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Who’s Holding You Back?

Maureen Larkin, for HealthLeaders Media, May 15, 2008

Everyone has one: The co-worker who is always complaining about their workload, their boss, and, well, everything. They're often just a bit too snappy with customers and will roll their eyes behind the boss' back when they're reprimanded.

Everyone has one—even hospitals.

These "special" people can severely inhibit an organization's efforts to create a quality healthcare experience for patients, said Gerald B. Hickson, MD, director of the Center for Patient & Professional Advocacy and associate dean for clinical affairs at Vanderbilt University Medical Center in Nashville. Hickson presented VUMC's policy of no tolerance for unprofessional behavior Wednesday afternoon during Leadership Day at the annual congress of the National Patient Safety Foundation.

VUMC has had a culture of no tolerance for unprofessional behavior for the last 10 years, Hickson said. This culture includes a rule that everyone—from the physician who brings in the most revenue to the custodians cleaning patient rooms—has the responsibility of giving patients a quality experience. That means that every employee must not only watch his or her own behavior—but confront fellow employees who may be out of line.

"People need to be trained to recognize when a pattern of unprofessional behavior exists and address it," Hickson said.

Hickson emphasized that although this program has been in place for a decade, it is constantly changing as the organization's leaders learn more about their employees and the organization. Addressing cultural issues that inhibit quality care is, he said, "a marathon, not a sprint."

NPSF is not the first conference to address workplace culture. In fact, most conferences targeting hospital executives offer sessions that offer ways that leaders can get nurses and doctors to work together, inspire change, and encourage communication. From the outside, all of this culture talk may seem like it's taken from a page in Michael Scott's management manual, (If you don't watch "The Office," you should.) but hospital executives tell me that bringing the different cultures of their organization together to work for quality patient care is one of the hardest parts of their job. They're hungry for any piece of advice that might make this part of their job easier.

There will be many pieces of advice shared here at NPSF this week and I'll continue reporting on the ideas exchanged here in Nashville. Check back in and send me any questions, comments, or suggestions you might have.


Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at mlarkin@healthleadersmedia.com.
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