Creating a Life-Giving "Connection Culture" in Healthcare Organizations
The best culture in a healthcare organization is a "connection culture." "Connection" is defined as a bond based on shared identity, empathy and understanding that moves individuals toward group-centered membership. People who work in a connection culture feel a sense of connection to one another and to their collective work. As a result, they give their best efforts and align their behavior with organizational goals. They are more energetic, more enthusiastic, more productive and more innovative. They also communicate better and, in doing so, help decision-makers become better informed so they can make better decisions. Patients and their families benefit from connection cultures, too, as the feeling of connection among the healthcare professionals extends to them and helps reduce the stress and anxiety that accompany illness.
Connection at Memorial Sloan Kettering Cancer CenterAs an example of a connection culture in a healthcare setting, let me share a personal experience. My wife Katie was diagnosed with breast cancer in 2003 and advanced ovarian cancer in 2004. The healthcare workers we met at Greenwich Hospital, part of the Yale-New Haven Health System, near our home in Greenwich, Conn., were kind and compassionate to us. Our whole family, including our daughters, who were 12 and 10 at the time, felt connected to the people we met there, including our doctors, nurses, the environmental services staff and the people who worked in the cafeteria. These connections helped us cope with the stress and anxiety from our concern about Katie’s uncertain future.
After Katie completed six rounds of chemotherapy during the spring of 2004, we decided to seek additional treatment for her at Memorial Sloan Kettering Cancer Center in New York City. I'll never forget our first visit to Sloan Kettering. As we came within eyesight of the entrance of Sloan Kettering's Rockefeller Outpatient Pavilion on 53rd Street in Midtown Manhattan, a tall doorman with a dark complexion and striking blue eyes locked his eyes on Katie and greeted her like a returning friend. This surprised me given that people in New York City rarely make eye contact. It dawned on me that the doorman, whose name we later learned was Nick, likely identified the cancer patients because of their wigs. Nick was intentionally reaching out to connect with Katie and others whom he recognized were cancer patients.
After being greeted by Nick, we walked into the lobby where a receptionist was calling everyone "honey." This, also, rarely happens in New York City. The security and administrative people we encountered were friendly and helpful. When we met our oncologist, Martee Hensley, MD, she was upbeat and optimistic. She spent an hour educating us about the treatment options and answering our long list of questions.
By the end of our visit, I had two distinct reactions. First, I knew this was one of the best medical teams in the world to treat advanced ovarian cancer because I had done my research. Second, I knew they cared, because I could feel it. The knowledge of their competence and the feeling of connection to them made me more optimistic that together we may be able to get Katie and our family through the difficult season ahead.
On January 7th, we celebrated Katie's ninth year of being cancer free. Many factors contribute to helping patients survive life-threatening illnesses. Research supports that the medical care Katie received and her faith likely helped her survive. In addition, research has established that the psychosocial support that came from feeling connected with our family, friends and the healthcare workers we interacted with also helped Katie survive.
In a connection culture collective beliefs and behaviors promote this bond of connection among people. There are three distinct elements in a connection culture that we summarize as vision, value and voice.
VisionVision exists when everyone in an organization is motivated by the mission, united by the values and proud of the reputation. The MD Anderson Cancer Center in Houston has a strong vision summarized in the phrase that appears as part of its logo: "making cancer history." MD Anderson has a reputation for being one of the best cancer centers in the world. Its vision provides an enormous source of pride to its employees, and it helps connect them.
Vision also includes an organization's values: its core beliefs about the ways it goes about doing its work and, by inference, the ways it deems as unacceptable. For example, many healthcare organizations embrace the values of excellence, integrity, respect, caring and compassion for patients and their families. Leaders are responsible for making these values clear. They do this by articulating them in word and deed. Because vision leaks as people get caught up in the day-to-day tasks and lose sight of it, leaders must regularly communicate the organization's vision.
ValueValue is the heart of a connection culture. Value exists when everyone in the organization understands the needs of people, appreciates their positive, unique contributions and helps them achieve their potential. People in a connection culture value others as human beings and treat them as such rather than treating them as "human doings."
Herbert Pardes, MD, when he was president and CEO of the not-for-profit New York–Presbyterian Hospital, was a great example of a leader who promoted value in a healthcare culture. Dr. Pardes, as a 72-year-old, well-respected psychiatrist and former director of the National Institute of Mental Health, devoted time to making bedside visits to patients, something that other leaders might dismiss as inefficient. Dr. Pardes did this because he was passionate about providing humane healthcare and he understood that connection made patients and their families feel better.
Dr. Pardes valued employees at New York-Presbyterian. He put practices in place to assure that people who worked at New York–Presbyterian were caring individuals and that they would be engaged at work. He advocated that everyone should have personal and professional mentors, and he strived to help the people he led balance their personal lives and professional growth. To extend the feeling of connection outward, he encouraged staff members to memorize the names of patients and their family members as well.
By combining value in the hospital system's culture along with sound management practices, Dr. Pardes and his team turned around the struggling hospital system. Under Dr. Pardes' leadership, New York–Presbyterian's revenue rose from $1.7 billion in 1999 to $3.7 billion in 2011. Although most hospitals struggle to attract and retain nurses, New York–Presbyterian's vacancy rate for nurses was less than one-third the national average. The New York Times observed that while "most urban hospitals have struggled, New York–Presbyterian has thrived."
VoiceThe third element of a connection culture is voice. This element exists when everyone in the organization seeks the ideas of others, shares their ideas honestly and safeguards relational connections. A culture with voice decision-makers know that they don't have a monopoly on good ideas so they are intentional keeping people in the loop on matters that are important to them and seeking their ideas and opinions to get different perspectives.
In "Fired Up or Burned Out," I wrote about the late Fred Epstein, MD, a world-famous pediatric neurosurgeon and founder of the Institute for Neurology and Neurosurgery at Beth Israel Hospital in New York City. Dr. Epstein increased voice in the institute's culture by reducing the degree of formality and making physicians and staff more approachable. White coats were banned. Physicians were addressed by their first names. Physician, nurses and other healthcare professionals were encouraged to collaborate with one another rather than treat the physicians as if they were better than everyone else.
The power of connectionConnection is important to heal the corrosive effects of chronic stress that many healthcare workers, patients and their families experience. Research shows that chronic stress damages telomeres, the caps at the end of chromosomes, by shortening them. This damage weakens the immune system and promotes rapid aging. Conversations in which participants experience mutual empathy and emotional support release telomerase, an enzyme that heals damaged telomeres.
Other research studies support the positive effects of promoting connection in organizational cultures. One global study of 50,000 individuals conducted in 2004 by the Corporate Executive Board established that people who felt engaged and connected at work were 20 percent more productive than the average employee.
Several research studies conclude that in America, 70 percent of employees are not engaged. They show up for the paycheck but don't give their best efforts. While this may sound bleak to some, I want you to see it as a major opportunity. Become intentional in connecting like Dr. Hensley and Nick the doorman, Dr. Pardes and Dr. Epstein. Like them, you can make a difference in the lives of your colleagues, patients and their families that you come in contact with each day. Mark this day — begin connecting and just watch what happens. You will experience the productivity, prosperity and joy that come from being an intentional connector.
Michael Lee Stallard is president of E Pluribus Partners, based in Greenwich, Conn. He speaks and teaches seminars and workshops about leadership, employee engagement, productivity and innovation. Mr. Stallard has spoken and taught a wide variety of organizations including G.E., Google, Johnson & Johnson, McKesson Corporation, the MD Anderson Cancer Center, NASA Johnson Space Center and Yale-New Haven Hospital. He is a frequent contributor to leadership periodicals worldwide. He can be reached at email@example.com.
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