Healthcare Summit – Provocative Propositions



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APPRECIATIVE INQUIRY CONSULTING, L.L.C.

HEALTH CARE ALLIANCE | |

Aiming Higher in Health Care

CONFERENCE OUTPUT

MAY 20-21, 2003 ST. LOUIS UNIVERSITY

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AI Consulting, LLC

Contact: Susan O. Wood, AIC Health Care Alliance

P.O. Box 72, Mt Gretna, PA 17064

Phone: 717-964-3069 Email: health@



Appreciative Inquiry – a positive revolution in change

DISCOVERY PHASE OUTPUT: THE POSITIVE CORE

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Group I -

Peak Experiences

- Personal journey experience

- Profound dedication

- Giving and getting

- Right time, right place – facilitate others, self as instrument

- Surrender – spirit-led

- Community

- Trust others (stay out of the way), trust the process

Qualities, Skills – Positive Core

- Enabling others

- Homeostasis

- Resiliency

- Welcomed into another life/organization

- Intimacy

- Flexibility

- Personal investment – recipient and delivery agent

- Responsibility/ownership

Wishes for the Future

- Accountability-personal

- Whole-fully integrated system – birth to end of life

- Implode – phoenix will rise

- Community

- Alternative care part of integration

- Different kind of conversation

Group 2 -

- Unconditional positive regard

- Making it work: “hard stuff” and “soft stuff” at same time

- Keeping harmony

- Leadership

- Service/caring is life giving force

- Community spirit

- Commitment to people

- Helping people discover “what’s in it for m?” “What sources me?” (all relationships: patient, doctors, insurance etc.)

- Passion

- Making a difference

- Looking holistically, passionate, listening

- Trust

- Creating spaces/experiences where differences/voices can be heard

Group 3 -

Peak Experiences

- Empowerment – patients, insurance, physicians, coaching, manufacturing plant manager

- Comes down to the individual

- Making positive changes in people’s lives

- Individual getting ‘Aha’ – breakthrough/transformed

Attraction to Healthcare

- Serendipity – at conference what I said resonated with needs of health care

- Service – clinical or not, to people in need, making things better

- HC industry strained now and baby boomers are coming and baby busters have to pick up load

- Develop model to deal with realities of future

Wishes for the Future

- Physician-patient relationship more collaborative

- Accessible, quality HC for everyone

- Holistic- concern for whole person – psychological, emotional, familial, communal not just physical

- Eliminate culture of fear, blame and denial; accept death more naturally

- Pride and recognition for HC work

- Corporation, physicians become more centered on prevention and holistic care

Group 4 -

Peak Experiences

- Realm of ideas

- Gets around “turf” protectors to results

- Sparks folks to move on, keep them on track

- Belief that “all things are possible

- Like to be powerful and make change

- Get the resources, people, processes, buy in to make things change

- Terrific respect for human beings to change direction or see themselves differently

- Seeing organizations “dress up in what their beliefs are” wearing it

- Celebrating the preciousness of moments and of life itself

- No other industry where patient safety is more difficult – because of our individual “preciousness

- Master weaver, not a funnel

- Concinnity – harmony and elegance of design in one part relating to other and to the whole

- There isn’t a more worthy cause than taking healthcare and make it responsive to peoples needs

- Reinventing yourself – choosing your direction

- Being a bridge with people and what’s going on inside of them – how I can impact quality of life

- Finding people “where they are at” in order to help them to “cross the bridge”

- Connect with people where they’re at

- I just really like people

- Faithe and in the truth of what I bring

- Ability to listen to various perspectives

- Connect corporate values on individual leels

- Facilitating change effectively

- The seeing heart

DESIGN PHASE OUTPUT: PROVOCATIVE PROPOSITIONS

Healthcare Star Search – Healthcare Star Search promotes memorable experiences that further expand and propagate the benefits of patient-centered values through collaborative efforts among the people and all who serve them in human healing. By:

▪ Local Star Searches

▪ “Healthcare” Soup for the Soul

▪ Oprah’s Angels

▪ Academy Awards of Healthcare

Patient-Centered Care – We will create patient-centered care by:

1) Establishing and atmosphere of respect by promoting honesty & truthtelling & complete information sharing as THE core value.

2) Empowering patients with knowledge of their responsibilities & rights, the “ideal functioning” of their care team, and the skills to provide feedback to their care providers.

3) Empowering patient’s families and friends with the knowledge of the healthcare system & the skills to advocate for their loved ones.

4) Establish a Patient Care Coordinator role to customize care plan with and for each patient and to facilitate understanding and agreement between the patient and their care team. (Coordinator evaluated only by the patients and their families – gold star program, patient rights cards, extra mile cards, etc)

Community/Patient Relationship – Local and virtual communities step up to facilitate conversations that reflect, lifts, and values individual cultures. By:

▪ Demanding a seat at the board table

▪ Driving demands on existing healthcare costs

▪ Creating new proactive support systems that identify care goals and links people to best resources

Management/Physician Relationship – Management and Physicians function in a demonstrated teaming relationship. As evidenced by:

▪ Speak the same language

▪ Have complementary priorities

▪ Aligned around mutually reinforcing metrics, incentives, and learning

▪ Open and honest communication

▪ Effective knowledge and information sharing

▪ Doing what you say

▪ Non-punitive environment

▪ Celebrate positive contributions to common mission, vision, and values

▪ Openness to input on respective areas of responsibility

Patient Centered Facilities -

The Patient Centered Facility is one that embeds the patient's vision of health as the initial agreement with the provider and family. The patient and healthcare provider (physician) develops supportive collaborations that include medical and non medical options, family involvement and where there is attention paid to matching patient and provider personalities to enable and enhance healing relationships.

The approach to care is holistic including integration of financial, psychological, spiritual and social needs. Sufficient time is allotted for explanations and education. Post care "go to" points are clearly established and the facility offers paths for dying (home, hospice, hospital or other creative alternatives).

The facility itself is architecturally designed as healing spaces with secured safe spaces and community hubs. Signage is patient friendly and technology supports interface with facility, outside systems and community. The facility links to community-based systems and healers go out into community to provide preventative care and preserve health. The processes and procedures of the facility aligns with patient and provider's expectations so that the cycle of care is relatively stress-free and seamless.

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DESIGN PHASE OUTPUT: NOTES FROM OPEN SPACE SESSIONS

Patient Centered Facilities: Open Space Discussion led by Jonathan Peck (contributors: Roger, Roberta, Suzanne, Patreece)

 

Goal: Develop Provocative proposition; Specify 1-2 steps to accomplish the dream

Ground Rules: Learn from each person's contributions

                       Demonstrate appreciation of roles (no vilification)

 

IDEAS - THE BIG VISION

 

Patient and Healthcare Provider (physician) to develop supportive collaborations

    -     To include medical and non-medical options

    -     Family involvement

    -     Consultative partnership (one example of the type of collaborative relationship)

 

Holistic approach to include:

    -    Financial care

    -    Psychological Care

    -    Spiritual Care

    -    Time to explain/educate

    -    Tangible and virtual (need clarity)

    -    Establish "go to" post-care points

    -    Offers paths for dying

    -    Embeds patient's vision of health as initial agreement with providers and families...

         Defined by patients

 

What does the Facility look like (operationally)?

     -    Architectural space focus from "control places" to "healing "spaces" with "secured safe spaces"

    -    Architecture includes community hubs

    -    Signage is patient-friendly

    -    Space and role for advocates...linked to community-based systems

    -    Unallocated space for emerge(nt)ncy needs

    -    Facility processes align with patient and physician expectations

    -    Facility matches patient and provider personalities to enable/enhance healing relationships

    -    Healers go out into community to preserve health

    -    Private spaces and communal spaces

    -    Technology supports:

                * movies, multi media, communication, learning technologies

                * Interface w/outside systems without or little stress (financial transactions/transport)

                * Interface with facility

                * Interface with community

 

 Family-Centered Care and Design with Surrogate families available

        -    Practical Parenting Association (like PTA)

 

Initial Steps:

1. Design processes that can evolve most readily to patient-centered care...then redesign facilities

2. Find models (e.g. Patch Adams) to learn from, including parts of infrastructure (e.g. labor and delivery that changed to be more patient and family centered

DESTINY PHASE OUTPUT: COMMITMENTS, OFFERS, AND REQUESTS

Commitments

 

Goal: Next AIC Healthcare Conference with 200-500 hospital/healthcare participants

    TONY: will post pictures on a website; will work on second conference in Cleveland

    JON: will provide a brief summary of this conference

    ROGER: will provide giant scanner for copying the information on flipcharts (may not be needed since Joyce typed up info)

     ROBERTA - will get info scanned (may not be necessary since people typed up info)

     PATREECE- will type up patient-centered facilities (from open space and send to Jonathan)

     JOE: will provide follow-up on the nurse/doctor relationship intervention

  

Offers

     MARIANNE: will offer her book of stories to anyone who requests

     ANNE RADFORD: offered access to tools related to self healing for healthcare practitioners

     JONATHAN: offers free advertising in a newsletter by referencing his experience in this conference with links

     ROBERTA: will brainstorm projects by telephone

 

Requests

    TONY: Would like help from anyone with the vision of a major Healthcare summit in

               Cleveland, Ohio

    General: Group would like contact list of attendees

    JOE: will share materials and write up of cases to share on AI commons

    ELLEN: would like anyone who is interested in participating in AI stories of the

                last 10% of life to contact her

AIC HEALTHCARE ALLIANCE

ST. LOUIS CONFERENCE, MAY 20-21, 2003

PARTICIPANT FEEDBACK

May we use picture?

Yes – 5

No – 0

Blank – 2

1. Where did you learn about this conference?

← AI Commons

← AI Listserve

← AIC

← AIC

← Through email from AI

← Listserve

2. What excited you?

← Enjoyed the whole two days. Just right for where I am now. I enjoyed B. Mohr & Marianne Arujo’s presentations.

← Initially – the SSM Malcolm Baldridge Award Process and how to apply it. Reality – the cool, interesting participants and their stories! Loved the video! Need the resource!

← The new vision for healthcare, the dinner deep dive conversations; working with Bernard, learning from others’ experiences, meeting new people.

← Virtual teaming. Making contributions that facilitated the process.

← Great two days, however the case studies met my interest. Just hearing how the AI process gets embedded into everyday life of an organization.

← The possibilities and seeing that it really can work; meeting consultants who are doing AI.

← Creating a generative image of the future with doable, practical ideas that could plant powerful seeds for a “gentle revolution” in healthcare in the US, while simultaneously creating visibility for my own practice, AI, and the healthcare alliance. And the graduation ceremony was exciting, moving, and deeply symbolic.

3. What possibilities for using AI in your work over next few months?

← I have a project in a hospital emergency department.

← Already use it extensively in strategic planning. Will start using it in more team building / chartering projects.

← Going back to my healthcare consulting models and successes; names of other possible colleagues to propose with; an idea of a new community health centre.

← Continuing to live the principles and develop designs, facilitation with the principles embedded.

← To help groups structure their future, shape goals, and use when problem solving.

← Team building in NP organization; in hospital situation.

← Not sure… I hope that some work will result from connections made through my work as part of the conference planning team.

4. What wishes do you have for future conferences?

← How would you design a 1.5 day session? Use the leftover .5 day for a “clinic” for people with special needs to work with experience practitioners.

← Variety of “case examples” across industries, profit and non-profit, etc. Authors speaking. Book and resource table – free and for purchase. Handouts of EVERY presentation and all Power Points!

← More people. Relaly like the interspersed cases. Take time for more group introductions.

← Find ways to market to specialty groups – e.g. physicians, healthcare administrators.

← Focus more on experience of using this new knowledge. Case studies that show the experience of each section of the AI phase – i.e. after learning about design, then practice (more than once), then attend case study session.

← Anything related to direct application of process.

← Larger, profitable, introduce AI to motivated, interested decision makers in healthcare in various capacities.

5. What would you like to learn more about?

← Using AI as a management style.

← Applications, tools, tips & techniques, more games and interactive exercises!

← Destiny in the way of implementing/creating new systems for collaboration.

← Strategic planning in healthcare.

← Using AI as the basis for leadership / management programs coaching

← Rolling out the dream; more practice on the provocative statements.

← The whole process, since I’m just beginning to learn.

← How to move conversations into paid contracts.

6a. Facilities

← Great

← Fantastic big room, wall of windows, flexible.

← Great

← Superior

← Great

← Superb

6b. Materials

← Great

← Package it ALL together.

← Helpful

← Good, could use to take away materials discussed in the case sessions and overheads.

← Great

← Great job Roberta. Useful, and just the right amount. Next time let’s put the conference case presentations on the CD.

6c. Length

← Fine

← Perfect! Close a little early on last day.

← 3 less-full days

← Too short – 3 days or 2.5 would allow for more practice time.

← Great

7. What else?

← Use “Mr. Sketch” markers please!! Water based, chisel tips.

← Collect bios from participants, give a contact list! Class photo with names of each.

← Yeah Sarah! Really excellent snacks and lunches! Dinner out was Fun! You made it easy.

← Good logistics, directions – Roberta!!

← Sarah Langan was very facilitative of my relaxed presence here – Joe.

← Roberta, Sara, and Lisa, thank you for being on the ground in St. Louis.

← Loved it. Felt like a vacation. The locals Roberta, Lisa, and Sara really modeled the caring and support. Conference team wonderful example of blending of styles.

← Build in more time to network and have dinner together… this builds for me the sharing and contributes to building relationships.

← Good job!! :-)

← Major kudos for the care and attention to detail of Sara, Lisa, and Roberta. And it was fantastic working with such a great, competent, fun, dedicated team of partners. It reenergized my experience of being part of AIC, and of the healthcare alliance, and generated hope for the future of healthcare and the possibility for us to individually and collectively have a tremendously positive impact in creating the gentle revolution that we envision.

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