Culture change is hard work. It’s especially hard when it comes as a result of a merger or acquisition, when multiple cultures must be blended together to create a new—and, hopefully, better—set of processes that drive how people work and how the highest level of quality services are delivered. That was the challenge for Hartford HealthCare (HHC), a large integrated healthcare network in Connecticut that had grown through acquisitions in recent years to include five acute-care hospitals, four behavioral health networks, various rehabilitation and senior services, as well as a large multispecialty physician group. Each of these newly acquired facilities, networks, and organizations came with its own processes and systems resulting in care delivery that was not as simple or coordinated as it could be. Combined with advances in technology, changing customer needs, and ever-constant legislative influences it was clear to HCC leaders that change was needed. And in 2012, the organization embarked on a rigorous journey to put technology at the very center of a system-wide initiative. Across the system—from acute care facilities to ambulatory practices and multiple service lines—they set out to make technology a true partner in providing exceptional service to patients and coordinating all aspects of care.
Making the HHC vision personal
At the outset, HHC leadership understood how daunting the challenge was. They understood the importance of connecting this project directly to the organization’s vision: “To be nationally respected for excellence in patient care and most trusted for personalized coordinated care.” They also knew that the vision for this project specifically must be made personal. It had to be about people, to reflect the patients and families the organization is committed to serve. So HHC leadership and key members of the communications team began creating clear and compelling stories about what the future would look like once the multi-year system and process changes were in place. For example, two fictional characters were created to help illustrate the service experience of a current patient (Betty) and that of a future patient (Janet) once the transformation in care delivery had been realized. In the current scenario, Betty contends with a healthcare system that is disjointed, disconnected, frustrating, and confusing. Her chronic health conditions go unmanaged because there is little true care coordination. Janet, on the other hand, experiences the type of care that this project was designed to create: one that is fully connected, that supports the patient and the family with a seamless, timely flow of information and care transitions across the continuum.
Using “Betty” and “Janet” stories, videos and communication materials were created and shared with all staff that showed how a fully integrated service and data model would improve the healthcare they were able to provide for patients. And it worked! People across the system were inspired about the possible future as the hard work of making the vision a reality began.
Epic CareConnect launches Within the year, contributors from across the organization came together to lead the transformation efforts and launch what HHC called the Epic CareConnect project. The CareConnect team was responsible for both technical and organizational goals in bringing all of HHC’s entities onto a single electronic platform for clinical, business, and revenue needs. In addition, they were asked to standardize care, processes, and procedures regardless of where patients encountered services throughout the system. And to keep focused on the end goal—to turn every “Betty” story into a “Janet” story—the team created The Five Ones, representing the ultimate experience they desired for the patients they serve:
- One health record
- One standard of excellence
- One relationship
- One registration
- One bill
Taking the next step in vision development
After more than two years working in the trenches to help lead the transformation and launch Epic CareConnect, two leaders from the project team—Jennifer Lewis, Revenue Cycle Application Director, and Elise Sinha, Acute Care Application Director—felt they needed to recharge their own batteries and find fresh ways to support their teams as the work continued.
The intensity of the work, and the resulting stress, had taken its toll on the project teams. Attrition was on the rise, morale was falling, and people were being worn down by the ongoing challenge. Yet a lot of work remained. With key project milestones looming, Jennifer and Elise were looking for a spark that would help keep their great teams of people on track. They found what they were looking for in The Leadership Challenge.
As part of an Integris-facilitated two-day The Leadership Challenge® Workshop, Jennifer and Elise were particularly intrigued with the Practice of Inspire a Shared Vision. Exploring the commitments and behaviors associated with this important Practice, they came to realize the trouble their valuable but tired teams were having keeping in view the organization’s broader vision—To be nationally respected for excellence in patient care and most trusted for personalized coordinated care—while working so hard to achieve it. The Epic CareConnect team needed a vision of its own, Jennifer and Elise concluded. So they teamed up to create a small ‘v’ vision—one that was more personal, more front-and-center for the team and yet linked directly into HHC’s broader vision.
In creating this new Epic CareConnect team vision, Jennifer and Elise wanted to convey how much they valued their staff and remind them that, although the work was long and hard, it was the why they were doing the work that was so important. They knew that the vision of why the team was created was strong in the beginning of the project, but staff had forgotten as the work got harder, the scope got bigger, and the stakes got higher. After several drafts and feedback from other leaders attending the workshop as well as the workshop’s expert facilitators, Jennifer and Elise’s message to their teams reads:
You make Janet’s story happen.
You make The Five Ones real.
You are the dream makers.
Without this team, those dreams are just ideas and hope.
Like the Disney imagineers, you turn ideas into a technical reality.
You are making healthcare happen in this new model.
You have connected the dots for Janet’s story from inception, design, through build, testing, training and implementation.
We are scaling the summit together.
Betty never had a chance to live the experience, but Janet will.
Thanks to you, soon all our patients will have that experience and can focus on healing, instead of navigating a complex and confusing healthcare system, confident that their caregivers have access to all of their clinical information.
The work you do is so very important.
Upon creating and sharing this vision with their workshop friends, Jennifer and Elise debated how to bring this important vision message back to HHC. How would it be received by the staff and other leaders across the Epic CareConnect team? Despite being unsure of exactly what the reaction would be, Jennifer and Elise were eager to share how reconnecting with the HHC vision and creating a compelling new team vision to share had reenergized them personally for the hard work and challenges still remaining. And they were hoping that in sharing this new team vision they could help lift the rest of the team up as well.
Bringing the team vision home
Jennifer and Elise’s first opportunity to share their vision with others at HHC came soon after returning from their Leadership Challenge workshop experience. At a large staff meeting of more than 140 attendees, they received very positive feedback with one attendee responding that “Your vision made me remember why I took this job.” But presenting at a staff meeting was one thing. The larger challenge was how to make sure that this new vision became part of the daily fiber of the hard work that was still ahead for the staff. Luckily, the project team had recently started daily huddles to improve communication, share recognition, and resolve work barriers. Elise and Jennifer posted the vision statement on the team huddle boards and referenced portions of the statement on a weekly basis. Staff were invited to stop at the board and re-read the vision whenever they were feeling overwhelmed, challenged, or worn out.
By incorporating the vision statement into quick leadership tips for the staff on a weekly basis, Jennifer and Elise made the vision one of the basic tenets of the program, much like The Five Ones and Janet’s story had become for HHC team members. The Epic CareConnect team was now able to not only see the vision, but better connect to the progress made toward realizing it for the healthcare system.
As important as the new vision statement has been to the team, the impact it has had on Elise and Jennifer is also significant. As an outcome of crafting the vision statement, both leaders have new-found energy and inspiration to focus on all aspects of leadership with their teams. They have renewed their attention on staff recognition and engagement, and are now much more solution-oriented with the leadership team in order to improve staff retention and morale. They more frequently find ways to demonstrate how confident they are in the abilities of their staff, their ability to make it over the finish line, and the value this project brings to the community for whom HHC cares. Continuing to Challenge the Process and inviting their teams to do so as well, they consistently focus on making the future of Janet’s story a reality.
The future of integrated healthcare
Thanks to the heroic efforts of the Epic CareConnect team and many others throughout the system, HHC recently rolled out the integrated system to their largest hospitals to great praise. The external consultants working with the organization, for example, remarked that it was one of the smoothest rollouts they had ever seen! And for Jennifer, Elise and their teams, they are gratified to have been able to do their part to make the future a reality and find ways to improve how such a large project could be accomplished going forward.
Evans Kerrigan, a Certified Master-in-Training of The Leadership Challenge is a founder and Managing Partner of Integris Performance Advisors, a consulting company dedicated to increasing the existence of healthy organizations and great places to work. He provides consulting services in leadership, team development, continuous improvement and strategic planning. Evans can be reached at firstname.lastname@example.org.
Jennifer Lewis, Director for Access and Revenue Cycle Applications at Hartford HealthCare, leads a team of analysts responsible for building, implementing, and supporting Scheduling, Registration, Health Information Management, Professional and Hospital Billing systems. Throughout her healthcare career she has held a variety of positions in Training, Information Services, and Revenue Cycle. Jennifer holds a B.A. in Psychology from the University of Connecticut and an MBA from Rensselaer Polytechnic Institute.
Elise Sinha is Director for Acute Care Applications at Hartford HealthCare, leading a team of analysts responsible for designing, implementing and supporting all aspects of inpatient care, including clinical documentation, provider orders and workflows, Emergency Care, Women’s Health and Pharmacy operations. Her healthcare career includes experience as a Critical Care Respiratory Therapist, and in Respiratory Care and Air Medical Transport Management, Organizational Development, and ITS Operational Leadership. Elise holds a B.S. in Respiratory Care and Biology from the University of Hartford and an M.S. in Healthcare Leadership and Integrated Delivery Systems from Rensselaer Polytechnic Institute.