Leadership and Culture

August 14, 2015

Sonya W. DawkinsSenior Vice President, Claims & Risk Management

PHT Services, Ltd.

“All too often we have the comfort of opinion without the discomfort of thought.”

John F. Kennedy

“Leaders are not born…..

….they are cornered.”

-Winston Churchill

What is Leadership?

Leadership- Defined

“If your actions inspire others to dream more, learn more, do more, and become more, you are a leader.”

-John Quincy Adams

6th US President

• Inspire a shared vision

• Challenge the System

• Enable others to act

• Model the way

• Encourage the Heart

Leader Responsibilities

• Self awareness

• Self- regulation

Motivation

Empathy

Social Skills

Emotional Intelligence

What is your contribution to Strategy?

Q: How do you align quality and safety activities with strategic goals?

What is your contribution to Strategy?

Q: How do you engage your stakeholders?

What is your contribution to Strategy?

Q: What is the most recent quality innovation that you integrated into your organization?

What is your relationship with Risk?

Q: How often do you meet with your risk manager?

Q: If you do meet with risk, how often do you collaborate on joint initiatives that the two of you are driving?

The Pursuit of Mediocrity

is Almost Always Successful.

-Author Unknown

https://www.youtube.com/watch?v=Hg2mSJtMFZg

"The world changes according to the way people see it, and if you can alter, even by a millimeter, the way people look at reality,

then you can change the world.”

James BaldwinAmerican novelist

What is Culture?

Healthcare providers have their own unique culture, one that is usually very different from that of their patients. Healthcare providers are socialized into the culture of their specific profession and work environment and, based on their specialized education, they have a particular way of viewing certain aspects of life that is very different from that of their patients.

Your culture is your corporate DNA. It is the mirror of your corporate ethic.

Simply: It’s the way we do business around here.

True Story

© 2012

Traditional Regulatory Model

• Retrospective

• Reactive

• Blame placed at the “sharp end”

• Severity of punishment dependent on severity of the outcome

a system of justice (investigatory and disciplinary action) that reflects what we now know of socio-technical system design, human free will and our inescapable human fallibility.

Just Culture

© 2012

What’s Just Culture About?

• It’s About Both Error and Drift• It’s About Both Pre- and Post-Event• It’s About Executive Commitment• It’s About Values and Expectations• It’s About System Design and Behavioral Choices• It’s For All Employees and Physicians• It’s About Partnership With Clinical, HR and Quality• It’s About Partnership With the Regulator• It’s About Doing the Right Thing• It’s About Producing Better Outcomes Together

5 Key Concepts of Just Culture

Create an Open and Fair Culture

Manage Behavioral Choices

Design Safe Systems Create a Learning Culture

Align Values and Expectations

The Three Duties – Helpful Hint

This Duty Always Exists

“To Do” “How To Do”

© 2012

Reckless (Intolerable)Behavior

Conscious Disregard of Substantial and

Unjustifiable Risk

Manage through:

• Remedial action• Disciplinary action

At-RiskBehavior

A Choice: Risk Believed Insignificant or Justified

Manage through:

• Removing incentives for at-risk behaviors

• Creating incentives for healthy behaviors

• Increasing situational awareness

HumanError

Product of Our Current System Design and Behavioral Choices

Manage through changes in:

• Choices• Processes• Procedures• Training• Design• Environment

Console Coach Discipline

The Three Behaviors

© 2012

At-Risk Behavior: Biggest Risk

Why? We Think We Are Safe! Cutting corners to save time Perception that rules are too restrictive Belief that rules no longer apply Lack of rule enforcement New workers see “routine violations”

Think this is the “norm” Insufficient Staff to perform tasks Right equipment is not available Extreme conditions Perception that practice is safe

© 2012

Event Investigation

What happened?

Why did it happen?

How were we managing it?

What’s procedure require?

What normally happens?

Establishing a culture for results

• What results do you want as a department/organization that you are not currently getting?

• What behavior patterns are hindering the results you want to achieve?

• What are the most important tools that enable your employees/team to deliver value?

© 2012

Action to Remember

“When your only tool is a hammer, you tend to see every problem as a

nail.”

Abraham Maslow, Psychologist

Final Thought