At the recent Quest for Excellence® Conference featuring current and past recipients of the prestigious Baldrige National Quality Award, we heard many inspirational stories from the senior leaders of the first long-term care facility to earn this recognition. Maryruth Butler, Executive Director of Kindred Nursing and Rehabilitation Center – Kellogg, Idaho, shared how their senior leaders intentionally created a culture of civility to engage employees in resident and patient safety.
Maryruth described a model that they learned from Sociotechnologix and have implemented in their center. https://sociotechnologix.wordpress.com/?s=civility With this model for a culture of civility (shown above), the senior leaders first had to create an environment of psychological safety where the employees know that an error or near-miss would be seen as a breakdown in a process rather than a willful or careless act. As a result, employees are comfortable speaking up to identify errors or concerns about the things in the workplace. The senior leaders not only listen, they take action and share their actions with the workforce. This approach, in turn, reinforces the organizational learning that such a culture provides. In fact, in their last survey, nearly 90% of their employees reported positively to the statement, “I am comfortable reporting errors without fear of retaliation,” versus 70% for the best-in-class comparison. And this culture of civility has resulted in high levels of patient safety reflected by the consistent 5-star overall rating and a 5-star rating for quality measures the center has received for seven consecutive years. https://www.nist.gov/baldrige/kindred-nursing-and-rehabilitation-center-mountain-valley
Many years ago, I saw a brilliant training video by John Cleese of Monty Python and Fawlty Towers fame. In “The Importance of Mistakes,” he uses an allegory of Gordon, the Guided Missile. Gordon receives ongoing feedback that adjusts his trajectory and speed to ensure that he hits his target. Cleese described how many organizations wait until an employee has missed an objective before leaders give him or her feedback – that the employee has failed. He posits that organizations and their employees would be far more successful if they could continuously learn by admitting that mistakes have been made and adjustments are needed.
Our client, PricewaterhouseCooper – Public Sector, a 2014 Baldrige Award recipient, has described in presentations at many conferences their evolution from a traditional annual performance appraisal process to a culture of continuous coaching. How has that been working out for them? Their parent organization was named #23 on the 2017 Fortune’s 100 Best Companies to Work For. http://beta.fortune.com/best-companies/pricewaterhousecoopers-23
How do you know if you have created a safe culture where lessons can be learned from mistakes and proactive coaching is the norm? Reflect on your reaction when you last heard about a customer problem. Was your first question, “Who?” (did it?), or “What?” (went wrong in one of our processes?)? Do you make it easy for your employees to tell you what they need to do a good job – equipment, supplies, or training, or do you view this as whining or complaining? In Item 1.1 from the Baldrige Excellence Framework, a question asks, how do senior leaders “encourage frank, two-way communication…?” How do you encourage this? How do you know?