Rare Gem in Health Care

Posted On: March 4, 2016 by: Doug Lundrigan

Rarity confers value. Take natural pearls, for example. Only about one in 10,000 natural oysters will have a pearl in it, and far fewer than that will have a pearl with desirable form and color. I recently stumbled across a high value pearl in business, a rare gem in the health care industry. Come gaze with me in wonder, at something exceptional.

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A talk I was giving at the Oregon Health Care Association was called, “Authentic & Mindful: A Powerful Combination.” After I concluded a man approached me, his body language exuding excitement. “You’ve validated what I’ve been doing at my facility!” He is the chief administrator of a skilled nursing care facility. Allen James, tall, good-looking, and fortyish, described to me an amazing transformation in culture that has occurred at his facility.

Frankly, I was skeptical. I know that successfully changing an organization’s culture is rare, takes many years, fraught with challenges, and requires much persistence. Kind of like forming a natural pearl. So we met at his facility, Gateway Care & Retirement Center (Gateway) in NE Portland. This time his passion in describing his people and culture was even more inspiring. His excitement was infectious to me. What came through was his love for his employees and facility residents as he described experience after experience of the wonderful interactions between people. I wanted to meet some of these people.

image1I interviewed a sampling of the 84 staff, and here’s what I learned about what is going on at Gateway:
1. Unity of vision. Each staff member could state and describe the facility’s vision. There were no outliers, no misunderstandings, no tangential visions. And they believe it. They have “bought in,” they are engaged in it. When asked, some of them said they were doubtful when first introduced to the new vision. Then they watched it come to fruition first in Allen’s actions, then in other leaders. That stimulated the buy-in.
2. Celebrate the Love. Every interviewee used the words “family” or “love” or both to describe their culture. They all had real examples of things coworkers or bosses did for each other that demonstrated their love. They talk about and celebrate those experiences with each other. They share one another’s joys and burdens, they cry together, and the feeling grows. What was most startling was that loving people at work was a choice for each person. Not like “falling in love” as if love is an external force acting upon us. The good staff at Gateway make a daily decision to act in loving ways. Their love for each other is generated from within themselves as a conscious behavioral choice. “Love is good business,” as Allen puts it.
3. Relentless. At every All-Staff Meeting, every party, every gathering, even in the break room the vision is discussed, and examples shared of it being practiced. This has been consistent for over a year. It takes extreme focus and commitment to keep that up.
4. Personification of Principles. Starting with Allen James, spreading on through department heads to the whole staff, the principles of their vision are acted upon and lived out. The vision is not a set of lofty platitudes to be posted on the wall and forgotten. It’s more like a way of life to be embodied by all. They make the vision real by their actions.
5. People CAN Change. And they did change, they are changing. Each interview included at least one example of a person who changed positively in some significant way. The first one to change was Allen James. What compelled the change? From our discussions Allen would identify believing and living the LEAP* principles as the compelling force. People see themselves differently first, feel loved and supported, which gives them energy and space in which to change themselves, and then change their world.
6. Perpetual Lovely Road. “We’re not there yet” was a frequent comment. Although there has been a rare and wonderful cultural shift, it’s not over. The common sentiment seems to be that, we have not arrived, we are enjoying the journey, we continue to do what’s working. The love we feel gives us energy to keep going, striving to change the world, talking about the proving experiences that what we’re doing is real and effective.
7. Metrics of Success. It’s not theoretical. Since the time their culture shift began to be implemented Gateway’s Medicare rating improved from a four star to a five star, Quality Measures improved from a one star to four star, turnover decreased by 15% from the previous year, and revenue improved by 10%. Wouldn’t we all like those kinds of results in our business?

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Nursing homes are not glamorous. Talking with residents who may have trouble with coherent thought, the scent of sanitized bodily excretions, the mundane daily tasks of keeping the elderly in reasonable health. This is not the stuff of dreams or an inherently engaging workplace. And yet out of these circumstances Gateway has created something precious. The staff won’t leave, even for higher paying jobs, and the residents consider it the home they love. The staff at Gateway are creating a pearl of great value.

* The Gateway vision is called LEAP, from the book called The Radical Leap, by Steve Farber. LEAP is an acronym for Love, Energy, Audacity, and Proof. A full explanation can be found in the book.

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