Wednesday, June 24, 2009

Culture and Quality Part IV

A couple months ago (April 4) I began writing a series that I entitled Culture and Quality. As the conversation has evolved a new model has emerged. We have entitled it the: Diversity HealthWorks' Cultural Competence-Quality Framework for Healthcare Excellence.

The premise of the model is based on what we have seen over the past year in the diversity dialogue in all industries including healthcare: contraction and a general lack of cohesion about the future of what diversity and inclusion can be and/or needs to be in our corporations and organizations. We simply have not elevated the idea of diversity to that of a core business function that is unquestionable.

Now of course there are exceptions to this rule, but overwhelmingly, most people/companies frame diversity and inclusion as "causes" that they are committed to. Historically, the framing of what I call cause-oriented diversity and what it stands for have been absolutely necessary. To this day, this remains true. Nonetheless, herein lies the conundrum:

1. If diversity is more cause-oriented how does it line up next to other core business functions such as marketing, sales, fulfillment, and all related measures assessing core functions?
2. What if the "cause" of diversity is not held in at a steady level of urgency like other core business functions?
3. Since by their nature causes change--does diversity change or even potentially go away?

No matter how we answer these questions, and I am sure we could (and have) discuss each from different perspectives for days, the fact remains that if a cause-oriented diversity leaning is perceived as the norm, inevitably someone or some group can claim or feign that they are not accountable.

On the other hand, there is Quality. What about quality? Quality is. . .
--Unquestionable
--Valued
--Measurable
--Historical; and
--It is ALWAYS in the budget!

You will never hear any one say out loud that quality is something that is "nice to have but not a need to have". Quality is at the foundation of every organization in one capacity or another. Even if the ambition of delivering the "highest quality" of this, that, or the other is not yet realized, the ambition and possibility remain prevalent.

Healthcare is no exception. In fact, quality is at the core of how healthcare gets done. The President has made this very clear as the conversation about health reform has escalated. In virtually every address he has done around healthcare over the past 2-3 months he has talked about quality. On May 11th, in one of his speeches he said:

"I'm also committed to ensuring that whatever plan we design upholds three basic principles: First, the rising cost of health care must be brought down; second, Americans must have the freedom to keep whatever doctor and health care plan they have, or to choose a new doctor or health care plan if they want it; and third, all Americans must have quality, affordable health care."

This is a mandate that all of us can sign on to. Whether we are conservative or liberal, for or against universal healthcare, feel that healthcare is right or a privilege, quality, affordable, [accessible] care is something we can all agree is a priority.

So how does cultural competence fit in? Two answers:

1) Many hospital organizations have undergone culture change/quality initiatives driven by the likes of greats such as the StuderGroup or the work of Fred Lee (If Disney Ran Your Hospital). Some have had tremendous success, while others less so. Few have made culture change and competent culture evolution something they would consider embedded into how they do what they do each day or more so an ongoing discipline that is cultivated by leaders and cascaded down through the organization.

I hold that it is not because they don't want to. I fundamentally believe that it is because the culture change and quality efforts are not integrated with and inclusive of all of the facets of the organization. In particular many times the not included is the myriad diversity of employees, patients, families, and the greater community that make up WHO the hospital is as well as performs the functions of what it does.

So, I believe that there are cultures within culture change and that we have to develop and evolve our competence in these cultures within an organizational culture to assure continuous quality improvement.

2) We have created a model to discuss these dynamics and we want to share with you in a series of free web seminars. On July 1st and July 8th we will host two free web seminars to share the DHW Cultural Competence-Quality Framework for Healthcare Excellence.

The July 1, 2009 event will be for Diversity HealthWorks members only. If you register for this event and you are not a member of Diversity HealthWorks, you will not receive a confirmation link to the event. Membership however is free. So, if you are not yet a member and want to see a demo of the model and have the change to comment, Join Us.

The July 8, 2009 event is open to anyone interested. We look forward to seeing you on-line.

To register for the July 1, 2009 Free Web Seminar Click the Link Below:
DHW Cultural Competence-Quality Framework for Healthcare Excellence--July 1

To register for the July 8, 2009 Free Web Seminar Click the Link Below:
DHW Cultural Competence-Quality Framework for Healthcare Excellence--July 8


We hope to see you as we share this integrated framework with all who are interested.

Make it a great day!

Friday, June 19, 2009

Draft Summary on Health Reform Bill from the House Ways and Means Committee

This summary released June 19, 2009 gives an overview of the provisions intended as part of the bill. Read it and know that the actual draft of the bill will have layers of stuff that is both reflective and not so reflective of the summary. I hope that people actually read it before they go about criticizing it.

Transparency has been a mantra out of the Obama administration and we have to consistently hold them accountable to this. So far, I have felt like they have done what they said they were going to do. This means we should trust them to continue, but not depend on it so that we become complacent.

Draft Health Care Reform Bill Summary

Make it a great day!

Monday, June 15, 2009

Expanded Jobs, Streamlined Tools at IMDiversity.com

The IMDiversity.com Career Center and Multicultural Villages network are migrating to a new jobs database and tools format this month, featuring expanded network jobs listings in healthcare and other other sectors, as well as streamlined tools for creating a custom job tools account, searchable resume, and personalized email job alert agents. We invite diverse jobseekers to visit the beta at http://jobsearch.imdiversity.com.

Special Note for Existing Users: Please note that those who previously created accounts on IMDiversity's former jobs site will still be able to access their tools, resumes, and application histories for a brief time during the transition at http://jobs.imdiversity.com. However, as of June all new healthcare openings will now be posted on the new job bank, and all users are urged to create a new account at http://jobsearch.imdiversity.com/jobseeker/create as soon as possible. (Please note that your old username and password will NOT work on the new system.)

Following the final release, we will be restoring many of the additional quicksearch tools on the IMDiversity.com Healthcare Careers and Readings Channel at http://www.imdiversity.com/healthcare.asp.

Thursday, June 11, 2009

Minority Politicians and Health Disparities: The Messenger, the Message

In 2002 the Institute of Medicine through the actions, concern and political will of the minority caucuses of the U.S. (primarily House Democrats)making a request to the National Academy of Sciences to create a comprehensive report (Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care) on ethnic and racial disparities that has become one of the definitive if not the most definitive report on health disparities that has ever been published.

The publications created a foundational conversation that, as I have shared before in other writings, politicized the issue and raised the level of the conversation. This has been a very good thing.

However, what has not happened is a moving of the health disparities conversation from a single-faceted issue to one that is central to the success of our healthcare system and to the overall success of health reform.

Quality accessible healthcare, cultural competency, eliminating disparities, workforce diversity, patient-centered care and many other aspects of what one would consider successful outcomes of healthcare organizational excellence are all necessary to consistently make successful outcomes a reality.

Now, more so, than perhaps any other period in recent history is time to align our message and enroll messengers to deliver it consistently.

So, on Monday(6/8)there was a flurry of activity in the media announcing that the Congressional Black Caucus (CBC) sent President Obama a letter outlining their desire to assure that health disparities are a core issue in the health reform conversation. They had a meeting about this and subsequently, Health and Human Services Secretary Sebelius published a report (I say a Brief) entitled Health Disparities: A Case for Closing the Gap that outlined some of the pertinent health disparities issues connoting a need for the issue to be addressed comprehensively as part of health reform. It was published on HealthReform.gov.

I agree with the need to focus, who wouldn't. However, I am concerned by two things in particular:

1) The Messenger. Health disparities is a very broad and complicated issue. Even though racial and ethnic disparities are very prevalent and have been central to the issue, what we are facing is much bigger. We are facing the dynamics of access combined with multiple populations that are vulnerable to adverse health outcomes regardless of accessibility of services and not because of their race or ethnicity.

HEALTH DISPARITIES IS AN ISSUE THAT IMPACTS ALL AMERICANS.

So, my concern is that the messenger is generally minority. This is not a bad thing, someone has to say something. The challenge is that when the CBC and other minority caucuses are the predominant leaders in this conversation about how to make health disparities a part of the overall health reform agenda, the issue settles consciously or unconsciously in many of our minds as an issue that they are responsible for. An issue that is all about them.

By not consistently engaging and enrolling a variety of groups such as representatives from the Lesbian, Gay, Bisexual, and Trans-gender communities, the disabled, veterans, non-minority women, and others we miss the opportunity to frame health disparities, health equity, and cultural competency as an issue that simultaneously is inclusive of and transcends "minorities". It is an issue that affects everyone living in the U.S. directly or indirectly.

2) The Message.
--What is framework for the health disparities conversation within the context of health reform?
--What does it need to be?
--As a health professional or other professional, if you believe that addressing health disparities, quality affordable/accessible care, cultural competence, patient-centered care are important: How do you articulate their interdependence? (more)

Thursday, June 4, 2009

Beware of Half Truths about Healthcare Reform

That a lie which is half a truth is ever the blackest of lies;
That a lie which is all a lie may be met and fought with outright;
But a lie which is part a truth is a harder matter to fight.
-- Alfred Tennyson Tennyson


I could write for 2 hours about the many articles that I have read that give a very incomplete, data-lacking, sub-par, politically spun (on all sides) overview of the healthcare landscape along with the possibilities and potential pitfalls of healthcare reform how it is being described to date. I won't bore you or reinforce their political positioning with more links.

This one, I will share because it well represents all that can do harm in terms of the dissemination of incompleteness of information in our society. I wrote a response to one article (there were many half truth/half fiction/anecdotal pieces) and I wanted to share it.

Let's be clear, there is going to be a battle in the reformation of our healthcare system in the U.S. I hope we can at the least share some full truths along the way as we get there.

In response to the blog at Public Plan Facts (loosely used word--"facts")

I am 100% for sharing both sides of a story. From what I have read there is intentionality in the writers for this site, not doing that. The rhetorical argument is one-sided and when citing stats only gives the content that supports your argument "that healthcare reform how we see it is bad for Americans and bad for the country" without presenting information that even edges close to being balanced.

These tactics will not work with the American people any longer. If the 2008 elections have told us anything, the people want to choose not be emotionally cajoled into thinking a particular way or resisting something based on incomplete information.

Say what you feel you need to say. Intentionally omitting important information or spinning the information that is out there is absolutely harmful to people and I hope that your tactics don't cause more harm than good.


Make it a great day!

Wednesday, June 3, 2009

National Healthcare Quality and Disparities Reports and more. . .

Over the past month there have been a few reports released that I felt important to share.

The first is from the Agency for Healthcare Research and Quality, their National Healthcare Quality and Disparities Reports.

This is the sixth year for these studies and given our current ramp up of the healthcare reform conversation, they are probably more important than ever. It will be critical for those who have a voice (that means you!) to make sure that we consistently align healthcare quality with eliminating health and healthcare disparities and leveraging cultural competency to see successful healthcare reform.

Quite simply as I have been sharing the past couple months, cultural competency and quality must be aligned and the elimination of healthcare disparities must be addressed if we are going to in earnest make a difference in the transformation of healthcare in this country. I believe it and I will repeat it over and over again as we get deeper into the health reform dialog.

The other report that was phenomenal comes out of the Canada-based Centre for Research on Inner City Health. They are doing such thoughtful and relevant work and have been doing so for some time. <more>

Monday, June 1, 2009

Getting There from Here: A History of Healthcare Reform from the New Yorker

This is one of the best, if not the best, most well-balanced articles on the realities of healthcare reform that I have read.

It is lengthy, but it hits home as to where we are going, where others have been, and the realities of moving forward with an understanding that there will be necessary hiccups along the way.

Annals of Public Policy: Getting There from Here: newyorker.com

Shared via AddThis

What is your message?

I am learning to be a better presenter. While I present for a living, when using PowerPoint, I know I can share ideas more effectively.

Learning to present with excellence is vital to organizational success. When selling yourself for a new job, selling an idea internally, or doing a sales pitch or presentation for funding, good slide presentations make a huge difference!

While I am preparing to talk to people publicly about Diversity HealthWorks' model on Cultural Competency and Quality, I have come across many good pieces on how to present effectively. This slide show is just one of many.

Use it, present with effectiveness. Know what your message is and what your audience wants/needs. And as always. . .

Make it a great day!