What does it mean to create a culture of change in healthcare?
August 25, 2020
by Gus Iversen
, Editor in Chief
HCB News: For Henry Ford West Bloomfield, a culture of change started with a 100-day workout. Can you tell us what that workout entails and how the idea originated?
Tracy Means: The 100-Day Workout Productivity Cycle, more commonly known as the 100-day workout, is a tool that can be used for culture transformation. It is a proven approach for achieving rapid gains in hospital performance and sustaining incremental increases in productivity. The workout includes essential elements of Lean-Six Sigma, non-negotiable goal setting, and project management. Combined, these elements provide an effective system for maximizing all aspects of your productivity cycle while transforming the culture of your organization. We implemented the initiative as part of a cost containment strategy in 2014.
The foundation of the 100-day workouts is around small changes, accountability, rhythm and rigor around change. We identified our targets and goals during three months of planning, including how to measure success.
HCB News: What are some of the specific small changes implemented through the workout that have yielded big results?
TM: To date, Henry Ford West Bloomfield Hospital has conducted a total of 12 workouts ranging from waste, patient experience and rapid response to sustainability, regulatory readiness and workplace wellness.
Each of the workouts requires team members to complete two changes per month. We have always followed that pace of change with speed to implementation. When talking about change, it is a small action rather than a project, program, or piece of education. Together, our efforts have resulted in meaningful change in our culture and how we operate. We have found that a collection of small changes can yield big results.
HCB News: Are there situations where a change is taken on that doesn't help achieve the goal of greater efficiency? How does failure factor into a culture of change?
TM: It is inevitable that some changes may prove unsuccessful. That’s part of the process and from that you learn and grow. When a change is tested and turns out to not yield the results desired, you evaluate why it didn’t work and adjust accordingly.
HCB News: Has anything in particular surprised you regarding the workouts and what has been achieved?
TM: What surprised me was the energy it creates within the organization. At initial orientation, it can seem overwhelming. Truth be told, it’s a lot of work. The key is how you implement the work. This tool can easily be worked into current processes and be used to transform culture to where it becomes part of your day-to-day work activity. Leaders are excited with brainstorming and identifying innovative changes and seeing them put into action. Departments embraced the collaboration, trust improved and work relationships improved. Accountability was commonplace and seen in a positive way.
HCB News: Has the culture of change impacted Henry Ford's ability to respond to the ongoing COVID-19 pandemic?
TM: Our ability to change and adapt has been critical to our COVID-19 response. Early on, changes were being implemented almost hourly. So having gone through the 100-day initiative prepared us for what the pandemic brought.
HCB News: What advice do you have for other hospitals interested in taking on similar initiatives to the 100-day work out?
TM: It takes a village. Having leadership support is crucial, as is having a clearly defined work and accountability structure. I would encourage other hospitals to be open to considering the tool for process improvement. You may encounter resistance, as often happens with managing change. Once you see the results, though, the path getting there will be worth it.