For the context of this interview, please see the accompanying story: Through its “productivity initiative,” Public Health serves more King County residents
“I’m very appreciative of working with such a strong, talented, and multidisciplinary team here at Eastgate where everyone seems to be functioning at a very high level. I appreciate how our staff has come to believe in our site vision of “service with joy and collective success” engrained in our identity of “one team and one mission.”
What was your and your staff’s reaction when these metrics and visual management tools were first suggested?
Initially, the reaction was mixed. We had those who felt the various demands from the central Incident Command Structure (ICS) to get the process started was overwhelming. Off course, there were some skeptics too. Part of this mixed reaction in my opinion was due to the fact that traditionally, the drivers of change and requests for productivity have been driven by budgetary constraints. So for some, it was like “Here we go again.”
What happened when you started to use them?
This time around was indeed different. For the first time we had employees engaged at all levels in data and metrics. The sponsors of ICS communicated very effectively. They consulted staff in ways that were very helpful to achieving staff engagement and ownership.
At each site we had the ability to meet and interpret data ourselves. Each supervisor meets with their program staff and discusses the data when it is released centrally on Wednesdays. For us, we use our Wednesday program meetings to update, review, and engage the different teams. The framing at these meetings is the same as we challenge ourselves with these questions: What is working well? Where are we in relation to target? Are there barriers? How are we doing with regard to program strategies? These have proven to be very successful, especially in our dental program.
At the end of the initial ICS in December 2013, feedback was solicited from all the health centers with regard to the ICS approach so it could be continued in a prolonged and sustained manner. It was through that process that we now have bi-monthly ICS site monitoring check-in calls with CHS administration.
Supervisors for the very first time in my view are now using productivity data to make informed coaching, staffing, and performance management decisions. The level of employee involvement is transformational. I thank the staff at Eastgate for being adaptive. We’ve had a lot of change in the last year.
What do you and your staff think about it now?
The ICS sponsors visited the sites several times to do process walks. That was powerful. They met with staff, watched our processes, and asked questions. It showed our employees a level of commitment and support from leadership as if to say “we’re all in this together.” It demonstrated purpose and shared vision. They have been adaptive: listening and responding. Before, management was more top down. Now it’s more bottom up, which leads to staff ownership. We’ve been able to go from resistance to performance. All the different segments of our matrix structure are on the same page – leadership, program managers, area managers and the front line staff who actually do the work. Lean principles are gaining ground.
In change management terms, we are now past the stage of shock and denial. There is a broad level of acceptance and we are moving forward. Employees now come to supervisors with “I have ideas about how to improve.” Supervisors are coming to their teams and to me with the same thing. Providers are saying, “I’m having open slots this week and I’m not sure why. What can we do about it?” There is a new awareness.
Transparency and communications have been high priorities. That’s made a big difference. Morale is higher than ever now, despite all the changes and uncertainties.
We were part of the enrollment event a few weeks ago and now we’re moving into implementation; we will be going live on Monday (April 28) across all sites. Unprecedented! We have our job aids, everyone’s been trained, and we’ve adjusted processes, in two weeks! That’s transformational.
We need to capitalize on this moment, continuing to provide outstanding service and quality of care to our clients in the context of health care reform and our budget challenges.
The Eastgate team has been terrific and our relationship with labor representatives has been stronger. They’ve all done so much. We achieved all of our health center priorities over the last 12 months such as – but not limited to – electronic health records implementation, the acquisition of patient centered medical home recognition status, expanded hours implementation, healthcare enrollment, and workforce excellence.”