tom peters’ re-imagine! business excellence in a disruptive age chime fall cio forum dynamic times...

Tom Peters’

Re-Imagine!Business Excellence in

a Disruptive AgeCHIME Fall CIO Forum

Dynamic Times Demand Dynamic StrategiesHilton La Jolla Torrey Pines/10.27.2004

Slides at …

tompeters.com

V.A. Moment …

1Y/2N: Commerce Bank2 Pizzas: JB

Plastic Bulldozer: MD

XYZ Corp: Complete Vision & Values

Any Service or Product of ours is yours

for absolutely NO CHARGE if any employee says—or implies—to you

at any point …

“It’s Not My Fault.”

V. Big Cheese, Founder, CEO & Dictator

Employee Manual

Item 1.0. I.N.M.F. =

Part I:

A Brand New Ballgame!

Re-imagine!

Summer 2004: Not Your

Father’s World.

“We’re now entering a new phase of business where the group will be a

franchising and management company where brand management is central.” —David

Webster, Chairman, InterContinental Hotels Group

“InterContinental will now have far more to do with brand ownership than hotel

ownership.” —James Dawson of Charles Stanley (brokerage)

Source: International Herald Tribune, 09.16, on the sacking of CEO Richard North, whose entire background is in finance

1. Re-imagine Everything: All Bets Are Off.

Jobs New Technology

GlobalizationSecurity

2. Re-imagine Permanence:

The Emperor Has No Clothes!

Forbes100 from 1917 to 1987: 39 members of the Class of ’17 were alive

in ’87; 18 in ’87 F100; 18 F100 “survivors” underperformed the market

by 20%; just 2 (2%), GE & Kodak, outperformed the market 1917 to 1987.

S&P 500 from 1957 to 1997: 74 members of the Class of ’57 were

alive in ’97; 12 (2.4%) of 500 outperformed the market from 1957 to 1997.

Source: Dick Foster & Sarah Kaplan, Creative Destruction: Why Companies That Are Built to Last Underperform the Market

3. Re-imagine Organizing I:

IS/IT Leads the (Virtual) Way!

Productivity!

McKesson 2002-2003: Revenue … +$7B

Employees … +500

Source: USA Today/06.14.04

100 square feet

E.g. …

Jeff Immelt: 75% of “admin, back room, finance” “digitalized” in

3 years.

Source: BW (01.28.02)

“Dawn Meyerreicks, CTO of the Defense Information Systems Agency, made one of the most fateful military calls of the 21st century. After 9/11 … her office

quickly leased all the available transponders covering Central Asia. The implications should change everything about U.S. military thinking in the

years ahead.

“The U.S. Air Force had kicked off its fight against the Taliban with an ineffective bombing campaign, and Washington was anguishing over whether to send in a few Army divisions. Donald Rumsfeld told Gen. Tommy Franks to

give the initiative to 250 Special Forces already on the ground. They used satellite phones, Predator surveillance drones, and GPS- and laser-based

targeting systems to make the air strikes brutally effective.

“In effect, they ‘Napsterized’ the battlefield by cutting out the middlemen (much of the military’s command and control) and working directly with the

real players. … The data came in so fast that HQ revised operating procedures to allow intelligence analysts and attack planners to work directly

together. Their favorite tool, incidentally, was instant messaging over a secure network.”—Ned Desmond/“Broadband’s New Killer App”/Business

2.0/ OCT2002

“MIT Everyware: EVERY LECTURE, EVERY QUIZ, ALL ONLINE, FOR

FREE. MEET THE GLOBAL GEEKS GETTING AN MIT EDUCATION,

OPEN SOURCE-STYLE.” —Headline/Wired/09.03

“Our entire facility is digital. No paper, no film, no medical records. Nothing. And it’s all integrated—from the lab to X-ray to records to physician order entry. Patients don’t have to wait for anything. The information from the physician’s office is

in registration and vice versa. The referring physician is immediately sent an email telling him his patient has shown up. … It’s wireless in-house. We have 800 notebook computers that are wireless. Physicians can walk around with a computer that’s

pre-programmed. If the physician wants, we’ll go out and wire their house so they can sit on the couch and connect to the

network. They can review a chart from 100 miles away.” —David Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)

“Some grocery stores have better

technology than our hospitals and

clinics.” —Tommy Thompson, HHS

Secretary

Source: Special Report on technology in healthcare, U.S. News & World Report (07.04)

“Ebusiness is about rebuilding the organization from the

ground up. Most companies today are not built to exploit the Internet.

Their business processes, their approvals, their hierarchies, the

number of people they employ … all of that is wrong for running an

ebusiness.”Ray Lane, Kleiner Perkins

Words to Live By …

“Hierarchy is an organization with its face

toward the CEO and it’s a__ toward the customer.”

Jack Welch

07.04/TP In Nagano …

Revenue: $10B

FTE: 1*

*Maybe

Not “out sourcing”Not “off shoring”

Not “near shoring”Not “in sourcing”

but …

“Best Sourcing”

IS/IT is strategy!

5% F500 have CIO on Board: “While some of the world’s

most admired companies—Tesco, Wal*Mart—are transforming the business

landscape by including technology experts on their boards, the vast majority are

missing out on ways to boost productivity, competitiveness and shareholder value.”

Source: Burson-Marsteller

4. Re-imagine the Organizing II: The

Professional Service Firm (“PSF”) Imperative.

Sarah: “ Papa, what do you do?”

Papa: “I’m ‘overhead.’ ”

Sarah: “ Daddy, what do you do?”

Papa: “I manage a ‘cost center.’ ”

Sarah: “ Daddy, what do you do?”

Papa: “I’m a ‘bureaucrat.’ ”

Answer: PSF![Professional Service Firm]

Department Head

to …

Managing Partner, Finance [IS, etc.] Inc.

“Typically in a mortgage company or financial services company, ‘risk

management’ is an overhead, not a revenue center. We’ve become more

than that. We pay for ourselves, and we

actually make money for the company.” —Frank

Eichorn, Director of Credit Risk Data Management Group, Wells Fargo Home Mortgage (Source: sas.com)

Eichorning

Mantra: “Eichorn it!”

5. Re-imagine Business’

Basic Value Proposition: PSFs Unbound/ The

“Solutions Imperative.”

And the “M” Stands for … ?

Gerstner’s IBM: “Systems Integrator of choice.” (BW)

IBM Global Services: $35B

“Big Brown’s New Bag: UPS Aims to Be the Traffic Manager

for Corporate America” —Headline/BW/07.19.2004

New York-Presbyterian: 7-year, $500M consulting (systemic) and equipment contract with

GE Medical Systems

Source: NYT/07.18.2004

Eichorning

Mantra: Eichorn it!”

9. Re-imagine the Fundamental Selling

Proposition: “It” all adds up to …

THE BRAND (THE STORY).

“WHO ARE WE?”

“WHAT’S OUR

STORY?”

Story > Brand

10. Re-imagine the Roots of Innovation: THINK WEIRD … the

High Value Added Bedrock.

FLASH:

Innovation is

Saviors-in-Waiting

Disgruntled CustomersOff-the-Scope Competitors

Rogue EmployeesFringe Suppliers

Wayne Burkan, Wide Angle Vision: Beat the Competition by Focusing on Fringe Competitors, Lost Customers, and Rogue Employees

“To grow, companies need to break out of a

vicious cycle of competitive

benchmarking and imitation.” —W. Chan Kim & Renée

Mauborgne, “Think for Yourself —Stop Copying a Rival,” Financial Times/08.11.03

“This is an essay about what it takes to create and sell something remarkable. It is a plea for originality, passion, guts and daring. You can’t be remarkable by following someone else who’s remarkable. One way to figure

out a theory is to look at what’s working in the real world and determine what the successes have in common. But what could the Four Seasons and

Motel 6 possibly have in common? Or Neiman-Marcus and Wal*Mart? Or Nokia (bringing out new hardware every 30 days or so) and Nintendo

(marketing the same Game Boy 14 years in a row)? It’s like trying to drive

looking in the rearview mirror. The thing that all these companies have in common is that they have nothing in common. They are outliers. They’re on the fringes.

Superfast or superslow. Very exclusive or very cheap. Extremely big or extremely small. The reason it’s so hard to follow the leader is this: The

leader is the leader precisely because he did something remarkable. And that remarkable thing is now taken—so it’s no longer remarkable when you

decide to do it.” —Seth Godin, Fast Company/02.2003

Innovation!

Imitation

13. Re-imagine

Excellence I: The Talent

Obsession.

Brand = Talent.

From “1, 2 or you’re out” [JW] to …

“Best Talent in each industry segment to build

best proprietary intangibles” [EM]

Source: Ed Michaels, War for Talent

Did We Say “Talent Matters”?

“The top software developers are more productive than

average software developers not by a factor of 10X or 100X, or

even 1,000X,

but 10,000X.” —Nathan Myhrvold,

former Chief Scientist, Microsoft

14. Re-imagine Excellence II: Meet the

New Boss … Women Rule!

“AS LEADERS, WOMEN RULE: New Studies find that female managers

outshine their male counterparts in almost

every measure”Title, Special Report/BusinessWeek

Women’s Strengths Match New Economy Imperatives: Link [rather than rank] workers;

favor interactive-collaborative leadership style [empowerment beats top-down decision making]; sustain fruitful collaborations; comfortable with sharing information; see redistribution of power

as victory, not surrender; favor multi-dimensional feedback; value technical & interpersonal skills, individual & group contributions equally; readily accept ambiguity; honor intuition as well as pure

“rationality”; inherently flexible; appreciate cultural diversity.

Source: Judy B. Rosener, America’s Competitive Secret: Women Managers

16. Re-imagine Leadership for Totally Screwed-Up

Times:

The Passion Imperative.

Start a Crusade!

G.H.: “Create a ‘cause,’ not a ‘business.’

“Beware of the tyranny of making Small

Changes to Small

Things. Rather, make

Big Changes to Big Things.” —Roger Enrico, former Chairman, PepsiCo

Make It a Grand

Adventure!

“Ninety percent of what we call ‘management’ consists of making it difficult for people to

get things done.” – Peter Drucker

“I don’t know.”

Quests!

Organizing Genius / Warren Bennis and Patricia Ward Biederman

“Groups become great only when everyone in them, leaders and

members alike, is free to do his or her absolute best.”

“The best thing a leader can do for a

Great Group is to allow its members to discover their

greatness.”

Yes!!!!!!!!!!!!!!!!!

“free to do his or her absolute best” …

“allow its members to discover their

greatness.”

“Reward excellent

failures. Punish mediocre

successes.”Phil Daniels, Sydney exec (and, de facto, Jack)

Dispense Enthusiasm!

“You can’t behave in a calm, rational

manner. You’ve got to be out there on

the lunatic fringe.” —

Jack Welch

Part II: Healthcare

Horrors & Hope

1. Premise.

“If one didn’t know better, one might think that hospitals set

out to design systems that provide the most sophisticated technical care but deliver the worst possible experience to sick people.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel

Golden American Age of Patient-centric, Genetics-driven Healthcare Looms!

Current status: $1.3T+. 30M-70M uninsured. 100K killed and 2M injured p.a. in hospitals. 85% treatments

unproven. Cure prescribed depends on locale in which treated. 50% prescriptions do not work. 2X hospitals.

IS primitive. Accountability & measurement nil.

And … EVERYBODY’S MAD-AS-HELL AND FEELS POWERLESS: DOCS, PATIENTS, NURSES, INSURERS,

EMPLOYERS, PHARMA & DEVICE COS, HOSPITAL ADMINISTRATORS AND STAFF.

2. Consumerism (Patient-centric Healthcare Arrives)

“We expect consumers to move into a position of dominance in the early

years of the new century.”

Dean Coddington, Elizabeth Fischer, Keith Moore & Richard Clarke, Beyond Managed Care

Today’s Healthcare “Consumer”:

“skeptical and demanding”

Source: Ian Morrison, Health Care in the New Millennium

“Savior for the Sick”

“Partner for Good Health”

Source: NPR

CAM (Complementary & Alternative Medicine):

83M in US (42%)CAM visits 243M greater than to PCP (Primary Care

Physician) (With min insurance coverage)W-F-Educated-Hi incDon’t tell PCP (40%)

(<30% procedures used in conventional medicine have undergone RCTs/randomized clinical trials)

Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Consumer Imperatives

ChoiceControl (Self-care, Self-management)

Shared Medical Decision-makingCustomer Service

InformationBranding

Source: Institute for the Future

3. Demographics: The BOOMERS Reach 60 in ’05!

“NOT ACTING THEIR AGE: As Baby Boomers

Zoom into Retirement, Will America Ever Be the

Same?”USN&WR Cover

Boomer World

“From jogging to plastic surgery, from vegetarian diets

to Viagra, they are fighting to preserve their youth and

defy the effects of gravity.”M.W.C. Howgill, “Healthcare Consumerism, the Information

Revolution and Branding”

“Pick up any copy of Glamour or Men’s Health, and you’ll see pages of advertisements encouraging readers

to enlarge their breasts, retard baldness, correct their vision,

improve their smile, or relieve stress through herbs, massage therapy,

acupuncture—you name it.”Coddington, Fischer, Moore & Clarke, Beyond Managed Care

“Sixty Is the New Thirty”

—Cover/AARP/11.03

4. “Quality”: COULD IT TRULY BE

THIS AWFUL?

“Quality of care is the problem, not

managed care.”Institute of Medicine

“A healthcare delivery system characterized by idiosyncratic

and often ill-informed judgments must be restructured

according to evidence-based medical practice.”Demanding Medical Excellence: Doctors and Accountability in

the Information Age, Michael Millenson

“As unsettling as the prevalence of inappropriate care is the enormous amount of what can only be called

ignorant care. A surprising 85% of everyday medical treatments have never been scientifically

validated. … For instance, when family practitioners in Washington State were queried about treating a simple urinary tract infection, 82 physicians

came up with an extraordinary 137 strategies.”

Demanding Medical Excellence: Doctors and Accountability in the Information Age, Michael Millenson

CDC 1998: 90,000 killed

and 2,000,000 injured from nosocomial

[hospital-caused] drug errors & infections

1,000,000 “serious

medication errors per year” … “illegible handwriting, misplaced decimal points, and missed drug

interactions and allergies.”

Source: Wall Street Journal / Institute of Medicine

HealthGrades/Denver: 195,000 hospital deaths per year in the U.S., 2000-2002 =

390 full jumbos/747s in the drink per year. Comments: “This should give you pause when you go to the hospital.” —Dr. Kenneth Kizer, National Quality

Forum. “There is little evidence that patient safety has improved in the

last five years.” —Dr. Samantha Collier

Source: Boston Globe/07.27.04

“This should give you pause when you go to the

hospital.”

“There is little evidence that patient safety

has improved in the last five years.”

RAND (1998): 50%, appropriate preventive care. 60%,

recommended treatment, per medical studies, for chronic

conditions. 20% chronic care treatment that is wrong.

30% acute care treatment that is wrong.

“In a disturbing 1991 study, 110 nurses of varying experience levels took a written test of their ability to

calculate medication doses. Eight out of 10 made calculation mistakes at

least 10% of the time … while four out of 10 made mistakes 30 %

of the time.”Demanding Medical Excellence: Doctors and Accountability

in the Information Age, Michael Millenson

YE GADS! New England Journal of Medicine/ Harvard Medical Practice Study: 4% error rate (1 of 4 negligence). “Subsequent investigations around the

country have confirmed the ubiquity of error.” “In one small study of how clinicians perform when patients

have a sudden cardiac arrest, 27 of 30 clinicians made an error in using the defibrillator.” Mistakes in

administering drugs (1995 study) “average once every hospital admission.” “Lucian Leape, medicine’s

leading expert on error, points out that many other industries—whether the task is manufacturing

semiconductors or serving customers at the Ritz Carlton—simply wouldn’t countenance error rates like

those in hospitals.”—Complications, Atul Gawande

“In health care,

geography is destiny.”

Source: Dartmouth Medical School 1996 report

Geography Is Destiny

“Often all one must do to acquire a disease is to enter a country where a disease is recognized—leaving the

country will either cure the malady or turn it into something else. … Blood pressure

considered treatably high in the United States might be considered normal in England; and the low blood

pressure treated with 85 drugs as well as hydrotherapy and spa treatments in Germany would entitle its sufferer to lower life insurance rates in the

United States.” – Lynn Payer, Medicine & Culture

Geography Is Destiny

E.g.: Ft. Myers 4X Manhattan—back surgery. Newark 2X New Haven—

prostatectomy. Rapid City SD 34X Elyria OH—breast-conserving surgery. VT, ME, IA: 3X differences in hysterectomy

by age 70; 8X tonsillectomy; 4X prostatectomy Breast cancer screening: 4X NE, FL, MI vs. SE, SW. (Source: various)

PARADOX: Many, many formal case reviews …

failure to systematically/ systemically/ statistically

look at and act on evidence.C.f., Complications, Atul Gawande

“Most physicians believe that diagnosis can’t be reduced to a set of generalizations—to a ‘cookbook.’ … How often does my intuition lead me astray? The radical implication of

the Swedish study is that the individualized, intuitive approach that lies at the center of modern medicine is flawed—it causes more mistakes

than it prevents.” —Atul Gawande, Complications

Deep Blue Redux*: 2,240 EKGs … 1,120 heart attacks.

Hans Ohlin (50 yr old chief of coronary care, Univ of

Lund/SW) : 620. Lars Edenbrandt’s

software: 738.

*Only this time it matters!

“Practice variation is not caused by ‘bad’ or ‘ignorant’ doctors. Rather, it is a natural

consequence of a system that systematically tracks neither its processes nor its outcomes,

preferring to presume that good facilities, good intentions and good training lead automatically

to good results. Providers remain more comfortable with the habits of a guild, where

each craftsman trusts his fellows, than with the demands of the information age.”

Michael Millenson, Demanding Medical Excellence

Genius Required?

Leapfrog Group:

CPOE/Computerized Physician Order Entry*ICU staffing by trained intensivists**EHR/Evidence-based Hospital Referral***

*Duh I: Welcome to the computer age.**Duh II: How about using experts?***Duh III: If you do stuff a lotta times, you tend to get/be better. Source: HealthLeaders

The Benefits of … FOCUSED EXCELLENCE

Shouldice/Hernia Repair: 30-45 min, 1% recurrence.

Avg: 90 min, 10%-15% recurrence.

Source: Complications, Atul Gawande

5. The IS/Web REVOLUTION

“Some grocery stores have better

technology than our hospitals and

clinics.” —Tommy Thompson, HHS

Secretary

Source: Special Report on technology in healthcare, U.S. News & World Report (07.04)

“We’re in the Internet age, and the average

patient can’t email their doctor.”

Donald Berwick, Harvard Med School

Computerized Physician Order

Entry/CPOE: 5% of U.S.

hospitals

source: HealthLeaders/06.02

“Our entire facility is digital. No paper, no film, no medical records. Nothing. And it’s all integrated—from the lab to X-ray to records to physician order entry. Patients don’t have to wait for anything. The information from the physician’s office is

in registration and vice versa. The referring physician is immediately sent an email telling him his patient has shown up. … It’s wireless in-house. We have 800 notebook computers that are wireless. Physicians can walk around with a computer that’s

pre-programmed. If the physician wants, we’ll go out and wire their house so they can sit on the couch and connect to the

network. They can review a chart from 100 miles away.” —David Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)

“Patient by patient, problem by problem—drug reactions, hospital

caused infections—Salt Lake City’s LDS Hospital has attacked treatment-

caused injuries and deaths. One of the secrets of LDS’s success is a custom-

built clinical computer system that may serve as a national model for how

to save patient lives.”Demanding Medical Excellence: Doctors and Accountability

in the Information Age, Michael Millenson

6. HealthCare21

HealthCare21: 21 Ideas for Century211. Hospitals kill people. (And many of those they don’t kill, they wound.) (And they deny it.) (ERRORS RULE!) And: Hustling ambulances kill pedestrians—and don’t save patients.2. Doctors are spoiled brats—who don’t like measurements. Or any form of “interference.” Docs are also cover-up artists. The REAL Hippocritic [sic?] Oath: “DON’T RAT ON A FELLOW DOC”. 3. Most prescription drugs don’t work—for a PARTICULAR patient. Current drugs = Blunderbusses.4. Think … WELLNESS. Think … PREVENTION.5. THERE IS LITTLE “SCIENCE” IN “MEDICINE.” (See state to state variations … country to country variations … the general lack of agreed-upon treatments.)6. You could save thousands of lives—if you simply outlawed handwritten prescriptions.7. “Detailers” will disappear … when GenX docs arrive.

HealthCare21 (Cont.)8. IS/IT in hospitals is primitive (despite smart people and enormous expenditures—think Sears v. Wal*Mart).9. Systemic IS/IT is worse—links between docs, insurers, providers, patients.10. ELECTRONIC MEDICAL RECORDS …TO UNIFORM STANDARDS. (NOW.) 11. THE WEB WILL LIBERATE. (Info = Power.) 12. 80M BOOMERS RULE. ($$$$$. Desire for c-o-m-p-l-e-t-e CONTROL. NOW. “LEADERSHIP” OF AGING PROCESS.)13. “Drug Discovery” processes at Big Pharma are … hopelessly over-complicated. (???: Bye Bye … Big Pharma.)14. 90% of the “healthcare fix”: HARVEST THE LOW-HANGING FRUIT. “They” are … NOT … the Enemy. “I have seen the enemy … and it am me.” Damn it.

HealthCare21 (Cont.)15. The number of U.S. un-insured is the nation’s #1 disgrace. That said, insured “consumers” are spoiled brats. They/we/me act as if healthcare were a free good … and believe that an incipient hangnail calls for at least a CAT scan … or two. ANSWER: MAKE US FEEL THE PAIN.16. Genetic engineering & biotech change … EVERYTHING. (Within 15 years.)17. New Medical Devices change … EVERYTHING. (Within 15 years.)18. IS/IT changes … EVERYTHING. (Within 10 years.)19. New Docs change … EVERYTHING. (Within 10 years.)20. New Patients change … EVERYTHING. (Within 5 years.)

HealthCare21 (Cont.)

21. ALL THIS = ENORMOUS OPPORTUNITY. The

Opportunity of Several Lifetimes. (For the Bold & Brave.) H’Care WILL be … TOTALLY … re-invented in the next two decades. (And, hey, it is our largest “industry.”)

7. Doing It RightPlanetree: A Radical

Model for New Healthcare/Healing/Wellness Excellence

“It was the goal of the Planetree Unit to help patients not only get well faster but also to stay well longer.” —Putting

Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

The 9 Planetree Practices

1. The Importance of Human Interaction2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information3. Healing Partnerships: The Importance of Including Friends and Family4. Nutrition: The Nurturing Aspect of Food5. Spirituality: Inner Resources for Healing6. Human Touch: The Essentials of Communicating Caring Through Massage7. Healing Arts: Nutrition for the Soul8. Integrating Complementary and Alternative Practices into Conventional Care9. Healing Environments: Architecture and Design Conducive to Health

1. The Importance of Human Interaction

“There is a misconception that supportive interactions require more staff or more time and are therefore more costly.

Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget.

Kindness is free. Listening to

patients or answering their questions costs nothing. It can be argued that negative interactions—alienating patients, being

non-responsive to their needs or limiting their sense of control—can be very costly. … Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring

far more time than it would have taken to interact with them initially in a positive way.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel

Press Ganey Assoc/1999: 139,380 former patients from 225 hospitals

0 of top 15 factors determining Patient Satisfaction referred to patient’s health outcome

PS directly related to Staff Interaction

PS directly correlated with ES (Employee Satisfaction)

Mgrs re staff: wages, security, promotion opportunities

Staff re staff: interesting work (M:5 of 10), appreciation (5 of 10), sense of being “in” about

what’s going on (10 of 10)

“Planetree is about human beings caring

for other human beings.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel (“Ladies and gentlemen serving ladies and gentlemen”—4S credo)

2. Informing and Empowering Diverse

Populations: Consumer Health Libraries and

Patient Information

Planetree Health Resources Center/1981Planetree Classification System

Consumer Health LibrariansVolunteers

Classes, lectures (CR)Health Fairs

Griffin’s Mobile Health Resource CenterOpen Chart Policy

Patient Progress NotesCare Coordination Conferences (Est goals, timetable,

3. Healing Partnerships: The

Importance of Including Friends

and Family

“When hospital staff members are asked to list the attributes of the ‘perfect patient and family,’ their

response is usually a passive patient with no family.” —Putting Patients First,

Susan Frampton, Laura Gilpin, Patrick Charmel

The Patient-Family Experience

“Patients are stripped of control, their clothes are taken away, they have little say over their schedule, and they are deliberately separated

from their family and friends. Healthcare professionals control all of the information

about their patients’ bodies and access to the people who can answer questions and connect

them with helpful resources. Families are treated more as intruders than loved ones.”

—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

“Family members, close friends and ‘significant others’ can have a far

greater impact on patients’ experience of illness, and on their

long-term health and happiness, than any healthcare professional.” —Through

the Patient’s Eyes

“A 7-year follow-up of women diagnosed with breast cancer

showed that those who confided in at least one person in the 3

months after surgery had a 7-year

survival rate of 72.4%, as compared to 56.3% for those who

didn’t have a confidant.”Institute for the Future

Care Partner Programs (IDs, discount meals, etc)

Unrestricted visits (“Most Planetree hospitals have eliminated visiting restrictions altogether”) (ER at one hospital “has a policy of never

separating the patient from the family, and there is no limitation on how many family members may be present,.”)

Collaborative Care ConferencesClinical Guidelines Discussions

Family SpacesPet Visits (POP: Patients’ Own Pets)

4. Nutrition: The Nurturing Aspect

of Food

Meals are central events

“There, you’re fed.”*

*Irony: Focus on “nutrition” has reduced focus on “food” and “service”

Aroma therapy (e.g., “smell of baking cookies”)

5. Spirituality: Inner Resources for Healing

Spirituality: Meaning and Connectedness in Life

1. Connected to supportive and caring group2. Sense of mastery and control3. Make meaning out of disease/find meaning in suffering

Griffin: redesign chapel (waterfall, quiet music, open prayer book)

Other: music, flowers, portable labyrinth

6. Human Touch: The Essentials of Communicating

Caring Through Massage

“Massage is a powerful way to communicate caring.” —Putting Patients

First, Susan Frampton, Laura Gilpin, Patrick Charmel

7. Healing Arts: Nutrition for the Soul

Planetree: “Environment conducive to healing”

Color!Light!

Brilliance!Form!Art!

Music!

Griffin: Music in the parking lot; professional musicians in the lobby

(7/week, 3-4hrs/day) ; 5 pianos; volunteers (120-140 hrs arts & entertainment

per month).

8. Integrating Complementary and

Alternative Practices into Conventional Care

Griffin IMC/Integrative Medicine Center

MassageAcupuncture

MeditationChiropractic

Nutritional supplementsAroma therapy

9. Healing Environments: Architecture and

Design Conducive to Health

“Planetree Look”

Woods and natural materialsIndirect lighting

Homelike settings

Goals: Welcome patients, friends and family … Value humans over technology .. Enable patients to participate in their care … Provide flexibility to

personalize the care of each patient … Encourage caregivers to be responsive to patients … Foster a

connection to nature and beauty

Access to nurses station:

“Happen to”vs.

“Happen with”Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Conclusion: Caring/Growth “Experience”

Care!Control!Connect! Engage!Grow!

De-stress!

8. Tom’s

HealthCare2

Healthcare’s 1-2 Punch

1. Hospital “quality control,” at least in the U.S.A., is a bad, bad joke. Depending on whose stats you believe, hospitals kill 100,000 or so of us a year—and wound many times that number. Finally, “they” are “getting around to” dealing with the issue. Well, thanks. And what is it we’ve been buying for our Trillion or so bucks a year? The fix is eminently do-able … which makes the condition even more intolerable. (“Disgrace” is far too kind a label for the “condition.” Who’s to blame? Just about everybody, starting with the docs who consider oversight from anyone other than fellow clan members to be unacceptable.)

2. The “system”—training, docs, insurance incentives, “culture,” “patients” themselves—is hopelessly-mindlessly-insanely (as I see it) skewed toward fixing things (e.g. Me) that are broken—not preventing the problem in the first place and providing the Maintenance Tools necessary for a healthy lifestyle. Sure, bio-medicine will soon allow us to understand and deal with individual genetic pre-dispositions. (And hooray!) But take it from this 61-year old, decades of physical and psychological self-abuse can literally be reversed in relatively short order by an encompassing approach to life that can only be described as a “Passion for Wellness (and Well-being).” Patients—like me—are catching on in record numbers; but “the system” is highly resistant. (Again, the doctors are among the biggest sinners—no surprise, following years of acculturation as the “man-with-the-white-coat-who-will-now-miraculously-dispense-fix it-pills-for-you-the-unwashed.” (Come to think of it, maybe I’ll start wearing a White Coat to my doctor’s office—after all, I am the Professional-in-Charge when it comes to my Body & Soul. Right?)

07.03: 60/264/180/145-85/14010.04: 61/195/092/097-60/058

Off …

Univasc (<1/2)BextraLipitorToprol

Propranolol

Determinants of Health

Access to care: 10%Genetics: 20%

Environment: 20%

Health Behaviors: 50%Source: Institute for the Future

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