Hartford HealthCare's COO: Take ownership to change hospital culture

It isn't easy to change a floundering hospital culture but it's possible with a commitment to change and involvement of patients and staff.

After Hartford (Conn.) Hospital went on probation for failing quality initiatives in 2007, new Chief Operating Officer Jeffrey A. Flaks and his team launched an immediate campaign, "How Hartford HealthCare Works," (H3W) to create a culture of ownership and accountability.

"We had a losing attitude, we had a lack of confidence in what we do," Flaks said during a presentation at the American College of Healthcare Executives Congress today in Chicago. "The system we had at that point in time was completely variable. The structure wasn't purposefully designed and it wasn't set up for success."

Hartford HealthCare restructured it's middle management system and used workgroups rather than departments to create clear and specifric goals with a strong customer focus. Each work group neets monthly and is led by an assigned leader, who attends a 10-class training session. 

Strong and coordinated middle management is essential for running a large healthcare organization, Flaks said, with a bottom-up, top-down communication structure. Each monthly meeting begins with recognition and includes data-driven dashboard measurement systems to gauge progress.

"You can't just be transparent, you have to be authentic in the process," Flaks said.

Work group processes also include input from patient advisory boards, who discuss patient concerns and ways to prevent them. 

Over five years, Flaks said Hartford Hospital went from the 18th percentile in patient satisfaction to the 53rd percentile. The organization also saw an increase in hand hygiene best practices, and reductions in both blood stream infections and mortality rates from sepsis.

H3W also resulted in changes, such as the use of patient journals, new ID badges, color-coded uniforms and food services transformation. 

To learn more:
- here's an executive summary of how H3W works (.pdf)