CENP, FACHE, FAAN, FAONE
Senior Vice President, Chief Operating & Chief Nursing Officer
Midland Memorial Hospital
400 Rosalind Redfern Grover Parkway
Midland, Texas 79701
432.221.4566 (office)
432.559.2911 (mobile)
Twitter: @bobdent
LinkedIn: bobdent
Facebook Page: rldent1
83
Text BOB to 66866 For my Leadership Philosophy and
continuing the conversation!
References