The ABC Medical Home - Creating a Culture for Success

1. The ABC Medical Home - Creating a Culture for Success Catherine A. Alder, JD, MSW Project Manager, CMS Innovation Award – Dissemination of the Aging Brain Care Program Chief Administrator – Aging Brain Care Wishard Health Services

2. Organizational Culture • Definition • Origin • Change • Culture of ABC Med Home • Visible/Invisible • What’s Working • Areas for Improvement • Change Vision • Feedback

3. What is Organizational Culture? • 1930 Hawthorne studies at Western Electric Company • First systematic attempt to use concept of “culture” to understand the work environment • Hawthorne Effect • Common threads and properties have emerged from social research examining the concept: • Shared • Learned • Affected by environment and history • Adaptive • Integrated • Includes both what people do and what they think

4. Components of Organizational Culture • Group norms of behavior (visible) • Underlying values, attitudes, assumptions, and beliefs that keep the norms in place (invisible) • The Key to Changing Organizational Culture – • Forbes (September 27, 2012)

5. Where Does Culture Come From? • “Culture usually comes from the values and behaviors of the founders or leaders of the organization. For whatever reason, they value certain things and behave in ways that seem to help the group succeed.” • Conscious • Unconscious • The Key to Changing Organizational Culture – • Forbes (September 27, 2012)

6. “How does culture change? A powerful person at the top, or a large enough group from anywhere in the organization, decides the old ways are not working, figures out a change vision, starts acting differently, and enlists others to act differently. If the new actions produce better results, if the results are communicated and celebrated, and if they are not killed off by the old culture fighting its rear-guard action, new norms will form and new shared values will grow. The Key to Changing Organizational Culture – Forbes (September 27, 2012)

7. ABC Medical Home at WishardHealth Services • Staff (23.4 FTEs) • 1 Medical Director • 1 Program Manager • 2 Social Worker Care Coordinators • 3 Nurse Practitioner Care Coordinators • 16 Care Coordinator Assistants • 1 Data Office Specialist • 1 Site Coordinator • Space on the 6th Floor • Social Worker Office • Nurse Practitioner Office • 2 Work Rooms with “Drop Down” Space • Conference Room

9. Current Culture of ABC Medical Home BEHAVIOR FLEXIBILITY ADAPTIVENESS RESOURCEFULNESS INDIVIDUAL STAFF MEMBERS ARE DOING AMAZING WORK! Better Teamwork Better Conflict Resolution UNDERLYING VALUES/ATTITUDES/ ASSUMPTIONS/BELIEFS RESPONSIBILITY DEDICATION TO MISSION AND PATIENTS! Growing Confidence in Self and Colleagues Comfort with Uncertainty Program Ownership

10. Change Vision for ABC Medical Home • People gathered (talking, relaxing, working alone or together) • Diversity (children, college students, workers, retired people) • Lighting and tables (facilitates conversation), smell of coffee • Friendly, accomodating staff (know customers by name) • Personalized service • Environmentally Conscious

11. Starbucks Culture and Values • Focus on Diversity and Customer Service • Not a franchise • Diverse sites and customer base • Management execs regularly visit stores to insure quality • Customer feedback regularly solicited • Flatter Organizational Structure • Streamlines information flow from customer to employees and from employees to management • Leads to more efficient and effective strategy

12. Social Networking • Vehicle for customer input • Creates open forum for discussion • Employee Relations • Open communication encouraged • Each employee valued as a partner • Managers visit frequently • Organizational Ethics • Mission statement is filter for decision making • Employee training includes review of mission and vision • Employees share in “Starbucks” experience • Promoting Corporate Citizenship (Shared Planet)

13. Questions Is Starbucks culture the “right” culture for the success of the ABC Medical Home? How do we change the culture of the ABC Medical Home?

14. Acknowledgements Malaz Boustani Ann Cottingham Michael LaMantia Kathy Frank Mary Austrom Deb Litzelman John Bedoya Lee Livin Chris Callahan Chris Steinmetz The staff and patients of the ABC Medical Home at Wishard Health Services and IU Health Arnett