Supporting Safer Healthcare

DNV's NIAHO Hospital Accreditation Program Granted Deemed Status by CMS

The Joint Commission and the American Osteopathic Association have a new neighbor in the hospital accreditation business. 

The U.S. Centers for Medicare & Medicaid Services (CMS) announced its approval of DNV Healthcare Inc. to become the first new hospital accreditation organization in more than 30 years. The National Integrated Accreditation for Healthcare Organizations program - NIAHO^SM can now begin deeming hospitals in compliance with the Medicare Conditions of Participation.

DNV Healthcare has operational offices in Cincinnati, Ohio and corporate headquarters in Houston, Texas.

References:
http://www.dnvcert.com/DNV/Certification1/News/PressReleases/MedicareApprovesDNVtoA/

http://www.fiercehealthcare.com/story/cms-gives-dnv-healthcare-authority-accredit-u-s-hospitals/2008-09-26

Previous Blog Post:
http://msspnexus.blogs.com/mspblog/2008/05/dnv-healthcare.html

Culture Change in Healthcare - Weathering the Storm

Healthcare leaders everywhere are talking about the need for culture change.  It seems much like talking about the weather - everyone is affected, everyone has a story, but no one quite understands how to change the climate. 

In the meantime we face the onslaught of the coming storm.  Winds are whipping, waves are crashing, and we're just not sure whether to shore up the building or flee to higher ground.    

We in healthcare seek process improvement and culture change through various methodologies and tools. We count, chart, graph, extrapolate, survey and review, and in general move forward at a snail's pace.  On the surface everyone appears to agree that the old culture must go, but in every organization, just beneath that calm facade, is a murky, swirling riptide of resistance fueled by fear, uncertainty, and self-interest.  And no matter who we are, none of us are completely immune to the draw of that powerful tide.  Change is scary business.

Leaders often contribute to the corporate status quo by hiring and promoting from within specifically because the candidate already understands the culture.  Unfortunately, that practice often translates into yet another employee who accepts the inevitability of the current system.  It is unlikely that needed change will come through a new leader already immersed in the corporate behaviors and beliefs.

Yet despite its many struggles, healthcare is still a noble profession, often chosen for the most honorable of reasons; a desire to help and to heal.  That in itself makes the battle for sustainable improvement (and it can indeed be a battle) worth the effort. But cultural change is not an undertaking for the faint of heart.  Swimming against the tide is hard work, made a bit easier if one doesn't have to swim alone.   

Author Anita Yelton offers insights about how to recruit "fellow swimmers" in Making the Journey Toward Culture Change in Healthcare. 

Employee acceptance is essential. Many organizations have declared their mission, written goals, produced vision statements and embraced a philosophy or set of values that fits their organization. These affirmations often include lofty themes.

However, often there is no structure to support the realization of these organizational objectives. The employees frequently lack a genuine commitment to their company's stated goals, mission, value statements and general philosophies because:

1. They feel they have no input into the process.
2. The statements are long, vague and do not relate directly to employees' work.
3. Goals and values are only communicated once a year and then not mentioned again.
4. The statements are constantly being changed or revised.
5. The leadership team is inconsistent in its actions and behaviors in support of the goals and values.

A simple equation to communicate the framework for sustainable change is Q x A = E, or the quality of the solution times the acceptance of that solution will equal the overall effectiveness.

"You must be the change you want to see in the world."

 Mahatma Gandhi

 

Personal Experience With Emmi Web-based Patient Education

Surgery, even out-patient surgery, can be a scary experience.  Several days ago I had outpatient shoulder arthroscopy and repair.  Since then I've been home suffering through enjoying physical therapy and rehab.  I'm quite determined to regain strength and range of motion, so I remind myself it will all be worth it in the end.  

Prior to surgery my physician explained the procedure; the anatomy of the shoulder, what he would be repairing, etc.  He gave me a nice brochure to take home that also provided information.  All that was good, but because my hospital is now offering web-based patient education programs from Emmi Solutions, I also watched the shoulder arthroscopy and anesthesia programs, and showed them to family as well.  As a result, I understood the procedure better, and felt calmer with the idea of someone poking holes in me with sharp instruments. 

While I was in recovery, the nurses were talking about a particular symptom I was experiencing and reassuring me that they had contacted the doctor and it was nothing to worry about.  In my twilight happy state I remember thinking, "No problem, I knew about that from watching the Emmi program."    (Even in my twilight happy state I was smart enough not to say, "Oh, I already knew that...") 

So from a patient perspective, never think that you're offering your patients too many education options.  We'll pick the ones that suit our learning style best, and we'll feel good about knowing what to expect, both on the day of surgery and in the days immediately following.   

Now if I could just get someone else to do that physical therapy for me...

Look for a new job, or keep the one you have?

The honeymoon phase of a new job is an exciting time.  New experiences, new opportunities, new relationships.  It's a time when both employer and employee are anxious to make a good first impression.  But eventually the honeymoon ends, and just as with a personal relationship there are bound to be good days and bad. 

What if the bad days begin to outnumber the good?  Is "job divorce" the answer?  The article Stay or Go at jobjournal.com suggests that your best option might be to avoid making an immediate decision unless you are in physical or emotional danger at work.

"It is both possible and advisable to cultivate a fondness for your current job as you look for a different one. This paradox brings multiple benefits. First, by making a better life for yourself where you are, you will reduce your risk of suffering from the ‘any port in a storm’ syndrome. If you are so miserable that anything else looks good, you might take an equally bad or worse position to escape. If you do, six months later the vicious cycle of misery will reassert itself."

If you find yourself weighing the pros and cons of staying in your current position, take a few minutes to review the Top Ten Ways to be Happy at Work by Susan Heathfield.

Susan's first tip is

Choose to be Happy

Happiness is largely a choice.  The author acknowledges that the concept is simple, putting it into action under difficult circumstances is not. 

Here is tip number 8: 

Practice Professional Courage

If you are like most people, you don't like conflict. And the reason why is simple. You've never been trained to participate in meaningful conflict, so you likely think of conflict as scary, harmful, and hurtful. Conflict can be all three; done well, conflict can also help you accomplish your work mission and your personal vision.

And this one is number 10: 

If All Else Fails, Job Searching Will Make You Smile

If all of these ideas aren't making you happy at work, it's time to reevaluate your employer, your job, or your entire career. You don't want to spend your life doing work you hate in an unfriendly work environment. Most work environments don't change all that much.