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Stephen Swensen

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Survey: Organizational culture is key in improving healthcare

An article in NEJM Catalyst, rich with survey material, says that “organizational culture” is the most important element in an institution meeting healthcare-improvement goals. The authors, Stephen Swensen, M.D., and Namita Seth Mohta, M.D., write:

“{I}t is notable that culture at many health care organizations is changing — and in the right direction, say nearly 60% of respondents to our latest NEJM Catalyst Insights Council survey. Three-quarters of respondents — who are clinical leaders, clinicians, and executives from organizations directly involved in healthcare delivery — label culture change a high or moderate priority in their organization.”

Those surveyed in NEJM Catalyst Insights Council Survey said, in the authors’ words, that “a commitment to quality, an emphasis on patient care, and a focus on each individual’s impact have resulted in positive culture change at their organizations, whereas concentrating too heavily on the bottom line and productivity has had negative repercussions.”

To read the NEJM article, please hit this link.


Esprit de corps essential for successful healthcare organizations

 

Esprit de corps is essential for well-functioning healthcare institutions, says Stephen Swensen, M.D., medical director for professionalism and peer support at Intermountain Healthcare. He is also a senior fellow of the Institute for Healthcare Improvement, where he co-leads their Joy in Work Initiative.

A NEJM Catalyst article (which includes a video link) about his talk includes this:

“Healthcare systems need esprit de corps to achieve high performance. But, as Swensen notes, ‘Most of you already knew this.’ He references a recent NEJM Catalyst survey, where respondents said the biggest barriers to high performance are unaligned goals and weak culture. Social capital, esprit de corps, helps us connect, align, and build a culture that focuses on the meaning and purpose of caring for patients and their families in the communities that we have the privilege of serving.”

“He references a recent NEJM Catalyst survey, where respondents said the biggest barriers to high performance are unaligned goals and weak culture. ‘Social capital, esprit de corps, helps us connect, align, and build a culture that focuses on the meaning and purpose of caring for patients and their families in the communities that we have the privilege of serving,”’ he said.

He notes that a third of the $3.2 trillion spent on U.S. health care is excess capacity, according to the National Academy of Medicine — approximately $1 trillion in waste every year.

“Six categories of waste build this excess capacity, and healthcare systems own the first three: overtreatment, failures of care delivery, and failures of care coordination. The ramifications of that waste, beyond money, are staggering. It hurts patients, the care team, and esprit de corps. ‘On a more positive note,’ he says, ‘this $1 trillion of waste, the excess capacity in this glass of water, is the funding opportunity for co-creating quality that will both address these defects of care and rebuild esprit de corps.”’

“How do you measure esprit de corps? By counting pronouns. When former Labor Secretary Robert Reich visited organizations to assess their vitality, he listened to the people doing the real work and counted how many times they used the pronouns “we, us  and ours.’ He also counted ‘they’ and ‘them.’ The organizations that used first-person pronouns were set up to thrive; the ones that used third person were set up for mediocrity. ‘We need to shift to the right pronouns, to have it reflect our engagement and our fulfillment in our purpose of the work we do.’

To read and hear Dr. Swensen’s remarks, please hit this link.


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