Transformation Tools For Healthcare Leaders

This past Monday IDEAS in conjunction with our partner, Healthcare Team Training (HTT), launched the pilot for StoryCare, a rapid cycle improvement product for healthcare teams to improve patient safety, patient satisfaction, and staff engagement. The site is DeKalb Medical in Atlanta, and we’ll be working with 4 units in the hospital—ICU, Long Term Acute Care, Labor and Delivery, and Housekeeping. The idea behind StoryCare is relatively simple, but the tools and assets we have wrapped around this idea make it, we believe, one of the most potent transformation tools available to healthcare leaders today.

StoryCare originated three years ago when Duncan Kennedy and I were sitting in a meeting with another healthcare company based here in Central Florida called Avatar International. Avatar is one of the premier patient satisfaction survey companies. We were discussing the fact that the Center for Medicare and Medicaid Services (CMS) had just come out with a new assessment tool called HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) that hospitals were being required to administer if they receive Medicare reimbursement. The kicker was that CMS was posting this data on a public site that allows patients to compare the scores of providers, and starting in 2011 would begin withholding up to 2% of Medicare reimbursements for hospitals that fall below the 50^th percentile on any of its measures. The 20 or so questions look at some very basic aspects of patient satisfaction.

• The degree to which staff members listen carefully to patients’ concerns and needs
• How well staff explained care decisions to patients
• Timely response of staff response to call button requests
• Whether or not staff consistently assisted the patient to the bathroom
• Keeping the room clean
• Maintaining a quiet, peaceful environment
• Responsiveness to the patient’s pain levels
• Fully explaining new medicines before administering them
• At discharge, fully explaining to patients what they can expect when they return home

Our original thought before the meeting was that IDEAS could develop a training tool delivered online to get teams on board, but there were already some large training organizations that had planted a flag in this space, albeit a low quality one that did little more than create awareness of the issues. It was doubtful that their courses would actually change behaviors long term, leaving hospital leaders in the same quandary they were in before they invested hundreds of thousands of dollars and forced all their staff to sit through hours of training. The challenge from our end was that to do it right would require probably close to a million dollars to build highly interactive, media rich courses which we do for so many of our Fortune 500 clients. When coupled with the fact that healthcare professionals are already burdened with more training than they have time to attend, it seemed like the makings for a bad business model.

Was there a better way? As we discussed this issue, Duncan was reminded of the experience of a chaplain at a client’s hospital who engaged nurses to discuss why they went into nursing, and to reconnect to their commitment to patient care. This short “intervention” surprisingly had an impact on patient satisfaction scores. I was reminded of my work years earlier with a woman named Paula Underwood who came out of the Oneida tradition. Her people had a tradition of learning stories to impart important lessons to children as they developed. Unlike many of our storytelling and learning traditions where we tell people a story and then tell them what they should have learned while listening to it, the Oneida had developed an understanding that for real learning and change to occur, listeners have to be invited to reflect on the story’s meaning and relevance for them. A native elder would follow her story with a simple question, such as, “What might we learn from this story?” Paula’s work has influenced me deeply, so what ensued as we bantered around ideas for a transformative learning product was a library of stories with lessons baked into the narrative, waiting to be discovered and revealed through the reflection of others.

Over the last three years the product evolved and we have built in a number of other heuristic tools to ensure that the stories engage teams, along with a process that assists the leader in using the story over a period of weeks to produce lasting, meaningful change that the team can own.

One way that the product has morphed is to also embrace a wide array of behaviors that ensure a safer patient environment where errors are reduced. This insight is owed in large part to Healthcare Team Training’s expertise in the safety field. One of their realizations over the past few years as they have labored to help healthcare organizations become safer places is that the patient experience and patient safety are inextricably linked. Organizations that let the patient experience drive how they deliver care are also safer places. HTT was wise enough to see that StoryCare could be the very tool that could synthesize both of these issues in a delivery platform that is disarmingly simple for team leaders to administer, requiring so little time from teams that organizations can seamlessly introduce StoryCare without the familiar reaction that the organization is stuffing another change initiative into the rotation. In the fall of 2010 we consummated the partnership to form a new company, eFFORM LLC, to take this product to market, with HTT being our central sales channel.

Our plan is to launch StoryCare at the end of this summer once the pilot is concluded. There will be three libraries of stories that focus on safety, satisfaction, and staff engagement. Every team in a hospital will be able to participate in StoryCare, from the C-suite all the way down to housekeeping, food services, and transportation. Leaders will determine their goals and select stories from the library that can catalyze discussion, action, and change.

Pricing for StoryCare is being finalized. One thing that is certain is that we will take it to market using a licensing model, and the annual fee will fall well below typical costs associated with training staff around these pivotal issues. To learn more about StoryCare, you can visit our website at www.storycare.com.