Gems From ACHE Congress, Part 2

September 22, 2021

I attended the 2016 American College of Healthcare Executives Congress where my new friend Melissa Cole, FACHE encouraged me to tweet some of the best ideas. Here, in tweet format are highlights we and others shared. Apologies as not all sources are named. Today's focus is on the Change and Culture gems. Stay tuned for next week's issue dealing with Patients and Physicians. Non-healthcare readers, will find nuggets relevant to your work.CHANGE

  • Gems from Governor Michael O. Leavitt:
  • "Misperceiving how quickly the market is moving [toward value-based payment] is dangerous."
  • "There are only 3 ways you can deal with it. You can fight it and die; accept it and have a chance; or lead it and prosper."
  • 3 Key Uncertainties
  • Will value actually replace volume?
  • If so, how quickly will it occur in my market?
  • Does my organization and our partners possess the competencies required to succeed in a value payment world?
  • Gems from the AUPHA/ACHE Joint Breakfast: Leadership Competencies and Healthcare Quality Improvement - Dr. Ronald Wyatt, The Joint Commission:
  • 2 root causes of sentinel events are leadership failure & communication failure. Let's fix!
  • What can one person do? Collective becomes a habit. Habit becomes a legacy. What will your legacy be? Exceed the standard.
  • "If you don't believe Zero Inequity is possible; please get another job."
  • To young healthcare admin - "We broke it. You own it."
  • "All healthcare organizations need change management training." Is your team trained?
  • We are moving from fee for service to fee for value. We need disruptive technology. HHS 2018 Goals: 50% of payments via alternative care models. 90% of payments via value-based purchasing arrangements (CMS)
  • Change is perpetual, 365 days a year, (so you can take 1 day off this leap year.)
  • Innovation doesn't become transformation until it scales.
  • Steve Purves, FACHE, Maricopa Integrated Health System shared how an AZ county hospital saved $88 million in less than 1 yr. using rapid cycle improvement.
  • What is your orgs leader's capacity for change? Make it visible. Hold people accountable.
  • "If you look at change as one more thing to do, you will fail! Must sustain, be part of what you do." Karen Poole, FACHE
  • Anthony Armada, Senior VP/CEO of Swedish Health Services & Providence Health gems:
  • Created an internal Shark Tank program to encourage and implement employee ideas. With a $200,000 budget, they awarded money to 3 of 9 projects submitted so far.
  • If disruption/innovation is not top level driven, the organization will kill it.
  • Providence Health has 30 telehealth clinics now, 300 in next year, soon 500.
  • Memorial Hermann offers convenient care centers: 24hr care ER, primary care at decreased cost, rehab, imaging, labs, all dx, increased access to all care!
  • Froedtert Health President Catherin Jacobson, FHFMA offers virtual urgent care, FaceTime Doc or on phone. Innovative and meets patient needs.
  • Access changing per Zach Griffin, Governance Inst. 48% of employers will offer telehealth this year. How are you bringing care to them?
  • Physicians are being incentivized for population health, interesting to see in the next 10 yrs if RN's & ancillaries will be incentivized.
  • Dr. Robert Wachter shared a thought from Ronald Heifitz, Kennedy School of Government on Adaptive vs. Technical Problems "... problems that require people themselves to change. In adaptive problems, the people are the problem and the people are the solution. And leadership then is about mobilizing and engaging the people with the problem rather than trying to anesthetize them so that you can just go off and solve it on your own."
  • Hospital Board members are hearing about transformation & they WILL find a CEO who will transform! Hospital CEO turnover rate in 2015 among highest reported in 20 years.


  • Fortune published the 19th Annual 100 Best Companies to Work For list, said one of the top criteria now is workplace culture. How do you compare?
  • "Leverage an organization's rich history as a platform & foundation to drive cultural change." Lorraine Yehlen
  • CRM & Just Culture gems:
  • Biggest impediment to error prevention is "that we punish for making mistakes" many frontline colleagues fear reprisals if they self-report errors. Lucian Leape
  • I suspect most of us intimately know a "second victim" - a colleague devastated by a medical error.
  • CRM & Just Culture: creates an environment of trust and fairness.
  • We have challenges with crucial conversations. A culture of low expectations. Must do more...just culture.
  • Experiences shape beliefs - help change their experience to change culture.
  • Richard Priore, "Drucker said 'Culture eats strategy for breakfast.' Structure drives culture." How do you hold people accountable?
  • Innovation is a social phenomenon. Diversity of thought & experience is critical.
  • Innovation doesn't become transformation until it scales.
  • Replacing talent runs as high as two times the annual salary for a role, yet approx 35% of companies invest $0 on onboarding.
  • More tips and tweets at #ACHE2016

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