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Open Mike - 2011

Put some passion in your workplace
February 17, 2011

At our annual shareholder meeting last week, I talked with our medical group about a period in my work life that I’ll never forget. I became the chief of the Bainbridge Island clinic when it opened in 1987, and something about that time has stayed with me all these years. We provided great care for our patients, and we laughed a lot too. Work was fun. And on some level I have been trying to recapture that experience ever since.

I realize now it was the first time I really understood how it felt to be on a team where everyone was truly inspired to work together. We all want and deserve to feel this way about work. Yet it doesn’t just happen. It takes some thought, some new habits. And just as this great feeling was uniquely ours at Bainbridge all those years ago, it can be uniquely yours at Lidgerwood Primary Care, in Orthopedic Surgery at Tacoma Medical Center, or in Behavioral Health Services.

In the last few years we’ve worked incredibly hard to master new tools for increasing quality while decreasing costs. We’ve focused on improving processes and achieving greater alignment. And even with enormous pressure on everyone, we have seen steady improvement in our Gallup staff engagement survey scores.

I see this as a sign that we are making some progress in our work environments. That’s why I’m so excited to see us forge deeper connections with each other. A great workplace will challenge your head and connect with your heart.

The Group Health strategic plan calls for continued improvement in our Gallup scores, but the real point is to work to start with our values and take care of each other—not just move the numbers. We’re all responsible in some part for building the workplaces we want and deserve. If we can do this, our Gallup numbers will take care of themselves.

Let’s take a look at some summary information from our 2010 Gallup survey—not because it is perfect or prescriptive—but because it’s the best tool we have for stimulating ongoing conversations about our workplaces.

GHP had highest agreement with these statements:

  • My coworkers are committed to quality work
  • This last year, I have had opportunities at work to learn and grow

GHP had the most improvement in agreement with:

  • There is someone at work who encourages my development
  • I have a best friend at work

GHP agreement decreased for these statements

  • At work my opinions seem to count.
  • I have the materials and equipment I need to do my work right.

Quality shines
There is value in comparing our own engagement trends to national data about healthcare organizations. Here’s one measure I feel amazing about: within GHP our mean score for “My coworkers are committed to quality work” was in the 99th percentile compared to Gallup’s database of other healthcare companies.

We’ve had tremendous third-party quality recognition this year that bears this out. I can’t thank you enough for bringing your best to your patients, and for modeling quality care for each other and for the nation.

Three measures GHP watches closely
There are three survey questions that I have paid very close attention to over the years. The way we answer these questions is tied to our ability to be the best place to get care and the best place to work.

Though we should all take pride in how much we've moved the numbers, it's no where near good enough. I am asking what will it take for us to get to 100 percent for these questions?

  • I would recommend Group Health as a place to get care. Since we started asking if you’d recommend Group Health to a close friend, the percentage of GHP staff who answered “agree” or “strongly agree” has increased from 65 to 93 percent.
  • I recommend Group Health as a good place to work. Since we started asking this question, the percentage of GHP staff who answered “agree” or “strongly agree” has increased from 43 to 83 percent.
  • I have the right amount of influence over the staff who support my care of patients. For many years this was our lowest scoring area. The percentage of GHP staff who answered “agree” or “strongly agree” when asked about their ability to influence support staff has increased from 31 to 53 percent since 2004, the first year we asked the question (note the question wording changed slightly beginning in 2009).

Gallup Results

Bottom line: more respect for front line opinions
Front line medical staff are closest to the work, and you are telling us through Gallup that your opinions are not being heard. We can and must do better at seeking and respecting front-line input, because our ability to adapt to change depends on it. An environment that not only accepts, but actually embraces change can only exist where there is respect for people. And respect can come to life in many ways—from formal recognition, to remembering to say thanks, to simply listening without rushing to judgment.

I strongly urge you to take advantage of the impact plan training we’ve set up for managers, chiefs and medical leaders. Building the plan with staff is a respectful action in itself. The Gallup data is a starting point but the ongoing conversation is up to you. What satisfies you, motivates you, or makes you want to tell your friends and family about your day? Do you know how your co-workers would answer these questions? Talk to each other to learn from each other.Print

Open Mike Articles
  • 2012  
  • |  2011  
  • |  2010  
The Path To The Best Care At Lower Cost   12/01/2012
The US spends $2.7 trillion on health care every year. If our collective wallets feel lighter, that’s because $304 billion comes out of our own pockets. How can these kinds of costs be brought under control, without sacrificing quality of care?

Certainty   09/04/2012
Sustaining momentum in uncertain times can be hard, but one way to keep it up is to celebrate progress. I’m really proud to call your attention to a study published in Health Affairs today.

Affordable Care Act ruling brings stronger imperative to transform health care  07/11/2012
As important as the Supreme Court Ruling is for the future of health care, it’s really just one step in a process that started before the Affordable Care Act passed and will continue for a long time to come.

Only connect 05/16/2012
This spring I spent five weeks in clinical immersion all over our system. I had 34 small-group discussions with 172 different clinicians. In March, I shared some early insights at the half-way point. Now I want to wrap up everything I heard.

What if? 04/11/2012
What if the “new normal” doesn’t feel normal at all, for many years? I try to remind myself and others that the current turmoil in health care is driven by market forces—not politics—and can only be solved by directly addressing the market. Our “new normal” is all about reaching across silos to work with partners in new ways.

Business problem? Diagnose it.
I’m about halfway through my 2012 clinical immersion. When I tried this last year it was new for all of us, and it felt right to start our conversations around values. This year I'm trying to dig a little deeper.

What will your legacy be?  02/24/2012
What a night! It felt terrific to see over 700 clinicians and special guests at the GHP Annual Meeting on February 15. “A Legacy of Leadership” was our theme for the evening, touching on our shared past, present, and future.

Performance matters  10/19/2011
Only nine Medicare Advantage plans in the country earned 5 stars overall, and Group Health Cooperative’s Medicare Advantage plan is one of them!

Looking back, and ahead: reflections on my first three years  9/17/2011
The last three years have passed quickly, largely because I’ve had such an amazing group of people to work with. What you’re capable of no longer surprises me. It inspires me.

Our people are our culture, and we’re constantly evolving  8/17/2011
One thing I’ve noticed since my last Q&A on Group Health culture with Scott Armstrong is that conversations like ours are spreading.

More than elbow room  7/6/2011
Growth is a good problem to have in turbulent economic times. But as I’ve heard in medical staff business meetings and conversations, growth is hard on daily life at work.

Erikson and Soman on partnership and growth  6/15/2011
Sustaining growth isn’t about Michael and I being leaders; it’s about teams of seasoned, excellent colleagues and leaders and clinical teams. We both have tremendous confidence in them.

The good, the bad and everything in between  5/11/2011
I went all over the state in March, talking with small groups of GHP physicians and other clinicians about critical issues. 

Why are we here?  3/23/2011
Easily eight out of ten of you mention that our philosophy of medicine—the way we practice—drew you here. And paired with the people and relationships in your workplaces, it’s a major thing that keeps you here.

Culture at Group Health: 7 questions for Scott & Michael  3/9/2011
Scott and I kicked off some fresh thinking about culture and respect for people at our Leadership Conference about five weeks ago. Recently, we sat down to check in with each other about it.

Sometimes growth don't feel like it should  1/28/2011
We know that taking on new patients—and engaging them in their own good health—takes time. But it’s what’s unique and important about our kind of medicine.

What will it take? You.  12/1/2010
About 350 leaders from the Group Practice and throughout Group Health gathered for the Group Practice Annual Fall Forum on November 12.

Demystifying clinical integration
Clinical integration is the key, so let’s define what that phrase means.

Step back and take it all in. You’re making great things happen.  10/21/2010
In the last issue of Open Mike we had just learned that we had won the 2010 Acclaim Award from the American Medical Group Association.

Group Health sees a big jump in NCQA private plan rankings  9/22/2010
Group Health is one of the highest rated health plans and among the top 50 in the nation, according to the National Committee for Quality Assurance (NCQA).

Innovation is where we shine  9/8/2010
I am very excited to share that the American Medical Group Association (AMGA) has honored our work with its 2010 Acclaim Award.

Notes from the Colorado Health Symposium  8/11/2010
During the last week of July I traveled to the Colorado Health Foundation’s annual symposium in Keystone, CO.

Measuring up  7/28/2010
Quality. Ask a hundred people to define it, and you’ll get a hundred answers.

The risk and opportunity of Accountable Care Organizations
Shared values, physician-led care models, and aligned incentives can bridge the distance between organizations in the world of accountable care.

Let’s start a conversation about our workplace  4/4/2010
People are our most important resource, our “secret sauce.”

Decreasing “unwarranted” variation in clinical care  3/24/2010
As you read this, we are in the midst of unprecedented reform to our national health care system.

Making the transition from “I” to “we”
Last night the Group Health Permanente Annual Meeting left me feeling inspired and confident.

Looking ahead to 2010  1/13/2010
First, for 2010, our goal is as follows: We will lead the top delivery system in the state.

Other GHP Leadership Publications