The Healthcare Experience

Daily perspectives of a healthcare executive in pursuit of patient safety, the premier healthcare experience, an engaged & healthy workforce and life balance.

Making "big", SMALL

Making

How do you make big, small when dealing with complex issues which may seem overwhelming and never achievable? As easy as it sounds, it is a major challenge to execute and ensure you are following a plan every day...making big into small. Essentially not "boiling the ocean" as the saying goes.

Some examples of complex issues include moving from volume to value payment models, patient flow, readmissions, hospital-acquired conditions and patient experience.

So how do you take any of these "big" and help make them "small"?

Start with understanding the position of "one," as this promotes the need for a more focused and disciplined approach. Let's take an example with a patient (n=1) at risk of readmission. She has congestive heart failure (n=1) which is one of the subset diagnoses with a higher risk of readmission.

Try this four-step approach to focus on the "n of 1" to see if you have a solid plan in place that can be managed every day:

Awareness: Ensure systems are in place to provide early identification that there is a patient you have to manage who has congestive heart failure. Do you know where all these patients are in your health system today? What tactics will ensure you do well and what obstacles get in your way to deliver consistent high performance?

Collaboration (Bridging Silos and Integrating: Who do you need to work with to coordinate the care of this patient while he or she is in your care and where will you transition this patient post-hospital stay? Do those post-acute locations know what they should be doing to continue the care you provided? How do you ensure you are all in sync with your efforts?

Intervention: How will you manage this patient while in the hospital? What are the patient risk factors and what is the plan of care and key care needs such as better nutrition, awareness of medications and potential side effects, and clear and understandable discharge plans?

Measured results and follow-up: Was this patient readmitted 30 days post hospital stay? If yes, why and how could it have been managed differently? If no, how was it managed so you could replicate with other similar patients and apply the same approach toward other "big" situations?

This approach will also help with the health and wellbeing of your team. With the rise in burnout along with the need to improve resiliency, these steps should help allow others to stay inspired and make a positive impact every day. 

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Fun at Work?

Fun at Work...
I've heard the comments..."there should be no fun in the workplace" and "they call it job for a reason." However, since many of us spend 30%+ of our time at work and another 20-30% of our time sleeping, it is good to find those fun times at work...What's going on in your workplace to make it more enjoyable for you and your colleagues?

I was speaking to one of our Surgeons and we started to discuss the excitement and challenges in healthcare. He enjoys surgery, good dialogue, his colleagues and having fun while at work. He let me know he would not want to work in a place that was not enjoyable day in and day out. That would be a "dreaded place to be." This doesn't mean goofing off all day long. It does mean enjoying the time you spend in the workplace and helping to make it enjoyable for you and others. That creates a place for all of us to thrive.  And the other beneficiaries of this kind of place..our patients.

Forbes had an article reflecting on the benefits of fun in the workplace.

Also check out  these 8 tips from Tres Coaching:

1. Put fun first on your list of priorities, and the rest will fall into place. 
2. Laugh more. Laughter can be a great medicine for what ails you and your workplace. 
3. Be spontaneous with recognition, praise and a simple “thank you”. 
4. Schedule fun-based activities with employees, customers and suppliers. 
5. Find your inner child. Let others see the humorous side of your personality. 
6. Live with the 3E’s – Energy, Enthusiasm and Empathy. 
7. Take mental health breaks and/or extended lunches to refresh and re-energize. 
8. Keep things in perspective. Your work is a means to an end, not the end!

Regardless of where you are in your career, if you’re not having fun – what’s the point? Life is too short to not enjoy what you are doing, so find a way to put fun back into your work or do something else. The continuing negative trends in business as a result of downsizing, restructuring and the financial markets meltdown have taken a huge toll on the workplace, and the workforce tasked with doing more with less. We need to find ways to reduce stress, improve productivity, and keep our morale and energy levels up.

There are unlimited challenges and exciting times ahead in healthcare. Why not make the best of it and ensure we have some fun while constantly improving the healthcare experience.
 
What do you do to infuse fun into your work environment?

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The Optimal Workplace Environment: Bridging Provider Work Life and Well-being

I'm one "click" away from a meltdown!

Recently, I was part of one of our clinical service line annual retreats. The focus was on several performance goals in support of our organization's strategic priorities.  The group's dialogue constantly moved us towards a shared vision. It was inspiring and refreshing to be part of this discussion.  

So many conversations in healthcare and around the nation are polarizing. An "all or none" or "a win or lose only scenario".  Even as health and well-being is discussed, many people want to stick with one view... People will share only one view..."it's all about lifestyle behaviors or the payment models/how and who gets paid or just take medications or just get the surgery or my patients will never comply".  Each view is a narrow lens of keeping our patient's overall care at the center of all our clinical decisions. There really needs to be a balance of all aspects of health to better meet our patients' needs. This includes clinician and staff's workplace wellbeing.  One example brought up in our retreat was around the electronic health record and the number of "clicks' to enter the necessary information. There is a delicate balance between ensuring high safe, quality care and exhausting those who are providing the care.

In the book, Mindful Healthcare: Healthy Team, Healthy Business, Dr. Wayne Jonas references the Quadruple Aim, focused on clinician's work life as well as the need to look at real ways to "transform" healthcare. He states, "as our policy leaders debate coverage, pre-existing conditions, central vs. local control, and the role of government in healthcare as it is, they will continue to miss healthcare as it needs to be and can become."  Our role in healthcare is to collaborate across our system and community, with patients and key partners in pursuit of an improved healthcare delivery system. 

What can you do to advance health in your organization?

We all know in order to take better care of our patients, you need to stay focused on the needs of your team.  Think about what is contributing to better clinician and staff work life and well-being. Also give thought to what takes away from this. If you are not sure, just ask your team and you will find out in 5 minutes! 

Try moving forward with small tests of change so you are better able to disrupt outdated care models and work processes. These steps could include:

1. Frame the vision and goals, facilitating the discussion and work towards a shared vision;

2. Understand your current outcomes and variances against national benchmark;

3. Review your work processes, work loads and work situations which contribute or reduce work place stressors;

4. Appreciate the need to reduce staff "burnout" and share stress management techniques to improve staff resiliency; and

5. Acknowledge that exceptional care can not be achieved consistently without the focusing on the wellbeing of your team.

Healthcare organizations need to learn from our health system as well as other industries.  Please share ways you are creating an optimal workplace environment in your organization. 

Game on!

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Only 5-Star Applicants Need Apply

Only Five-Star Applicants Need ApplyIn a recent post, I shared our health system’s four strategic priorities and how each facility and every department cascades these priorities to their respective areas and to every individual working in them.

Every week during orientation, I remind new and returning employees about 5 key things that are key to ensuring they could help us run our health system every day:

  1. Know your own “purpose” and “why’ you chose to take this job. Was it because you had a calling to be a caregiver, because you get to impact the lives of others, because you could provide a livelihood for your family. Whatever the reason, everyone is excited when they receive the offer and yet sometimes these same employees forget why they were excited, their they forget their purpose and they start to negatively impact their colleagues, patients and families we serve.
  2. Ensure you align with our mission, vision and values.
  3. Learn our goals.
  4. Understand how your role contributes to helping our health system achieve its achieve goals.
  5. Learn how you help the organization improve every single day on every shift.


We count on our leaders to select for the “right fit”. After all, we have a community of nearly 20,000 employees, physicians and volunteers serving our patients, families and community.

In the 2/28 blog, “Industry Voices—The power of rounding to engage staff in your organization’s strategic priorities”, my co-author, Matt Walker shared how his Director was excellent at selecting the right individuals.

Kristi Cottrill, Lee Health - Healthpark Medical Center’s Director of Housekeeping and Transport Services shared the following about “hiring the right people”:

As we continue our journey toward excellence, finding and hiring the right people is crucial to our success. Without 5-Star employees, we cannot be a 5-Star organization. Interviewing and selecting the right talent is one of the most important jobs a department leader can do for the team. For large departments, the commitment is huge and the results are well worth the undertaking.


Who knows more about what you’re looking for than you?

My team recognizes that our responsibility goes beyond finding the right people to transport our patients. Many staff members use this entry level position as a stepping stone to other healthcare careers. With that in mind, we utilize the interview process to select those individuals we believe will become outstanding healthcare professionals for the larger team. It is a two-way street. What we are looking for and what the applicant wants as well.

  1. It begins with the all-important first impression.
    Is the applicant neatly groomed? We don’t expect formal attire, as not everyone has the means to dress professionally. We do expect the applicant to be clean and neatly groomed.
    A warm, outgoing personality and an ever-present smile rank very high on our list of priorities. We try to look beyond the expected nervousness that goes along with an interview to determine if they possess the verbal communication skills that will “wow” our patients. Do they fit the image of a 5-star professional?

  2. Short and long-term goals are discussed to help us determine if the applicant is focused on his/her future. Are they ambitious? College students studying health professions have an advantage, as we recognize our organization’s need for great nurses, Physician Assistants, Emergency Medical Technicians, etc. Additionally, it gives us an idea of how the applicant’s educational commitments will impact our department. If the applicant receives a job offer, we make every effort to assign a shift that will keep school related scheduling adjustments to a minimum.

  3. While reviewing the work history, we focus on job stability. An unstable work history is an indication of “job hopping” and requires explanation. We want reasons why the applicant moved around so much. We also want to know what their past employers have to say about them. We check references!

  4. Teamwork. In our department, the ability to work well on a team is important, as transporters often help each other with more difficult transports, and assist other departments during periods of lower activity. Often a team member will be routinely assigned to a high-volume area such as the Emergency Department. They become as much a part of that team, as they are a part of our team. For these reasons, we ask the applicant to share work and/or school examples of team projects, specifically, what they liked about working on the team and what challenged them.

  5. Applicants are encouraged to share their customer service experiences; their greatest success stories and the ones they wish they could do over. They are asked to provide examples of how they handled certain situations such as: their most challenging customer, a time they disagreed with a policy, an example of when they went above and beyond, etc. This helps us evaluate their interpersonal skills and by their responses, we can determine if they are genuine and open in their communication. We listen intently as we evaluate their fitness for our team. Then, the applicant has an opportunity to convince us that extending a job offer would be the right decision for us, and for our patients.

  6. The focus of the interview will then shift to what we have to offer.
    We build their excitement by sharing the great opportunities available for top performers within our health system, including tuition assistance and growth/advancement.
    We boldly declare that we are the best employer in the county and we are interested in hiring only the very best people. We paint a very clear picture of what that looks like such as; our very high standards for patient safety, dependability, compassionate behavior, and teamwork.
    Our team is especially proud of our commitment to “Patient Experience” and the opportunity we have not only to be one of the first people a patient sees, but also the last, as they are wheeled out upon discharge. We pride ourselves in providing both a great beginning and a warm, friendly end to their stay with us. While here, we strive to treat them like our most favorite relative.

  7. While sharing what we’re passionate about, we watch their non-verbal communication to gage whether or not a fire has been ignited inside them.

The ultimate goal is to “hire tough,” so that leading the team will be easy.

Selecting the right candidates is only part of what makes a winning team. Setting the bar high and holding them accountable for the promises they made during the interview are key to the ongoing success of both the employee and Lee Health.

Be well. Stay inspired.

Scott

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My New Book: Mindful Healthcare

Mindful Healthcare: Health Team BusinessScott's New Book: Mindful Healthcare: Healthy Team, Healthy Business

A healthcare organization needs to be more than capable nurses and doctors, sterile operating theaters, a business office, and an emergency room. Every successful medical organization should be an optimal healing environment. This holistic, person-centered approach to the business of medicine focuses on empowering the hospital and health system's working community. It reduces stress, eliminates burnout, and increases staff resiliency, helping your team to remember why they chose to pursue a career in healthcare. When your healers thrive, your hospital will flourish.

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Focus on Health & Well being Leads to Corporate Outcomes

Focus on Health & Well being Leads to Corporate Outcomes

Focus on Health & Well-being Leads to Corporate OutcomesFocusing on your team's individual well-being will lead to them taking better care of themselves and in turn, your organization.

Share ways you have helped your team member do the same.

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Fun at the Workplace...

Fun at Work...
I've heard the comments..."there should be no fun in the workplace" and "they call it job for a reason." However, since many of us spend 30%+ of our time at work and another 20-30% of our time sleeping, it is good to find those fun times at work...What's going on in your workplace to make it more enjoyable for you and your colleagues?

I was speaking to one of our Surgeons and we started to discuss the excitement and challenges in healthcare. He enjoys surgery, good dialogue, his colleagues and having fun while at work. He let me know he would not want to work in a place that was not enjoyable day in and day out. That would be a "dreaded place to be." This doesn't mean goofing off all day long. It does mean enjoying the time you spend in the workplace and helping to make it enjoyable for you and others. That creates a place for all of us to thrive.  And the other beneficiaries of this kind of place..our patients.

Forbes had an article reflecting on the benefits of fun in the workplace.

Also check out  these 8 tips from Tres Coaching:

1. Put fun first on your list of priorities, and the rest will fall into place.
2. Laugh more. Laughter can be a great medicine for what ails you and your workplace.
3. Be spontaneous with recognition, praise and a simple “thank you”.
4. Schedule fun-based activities with employees, customers and suppliers.
5. Find your inner child. Let others see the humorous side of your personality.
6. Live with the 3E’s – Energy, Enthusiasm and Empathy.
7. Take mental health breaks and/or extended lunches to refresh and re-energize.
8. Keep things in perspective. Your work is a means to an end, not the end!

Regardless of where you are in your career, if you’re not having fun – what’s the point? Life is too short to not enjoy what you are doing, so find a way to put fun back into your work or do something else. The continuing negative trends in business as a result of downsizing, restructuring and the financial markets meltdown have taken a huge toll on the workplace, and the workforce tasked with doing more with less. We need to find ways to reduce stress, improve productivity, and keep our morale and energy levels up.

There are unlimited challenges and exciting times ahead in healthcare. Why not make the best of it and ensure we have some fun while constantly improving the healthcare experience.
 
What do you do to infuse fun into your work environment?

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Why Healthcare Leaders Should Stay Humble

My kids help me stay humble and make me realize how simple life lessons could stay with you a lifetime.

One of the lessons includes feedback. Very few people accept feedback; fewer intentionally make changes once they receive the feedback (that includes not getting defensive); and very few actually solicit feedback.

To read more, go to:

http://www.hospitalimpact.org/index.php/2015/03/11/why_healthcare_leaders_should_stay_humbl

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Optimal Healing Environment Encourages community wellness

This past week, my hospital broke ground on our Pathway to Discovery. We continue to transform our hospital beyond a place for the sick.

We are creating a model health and wellness campus, serving our community when they are sick and providing a place for them to stay healthy throughout the year. The campus is open to everyone.

To learn more click on the link below:

http://www.hospitalimpact.org/index.php/2014/11/06/optimal_healing_environment_encourages_c

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FierceHealthcare

How health leaders can optimize employee wellness

Fierce exclusive: Health execs share success stories, lessons learned

by Zack Budryk
 
As important as patient engagement is in today's healthcare landscape, engaging employees in their own health and lifestyle choices can be just as vital.
 
One way healthcare leaders can achieve this goal is through employee wellness programs, particularly in light of research that shows healthcare professionals are no healthier than their patients.

To learn more, please click the link:

http://www.fiercehealthcare.com/special-reports/how-health-leaders-can-optimize-employee-wellness

 

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Healthcare lessons from Captain Carmine Marceno

In a prior blog, I asked what our obligation to role model healthier living is in our respective health systems. Not a right or wrong answer, just a philosophical approach.

 

For more information, please click the link below:

http://www.hospitalimpact.org/index.php/2014/07/10/healthcare_lessons_from_captain_carmine

 

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Healthy Eating at Hospitals: What's our Obligation?

Here's our simple question. Forget for a moment your own personal beliefs on whether you think we should eat healthier as a society. As healthcare leaders, do you think it's our obligation to offer healthier options in our healthcare organizations?

To learn more, click on the link below:

Healthy eating at hospitals: What's our obligation?

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"Kids Health - 4 Effective Ways to Improve Diet"

Kids Health - 4 Effective Ways to Improve Diet

Childhood can be a quite challenging time when it comes to making the best choices in your kids' nutrition. Not only are kids growing fast and requiring more nutrients, but thanks to the poor quality of most of the commercial foods, not knowing your kids' nutrition, being strapped for cash, and having kids who are picky eaters to deal with, children's nutrition has become an overwhelming topic for most parents. Below are some effective and proven ways to improve your child's nutrition.

Go Back to Nature

• Even though processed foods are more convenient, they tend to contain much more calories as compared to the natural foods.
• Whenever possible, try to stick to foods in their purest forms. Vegetables, fruits, grains and meats should make up the bulk of your kid's diet.
• Save the processed foods and the fast foods for occasional treats. The rule of thumb you should probably use is In case you can't pronounce all the ingredients on the food label, it's better to skip it
• Also, promote the low-fat or fat-free dairy products. Your children need the calcium in the dairy so as to help their bones grown the normal way. However, the normal dairy products are usually unhealthy since they contain saturated fat, which causes heart disease.
• Try and avoid the full-fat dairy products. Rather, give your children fat-free or low-fat cheese, milk and yoghurt. They may not know the difference, but their heart does.

2. Bigger isn't better

• The best thing you can teach your kids is to eat when they feel hungry and stop when they're full.
• Don't push you children to eat more than they actually need, even when you think they haven't eaten enough.
• Bear in mind that all foods, even the healthy kinds can be harmful to your child if taken in excess portions. Make sure you serve your kids appropriate portions of their meals. • At a restaurant, you can share the starters or ask the waiter to pack part of your kid's portion before he or she starts to eat it.

3. Avoid Fried Foods

• Teach your kids that fried foods are unhealthy and try as much as possible to stay away from them.
• While in a restaurant, ask them to bake or grill your food rather than frying it A good way to avoid fried food cravings is to serve a healthier form at home.
• When your children want fried chicken, for instance, you can serve them chicken that has been breaded then baked in an oven with French fries that's made from potatoes that have been baked to a crisp.

4. Avoid High Caloric Drinks

• Many kids lose weight just by giving up the sugary drinks. Parents seriously underestimate the amount of calories and sugar in what their children drink.
• Did you actually know that one bottle of soda contain ten teaspoonful of sugar? You wouldn't give your child that much sugar knowingly, would you?
• And juice isn't all that different. Kids don't need juice for its vitamin C. they can get plenty of vitamin C from other sources. You can replace such drinks with water or even flavored seltzers.

In conclusion, your child's health is very important hence the need to provide them with a healthy diet. Unhealthy diet can cause a lot of health complications in your child's life, and that's the last thing you need. Just make sure you have an EHIC handy in case you need to take your child to the hospital or need to consult a doctor about your child's nutritional needs.

Author: James Anderson

https://www.ehic-uk.org/

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I have the perfect example...

It has been a very good week. We implemented our Bedscapes 7.0 - pictures of local Sanibel beaches ties in with music. The pictures were created by Jenny, one of our employees - they look amazing.  The intention is to help patients relax (it works for families too), relieve anxiety and reduce pain. In the first 2 days, it has been well received. Yosaif August, the creator of Bedscapes, joined us to train staff and provide presentations on Caring for the Caregiver.  We started with our Women's Suites - Birthing Center.

Work has been balanced with my 13 week Leadership Cape Coral (one day/week) where we get to learn about the Cape Coral community and businesses. We had a very educational (pun intended) time learning about our education system followed by a team get together at Bubba's Roadhouse.  First time there...great owner, Jay is in our Leadership.  

On an unrelated topic, I have been hearing people share stories starting with..."I have the perfect example".  After giving that some thought, I would suggest not starting any reference as I have the "perfect"...allow others to provide that adjective for you once they hear your example.

Enjoy your weekend.

 

 

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Guest Blogger: Jessica Lindsey

Good afternoon Cape Coral Employees, Physicians, Volunteers and Auxilians…


Hello My name is Jessica Lindsey:


I am the Director of Radiology at Health Park Medical Center and so pleased to be here with you tonight, to share in the celebration of commitment to education and this great health system.


Life experiences have an ironic way of molding you; I believe the events in my life have molded me to be a Lee Memorial Health Care Administrator. I was born at Lee Memorial downtown campus to an ER Nurse who has worked for this system for over thirty years. I grew up with a fond appreciation for my Mother’s work ethic and for Lee Memorial Health System.


The organization is our extended family. In sixth grade my algebra tutor was one of my Mother’s co-workers. When my mother was called to come in the middle of the night, I slept on the couch in the Cath Lab break room. I attended all of the company picnics and our cupboards were full of LMHS mugs. Anyone who was here in the 80’s would remember our logo with the bathroom people!


Many of these childhood memories occurred in Health Park; a facility where I now oversee daily operations of the Radiology department. The journey to having my name on the door has been a process of discovery and education. In 2011, I accepted my first leadership role as Manager of the Radiology department. Since this time in addition to leading the Radiology Department I have enjoyed an expanded role helping to facilitate training for; patient safety, patient experience and customer service programs. I was promoted to Director of the department in the summer of 2012. Most recently, I was selected to participate in the Leadership faculty. Through this framework, we have been able to train many system leaders in the core competencies of "Coaching for Results" and "Communicating Intentionally."


I have thoroughly enjoyed my path, I believe the time is now to top off my education with a Masters in Health Care Administration. I love the work we do together and the more I dig in the more I realize it is truly all about the people. I would like to see us continue to be, "caring people caring for people." I believe this degree will ensure I continue to make the best-informed decision for our organization for many years to come.


The financial challenge detours many individuals away from furthering their education. I am blessed enough to have an organization who has stood by me and financed a significant percentage of my schooling. The monetary commitment LMHS made softened both burdens from my Associate and Bachelors degrees. My sincerest thanks for your investment in me thus far; it is not something I take lightly, I know when I walk these halls and travel amongst the community, I am always representing Lee Memorial Health system.


My personal life is on a high I am enjoying my role as a Mom. My husband (also and LMHS employee) and I are focused on providing the best of everything for our daughter. I often wonder as she grows what she is witnessing of the work we do as parents who both work for Lee Memorial. After all, the bathroom people mugs have made their way out of the cupboard, replaced by LMHS tervis tumblers. If the pattern continues, we could be cultivating our next great investment.


Thank you for having me tonight, Congratulations to the students in the room and thank you to those who love and support us.

Scott

Scott Kashman, FACHE
Chief Administrative Officer
Cape Coral Hospital 
Blog: www.thehealthcareexperience.org
This email address is being protected from spambots. You need JavaScript enabled to view it.

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Clean the Toilets

I wanted to share a recent experience I had while "In Your Shoes" with Danette from our Housekeeping team. This was written as part of my blog with Hospitalimpact.com... Last week I worked with one of the great ones. Dannette is part of our housekeeping team and she put me to work. While she said she would not make me clean the toilets, I told her to definitely make me clean the toilets as that's the first thing people will want to ensure she made me do! It quickly became apparent Dannette had a lot of oversight to provide while working with me. Between mopping, cleaning toilets, wiping down the room and pulling trash, Dannette made sure I greeted each patient with a smile, asked if there was anything specific they wanted moved or cleaned, and of course, performed one more check-in with the patient before we left the room. When I asked Dannette if she takes care of cardiac patients, she first responded by saying, "is this a trick question?" She went on to explain she takes care of cardiac and many other patients. And as with all patients she starts with a big smile, which she said is "contagious." She is always very nice and thoroughly cleans the room. Dannette's leading indicator or daily focus: She felt the warm greeting and check-in at the end were two things she does every day to ensure she impacts our organizational goals. And she was right. After only one month on that patient floor, the patient scores skyrocketed in room cleanliness and courtesy of housekeeping staff. It's amazing what we find out when we just ask our team for the answers. Usually employees know they are valuable to an organization. It is still key to let them know that is truly the case.
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We Despise Your Positon

For years, managers and bosses have been the core of many jokes or "around the water cooler conversations)...I even have a few myself (not for any of my current or past bosses!). One I enjoyed was when of our physicians, Dr. Dressler said to me... "It's not you we dislike, Scott...it's the position you stand for that we despise." How can you not love feedback! Keep a thick skin, take your job seriously, laugh a lot and don't take yourself too seriously as the saying goes.
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Primo Garden - Support Local

This evening I arrived in Orlando to attend the Florida Sterling conference as we look to build on our current foundation of care delivery, consistency and high reliability. For dinner, I joined Nancy and Chris, a couple of my colleagues. We enjoyed the restaurant and spoke to one of their pasty supervisors who we saw pulling vegetables from their garden. I asked how much of their vegetables came from their garden. He quickly shared 70% with 98% for their other restaurant in Maine. The hotel and this restaurant have their own garden. I'm very excited to share we are on a similar journey. I look forward to one day hearing our team and community members sharing how great it is to have fresh vegetables and fruit from the same place they receive care. Makes sense...food is medicine, food is healing. I checked, you can't grow your own pastries!
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7%

7% Written by a 90 year old Written by Regina Brett, 90 years old, of the Plain Dealer, Cleveland , Ohio . "To celebrate growing older, I once wrote the 45 lessons life taught me. It is the most requested column I've ever written. My odometer rolled over to 90 in August, so here is the column once more: 1. Life isn't fair, but it's still good. 2. When in doubt, just take the next small step. 3. Life is too short – enjoy it. 4. Your job won't take care of you when you are sick. Your friends and family will. 5. Pay off your credit cards every month. 6. You don't have to win every argument. Stay true to yourself. 7. Cry with someone. It's more healing than crying alone. 8. It's OK to get angry with God. He can take it. 9. Save for retirement starting with your first paycheck. 10. When it comes to chocolate, resistance is futile. 11. Make peace with your past so it won't screw up the present. 12. It's OK to let your children see you cry. 13. Don't compare your life to others. You have no idea what their journey is all about. 14. If a relationship has to be a secret, you shouldn't be in it. 15. Everything can change in the blink of an eye, but don't worry, God never blinks. 16.. Take a deep breath. It calms the mind. 17. Get rid of anything that isn't useful. Clutter weighs you down in many ways. 18. Whatever doesn't kill you really does make you stronger. 19.. It's never too late to be happy. But it’s all up to you and no one else. 20. When it comes to going after what you love in life, don't take no for an answer. 21. Burn the candles, use the nice sheets, wear the fancy lingerie. Don't save it for a special occasion. Today is special. 22. Over prepare, then go with the flow. 23. Be eccentric now. Don't wait for old age to wear purple. 24. The most important sex organ is the brain. 25. No one is in charge of your happiness but you. 26. Frame every so-called disaster with these words 'In five years, will this matter?' 27. Always choose life. 28. Forgive 29. What other people think of you is none of your business. 30. Time heals almost everything. Give time time. 31. However good or bad a situation is, it will change. 32. Don't take yourself so seriously. No one else does. 33. Believe in miracles. 34. God loves you because of who God is, not because of anything you did or didn't do. 35. Don't audit life. Show up and make the most of it now. 36. Growing old beats the alternative of dying young. 37. Your children get only one childhood. 38. All that truly matters in the end is that you loved. 39. Get outside every day. Miracles are waiting everywhere. 40. If we all threw our problems in a pile and saw everyone else's, we'd grab ours back. 41. Envy is a waste of time. Accept what you already have, not what you need 42. The best is yet to come... 43. No matter how you feel, get up, dress up and show up. 44. Yield. 45. Life isn't tied with a bow, but it's still a gift." Its estimated 93% won't forward this. If you are one of the 7% who will, forward this with the title '7%'. I'm in the 7%. Friends are the family that we choose.
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Team Culture - Learning from NCAA

I was reading an article by Peter Schroeder entitled, Changing Team Culture. One section read: Ten NCAA Division I head coaches were interviewed. Each guided a previously unsuccessful team to championship levels within five years. A qualitative analysis indicated that these turnarounds featured changes in team culture. Coaches started the cultural change process by creating core sets of values specific to their teams. To ingrain these values, coaches taught them with several tactics, recruited athletes who would embrace team values, and punished and rewarded consistent with the values. These actions were taken with respect to the unique environments of each team. The results were generally consistent with the literature on organizational culture change. Cultural change and evolution never ends. What are you do to positively influence and move the culture in your Organization?
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