“Working harder or longer is not the solution. We need new models of care.” Said Maureen Bisognano, President and CEO of Institute for Healthcare Improvement.  

  • You can transform healthcare leadership at three different levels
  • Make a different to the patients' journeys
  • Focus on innovation and creating new care models as as team
  • Lead the change from a system level

At her keynote address at the Singapore Healthcare Management Congress 2015, Ms Bisognano, a prominent authority on improving healthcare systems, shared insights on how to transform leadership at three different levels in healthcare, which will lead to transformational change.  

Leading at Patient Level

Jess was a little girl being treated in a hospital in Massachusetts for a bleed in her brain.   When Ms Bisognano visited her ward, she witnessed how the medical team planned a holistic care plan for Jess. Every day, a group of people came - doctor, nurse, therapist, even housekeeping.  

The first thing that the doctor asked was what the Jess was worried about (she said, the pain in her head).   The team then planned the day to make Jess pain free around her schedule (lunch, play time, what she wants for breakfast) and her family’s (when the mother will be home from work, which family members are visiting).

The hospital conducts such rounds daily with the patients, their family and the care team.   They impose no limited visiting hours so that they can bring in the asset of family support to the care experience.  

Jess’ story illustrates how leading at the patient level can be done – by doing rounds that start with the patient in mind, and by understanding where the patient and family come from and where they are going.  

Asking the right questions to the patients can make a huge difference in their care experience.

Instead of just asking “What’s the matter?”, the care team can find out more about the patient by asking “What matters to you?” and “What will make your day?”.  

Leading at Team Level

Team-based care is seen as critical in delivering efficient care to patients.   But it doesn’t stop there. Cincinnati Children’s Hospital Medical Center conducts daily huddle that involves everyone – from doctors to security – to think about how they can make the day better.

ThedaCare in the US has taken the concept further to implement a team admission process where all patients are admitted with a doctor, a nurse and a pharmacist.   This has resulted in reduced cost, shorter length of stay, less errors, and increased patient satisfaction.   

At the team level, focus on innovation and creating new care models is essential to bring transformational change.

To facilitate innovation, Maureen introduced the term “Exnovate”: doing off with things that add no value to your work, which can up time to innovate.

She also shared the principle of “see, solve, and share” - empowering other members of the team to solve the problem once a solution has been found, reducing repetitive work because only one individual can solve that one problem.  

Underlining all these, is curiosity. There are ways to measure a person capability to innovate – IQ, EQ, “But, “ Ms Bisognano said, “my judgement falls on CQ – Curiosity Quotient.”  

Leading at System Level

On top of addressing problems in a department, the patient journey need to be seen from what they are like before admission to what conditions they are at home after discharge.   Ms Bisgonano shared examples from NHS Scotland where every healthcare worker can see their place in the system map, which has helped improved safety significantly.

Similarly in NASA, a system map points out every safety challenges and requirements at every point of a mission.  

Ms Bisognano concluded the session by emphasising that everyone in healthcare need to join hands to bring change. She quoted an African proverb:

“If you want to go fast, go alone. If you want to go far, go together.”