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Open Mike - 2011

Our people are our culture, and were constantly evolving
August 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. There’s much more going on than we can possibly talk about here. And while action plans and management techniques give us ways to jump in, everyday engagement is not a project with a firm beginning and end.

Engagement is ongoing, and it resides in each of you. Our hope is that you’ll keep exploring what works in your teams, and most important, keep talking.

Since you last talked about people and culture at Group Health in March, how has your thinking evolved?

Michael: We’ve really come to recognize that people are the culture at Group Health, and our culture is evolving. Our people bring our strategies to life every day with humanity, compassion and professionalism. I’ve seen tremendous enthusiasm from staff who want to be part of a high-performance, fully engaged workplace. That was really driven home in March after I finished my talks with 175 of our GHP doctors.

Scott: Both of us keep asking, if we’re serious about our people—about listening, being present, learning from the organization, and making ourselves available—are you seeing that in how we spend our time? I think we're really paying much more attention to walking the talk, making time to go see peoples’ work, and encouraging our teams to as well.

What have you been learning about people’s work lately?

Scott: I’m definitely seeing some of our major projects in a new light. People are working across different functions for major change projects like Health Plan Business Transformation. And the Integrated Care Facilities Design effort is just amazing for the way it has involved our staff in testing and modeling a medical center that works best for staff and patients together.

I was just at Northgate, where I saw so much pride and a transformation in the pharmacy staff going through a Frontline Improvement (FLI) project. They felt like they could finally fix things, and they took total ownership of the preparation. They learned from their colleagues who had made previous attempts. The more I experience teams designing their own problem-solving, the more I understand what a renewed focus on people engagement is really all about.

(FLI is a structured program that has started in 25 of our primary care clinics and in several specialty and APPLE care teams, involving hundreds of frontline staff who have already found dozens of solutions to problems.)

Michael: Another way we’re getting more insight is through a new Engagement Guidance Team. It’s made up of people from lots of different functions around of Group Health. The Executive Leadership Team is sponsoring this group as a sounding board for changes that are coming. It’s one way to get a variety of perspectives on how decisions affect everyday work. This team is also working on developing ideas and plans for new ways to help engage staff all across Group Health.

Do people feel they have the tools to turn ideas into improvements?

Scott: FLI success in some areas is creating desire for more of it, and we want to grow it without going so fast that we have setbacks. We need to figure out how FLI becomes a routine part of how we manage here. We don’t know exactly what the right pace is yet, but we want to see it spread. I think the long term challenge is training more local managers and leaders in people engagement principles, to help them involve their own staff in shaping culture and getting viable ideas off the ground.

Michael: There’s never been an absence of ideas, but we now have more places for ideas to go—FLI being one where there’s a structure and expertise to help. Two other programs that not nearly enough staff take advantage of are the Partnership for Innovation, and Tomorrow’s Medical Leaders grant programs. Staff with care improvement ideas can apply for funding and get some help thinking about projects from different angles.

In March you said you hope for a future curriculum to help staff create and sustain the kinds of work environments they want to have. Is that still part of your vision?

Scott: Yes, and I keep refining it. There are 200 frontline leaders that supervise 80 percent of the people at Group Health. They have huge influence over what it’s like to work here. So how can we help them really feel supported and capable of impact? If we invest in that kind of curriculum, it will take us far. But first I want to learn what’s its like to be a frontline leader again—what works? What doesn’t? I’ve set up breakfast meetings all around the state with groups of 8-12 frontline leaders from all different operating departments, talking with all 200 of those people to get their input to inform our actions.

Michael: GHP and GHC are trying something new right now with local dyads (operational leader partners managing in the same setting: one from administration and one from medical staff). Throughout 2011, nine pairs of leaders are completing GHP’s facilitative leadership training together. It’s a small number but it’s nine more than we did last year, and it may grow. GHP has also been designing more supports for our specialty services leaders. Do they have the time they need to do their jobs, are demands on clinic time hurting service access, have they had the management training they need— things like that. And we’re talking in more detail about specialty leader expectations so they can succeed in their roles.

Group Health is very different from when you were frontline leaders. What do you have to learn from people on the front lines now?

Scott: Looking back, I’m actually worried that I still have assumptions based on experiences that are now really dated. I want to see if they’re still true or not. I remember times when our success and satisfaction was defined mostly by whether we “beat” other operating departments. It’s amazing how many different ways we’ve created opposing teams over time. It’s so much better than 25 years ago, but there is still so much opportunity to do better than that.

Michael: Since I was a clinic chief, the content and expectations of being a frontline leader have changed. But there’s a feeling that hasn’t changed. It’s that feeling of trying to be successful sitting between the needs of your own staff, and the expectations that leaders are setting for a whole enterprise. That’s a feeling that will always exist, and I try to remember what it's like.Print

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