Unlocking the healthcare growth mindset - Philips (PDF)

Unlocking the healthcare growth mindset Why Hospital Operations innovation has never been more important and how small mindset changes can have a big impact Services and solutions delivery Operational Intelligence  2 3 “There are two main mindsets we can navigate life with: growth and fixed. Having a growth mindset is essential for success. It’s also key to transformation and so if we want to transform healthcare, we need to look at our individual mindsets, their role in our motivation and self-regulation, and their impact on achievement and interpersonal processes.” Dawn Bruce, Services & Solutions Delivery Leader, Canada Healthcare Growth Mindset | May 2021 May 2021 | Healthcare Growth Mindset Transformation is a term that is synonymous with healthcare and yet all too often the mere mention of word strikes fear in our hearts. Fear that healthcare is so complex and fragmented that we’ve failed at change before we’ve even started, or perhaps fear because the solution is so often outsourced to technology and ignores the fact that value-based transformation, while enabled by process and technology, can only be enabled by an intangible and inconsistent element: people. Strategies are lofty, solutions are many and yet few discussions around the pursuit of successful healthcare transformation pay more than lip service then to the psychology of its key players and the importance of believing that change is possible. A pioneer in the importance of believing that improvement is possible, American psychologist and professor at Stanford University, Carol Dweck has found that humans approach a challenge with either a fixed or a growth mindset. In a fixed mindset we believe our talents and abilities are fixed, we are who we are. In a growth mindset, by contrast, we believe there is always room for improvement. In a fixed mindset, feedback about suboptimal professional performance is threatening as it confronts ourselves with our own shortcomings. In a growth mindset, feedback is a gift, as it helps us to further develop. Recent advances in neuroscience go even further, revealing that the brain is far more malleable than we ever knew. Research into brain plasticity has shown how connectivity between neurons can change with experience. With practice, neural networks grow new connections, strengthen existing ones, and build insulation that speeds transmission of impulses. These neuroscientific discoveries have shown that we can increase our neural growth by the actions we take, such as using good strategies, asking questions, practicing, and following good nutrition and sleep habits. Why Hospital Operations innovation has never been more important and how small mindset changes can have a big impact I can get smarter Learning is my goal Effort makes me stronger I’d spend more time & work harder Higher achievement  4 5 Healthcare Growth Mindset | May 2021 At the same time that these neuroscientific discoveries have been gaining traction, researchers have also started to explore and better understand the link between mindsets and achievement. It turns out, if you believe your brain can grow, you behave differently. This supposition has resulted in numerous interventions and studies that prove that we can indeed change a person’s mindset from fixed to growth, and when we do, it leads to increased motivation and achievement . Healthcare transformation is perhaps the ultimate mindset challenge; an industry where complex change is required and yet even the best hospitals have a work culture that is populated with setbacks, challenges and hierarchy and constraints. As the Harvard Business Review has reported in its article, ‘Positive intelligence’, “research shows that when people work with a positive mind-set, performance on nearly every level – productivity, creativity, engagement – improves.” New research from MIT also bears this out. In fact breakthrough research by a team at MIT’s Picower Institute for Learning and Memory has documented one type of environmental feedback that triggers plasticity: success. Equally important and somewhat surprising: its opposite, failure, has no impact. Is a positive mindset, then, perhaps a missing factor in achieving the Quadruple Aim in healthcare? Professor Jill Klein of the University of Melbourne believes so and has written that many clinical settings are characterized by factors that promote a fixed mindset, like competitiveness and a focus on talent rather than shared learning. And so how do we unlock the growth mindset of healthcare transformation? Improved patient experience Improved staff experience Better patient outcomes Lower cost of care + Positive mindset May 2021 | Healthcare Growth Mindset Two mindsets: Carol S Dweck, PhD Fixed Mindset Intelligence is static As a result, they may plateau early and achieve less than their full potential. All this confirms their deterministic view of the world Growth Mindset Intelligence can be developed As a result, they reach ever-higher levels of achievement. All this gives them a sense of free will Challenges Avoid challenges Obstacles Give up easily Effort See effort as fruitless or worthless Success of others Feel threatened by the success of others Challenges Embrace challenges Obstacles Persist in the face of setbacks Effort See effort as the path to mastery Success of others Find lessons and inspiration in the success of others Leads to a desire to look smart and therefore tendency to... Leads to a desire to learn and therefore a tendency to... The Quadruple Aim in Healthcare and a positive mindset Is a positive mindset needed to unlock healthcare transformation?  Get Operational. Educating for and embedding change starts in Operations The growth mindset model: Operational Intelligence Healthcare Growth Mindset | May 2021 May 2021 | Healthcare Growth Mindset Canadian Services & Solutions Deliver leader at Philips and a passionate advocate of people-powered change, Dawn Bruce believes that a great place to start is in Operations, the backbone but also the brain of a hospital and where a range of departments and disciplines come together and where strategic and structural change can be most effective. In fact Operations, she believes, has the ability to be the driver of change if it can build the new capabilities and behaviors that modern healthcare needs. This is why she and her teams have worked with healthcare partners to develop a methodology and mindset – known as Operational Intelligence - for operational innovation that helps facilitate the change management required to break down silos, embed new ways of working alongside process and technology to help make transformation stick. To hone and develop the approach, the team took a step back and returned to the essence of healthcare: its people. Informed by the belief: “at the end of the day, care is a human activity. Technology is not there to replace caregivers, it is there to support them”, the team sought to prioritise people in their model and also to incorporate disruptive thinking, including game theory but also smart simplicity as first identified by Yves Morieux. Operational Intelligence then takes a holistic approach to integrating people, process and technology and is an integrated, service-based healthcare model with a focus on behavioral change to connect silos and build relationships to optimize planning, alignment and outcomes. The operational Intelligence approach is now being employed across all long term strategic partnerships – many of which span 10 – 15 years and are millions of dollar investments – and yet these successes all hinge on an intangible and invisible truth; the need to prioritize equipping people for success if we are to successfully pull off innovation and accelerate affective and lasting healthcare transformation. And while the big ticket items are often covered, Dawn Bruce encourages us to consider the value of applying a growth mindset in Operations, starting with 3 simple starter suggestions to affect change and build the resilience to enable and embed it. “Organizations should embrace an environment in which employees can work with one another to develop creative solutions to complex challenges.” Yves Morieux “Care is a human activity. Technology is not there to replace caregivers, it is there to support them.” Dawn Bruce, Philips Services & Solutions Delivery Leader, Canada. 4. Im pl e m en t op er at in g & tr ac ki ng c ad en ce 3. Cr ea te e m po we re d te a ms 2. Se t KP I- dr iv en q ua rt er y go al s 1. Id en tif y KP Is & k ey d ri ve rs Technology People Operational Performance Process 6 7  Healthcare Growth Mindset | May 2021 May 2021 | Healthcare Growth Mindset 3 key ways to unlock a growth mindset in Operations 2 Pursue a new Procurement mindset – Literally, thinking ‘out of the box’ Rethink Governance – From closing down to opening up innovation As health technology companies continue to partner with healthcare systems to develop solutions, a blocker to integration can be procurement, as often existing procurement processes and models are designed to purchase single items of equipment – a CT scanner for example - rather than tender for wider, more integrated, vendor neutral solutions. Dawn Bruce explains: “An Operationally Intelligent approach to procurement could, instead, help procurement experts to explore ways of unlocking more value by disrupting their approach. Procurement could instead focus not only on the price of a particular product or service but also on the overall value the solution could create, to encourage more collaborative tender approaches.” According to reports, the Dutch Healthcare Authority is advancing this type of value-based contracting as a central concept throughout the Dutch health care supply chain, in tandem with the shift toward outcome- based health care. Denmark is also considering how to standardize health technology procurement while other countries, such as Ireland, are reported to be moving away from lowest price procurement. The challenge here is to help procurement teams harness this new mindset and build the appropriate expertise and infrastructure to measure patient-relevant outcomes and total cost of care in order to demonstrate the real-world quantitative and qualitative benefits over traditional procurement methods. Similarly, procurement incentives should align with long-term value, rather than with just the upfront purchase price or financial rewards for hitting short-term budget targets. Instead of being a starting point for risk, worry and closed thinking, however, Dawn Bruce believes – from experience – that a modern, innovated governance model is central to the formation of any good relationship and is integral to realising change management. When embarking on a new external relationship, framing the governance process and adopting an innovative model from the start can make or break relationships, priming for success rather than failure. Dawn Bruce explains: “Many external partners will come to a healthcare organization and say, ‘we will do this for you and the process is this. The card is marked, the field is set before the match has even started.’ And yet operational challenges can’t be solved off the shelf. This is where a different approach to partnership comes into play which starts with a new approach to governance. An operationally intelligent governance model and process opens conversations within the context of a confidentiality wall, provisional guidelines and the like, but also enables both partners to be less transactional and more solutions focused and coaching. An innovated governance approach becomes a virtuous circle of continuing learning and optimization.” 1 8 9  10 Healthcare Growth Mindset | May 2021 3 Integrate Clinical, IT and Operations – “Great teams think unalike” While Operational teams may have more exposure to responsible business and disruptive innovation practices, clinical and IT teams can tend to be siloed. IT professionals can feel disconnected from the delivery of care while studies highlight that clinical hierarchies can isolate clinicians from communication. In fact, in the opening address of the 2018 BMJ/IHI International Forum on Quality and Safety in Healthcare in Amsterdam, Wim Helbing, highlighted this problem stating, “I’ve been a professor in a university hospital, leading one of the largest departments in the university children’s hospital. I never get any feedback.” Dawn Bruce explains: “Clinical and IT teams within hospitals come from different worlds, talking different languages and with completely different objectives and goals. Interoperability isn’t just about getting technology, from PACs systems to telemetry and patient monitoring, talking, it’s about breaking down siloes within the hospital. Bringing together multi-disciplinary teams lets specialists and generalists learn from each other and solve from a 360 degree perspective. Multidisciplinary teams is a way of working that is so successful that many papers, including NICE guidelines, have been written on the subject, outlining how working this way limits adverse events, improves outcomes and contributes to patient and employee satisfaction . And yet, it’s often under utilized in healthcare. If brought together effectively, people who think differently have a lot to contribute to one another.” In his book Rebel Ideas, the innovation expert Matthew Syed highlights that times of unprecedented change demand a need to think differently. He argues that solving of complex problems can sometimes only be achieved by assembling a group consisting of different- minded people and then getting the group to work on the difficulty using each individual’s particular talents to provide some part of the solution. By combining different perspectives, insights and thought processes, sometimes even the most challenging of obstacles can be overcome. What the author refers to as ‘cognitive diversity’, i.e. diversity in the way a problem is looked at, the usefulness of any pre-existing knowledge of the problem and the thought processes that could be used to solve the problem, highlights the importance of bringing together people who think differently, such as clinicians and IT technicians to break down the invisible and visible barriers within healthcare systems. It’s a belief backed up by Sara Canaday writing in Psychology Today who observed that, “a culture that encourages (explicitly or implicitly) conformity of thought breeds stagnation and imperils a company [or organization] .” Adopting an operationally intelligent way of working helps to make sure all perspectives and voices are allowed into the discussion and given equal consideration, including those whose voices are usually absent. Groupthink creates pseudo-harmony and leads to serious errors. To counter this, forge multidisciplinary teams and invite challenge from the ‘unusual suspects’. Embracing a growth mindset is key to healthcare transformation not least in terms of enabling its disparate workforce to believe that change is possible but also to have the resilience to realize it. This is especially vital since research indicates that resilience, originally studied in young children suffering major traumatic events, is an essential quality in healthcare and that for an environment to facilitate resilience it needs to be both high in challenge and support. It’s a quality that has never been more in demand, as Dr Helen McGill, Medical Director and Responsible Officers, NHS Professionals, has recognized stating: “Resilience is needed in the NHS now more than ever – at an individual, organisational and systemic level. We all need to work together to prepare for, respond to and adapt to both ongoing change and major unexpected disruptions. This is not just about surviving, it’s about minimising crises and identifying improvements, both personally and professionally .” May 2021 | Healthcare Growth Mindset 11  © 2021 Koninklijke Philips N.V. All rights reserved. Specifications are subject to change without notice. Trademarks are the property of Koninklijke Philips N.V. or their respective owners. 0000 000 00000 * JuN 2021 How to reach us Please visit www.philips.com [email protected] Interested to learn more? Lets talk. Even better, lets collaborate We’d love to help you apply Operational Intelligence to help solve your key people, process and technology challenges. For more information, please visit https://www.philips.com/operational-intelligence