A caring difference you can feel: how Overlake Medical Center has created a culture of caring

Debra L. Glasser, M.D.

PHOTO BY GLORIA TOWNE

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A few columns ago, I wrote about my son’s partner’s experience in Overlake Hospital’s Emergency Dept (ED) in Bellevue.  I felt the care given to her was exceptional in the few short hours I spent with her on 3 West, their new post-ED Short Stay Unit. This was in sharp contrast to how things went for my son in Olympia at Providence St. Peter’s ED a few months earlier.

At Overlake, there was a caring difference I could feel.   

How do they accomplish this?

Ryan Hodges, Senior Public Relations Specialist at Overlake set up a TEAMS meeting for me with 4 of Overlake’s leadership team. One hour with them was enough to get a glimpse of what is special and how they accomplish what they do.  

Creating a CULTURE OF CARING takes COMMUNITY, COLLABORATION, COOPERATION, and COMMITMENT to take the Patient (and Community)-Centered Care Promise seriously.

It starts with the PFAC (Patient and Family Advisory Council)

Tamara Kam, Overlake’s Director of Patient Experience, leads their PFAC. This is a group of staff, physicians, and a diverse group of community members. Each member is required to serve a term of 3 years with the option for two more. To date, everyone has served the full five years because they love making a difference!

The administration not only supports the council’s work; they expect their support. “From the top down, they want our help, and they walk their talk,” says Kam.  After leaving our meeting early, the others piped in to say that Tamara is one of a kind, having produced outstanding results leading this council in her four short years at Overlake.

Here are examples of the PFAC’s involvement:

• Members are ‘embedded’ on hospital committees, which typically are comprised only of staff, and make important hospital policy decisions. Community members have a seat and a voice at the table in the running of hospital departments.
• The Short Stay Unit was co-designed with PFAC’s input.
• After the Unit was opened, it was PFAC’s vision to develop and implement a “Wayfinding” process. They developed a campus map plus training that every staff member takes with the idea that anyone working at Overlake can direct patients and guests to their needed destination.
• It was the PFAC’s idea to create a Patient and Family Brochure for the Emergency Department, guiding patients and families on what to expect with triage, post-triage waiting, and how the ED process works.

Alice Cloutier, RN Nurse Manager of the Emergency Department and 3 West Short Stay Unit, rushed to our meeting from the ED where she had been helping in the unit (which means the manager was ‘getting her hands dirty’ helping with patient care).  It was a Black Surge Day, which means = VERY BUSY!

A smiling Asian nurse helping a patient check her temperature.

What happens in the ED to contribute to the culture of caring?

1 - Every single patient survey is read by unit leaders and administrators to the tune of thousands each year.

2 - Alice adds, “We take all the feedback seriously. We share it with staff, the good and the bad. We let people know if they were appreciated. We make suggestions actionable when we can. We praise what we want more of.”

3 - Here are a few patient requests they were able to accommodate:

     >One patient asked for a recliner to rest in the waiting room. Staff and admin looked into it and voila: there are now seven recliners in the ED waiting room!

     >An African American patient requested a special shampoo and voila: that shampoo choice is now available! A request of this type is not considered trivial in an organization that takes patient-centered care seriously.  

Manager Alice’s words, “This is how change starts with compassionate care.”  

Lisa Morten, Chief People Officer, enlightened me further on how Overlake creates a culture of caring.

Overlake practices JUST CULTURE, a methodology for reducing risk and improving safety.  Leadership refrains from blaming and shaming and instead maintains an attitude of helping staff succeed. Their job is not to reprimand but to help staff solve challenges, improve quality, and avoid mistakes.

Every department has a SHARED LEADERSHIP COMMITTEE comprised of any employee who wishes to participate. This includes physicians, housekeepers, aides, nurses, and more, depending on the department. Together, they help lead the department in contrast to the manager and her superiors.

This works because there is collaborative LEADERSHIP ENGAGEMENT.

Leaders they hire are expected to be transparent and cooperative, to be open to employees helping to guide decisions and processes.

Leadership engagement includes all levels of leadership and entails:

• Transparency between all levels
• The CEO attends every new employee orientation, which occurs twice a month.
• Executive Rounding is a regular occurrence – the CEO and the leadership executives round in each department (like doctors and nurses round on their patients every morning) to talk to staff on the front lines. Alice said that their CEO knows most of her staff by name!
• In the ED, Alice has an idea-generating board where staff are encouraged to write their suggestions and concerns. They fill it every week! No matter how minor, every concern is addressed in their department meeting. Staff feel free to speak and provide feedback.
• Staff feel heard because their Leaders listen, are open and receptive, and take their input seriously.
• Leadership is Process improvement-driven, led by the department committee in which every member is engaged.

Here is an example of how Leadership Engagement Committees guide Process Improvement

The ED committee wanted to do something about their 6-7 hour wait times and 4.6% risk of a patient “Leaving without Being Seen (LWBS).” These LWBS patients are known to be at very high risk of having bad outcomes. So, in the last year, they came up with a process they call Vertical Triage. In this new process, patients are seen by a physician or provider quickly, followed by treatment and diagnostic test initiation. Afterward, patients return to wait in the ‘vertical area’ for results and further plans. Since instituting this process change, wait times have substantially shortened and the LWBS rate has decreased to 0.9%!

What about staffing?

Have they had the kind of staff shortages we have in Olympia? How are they dealing with the state and nationwide healthcare personnel shortage?   Ms. Morten said that Overlake has not been immune to staff shortages, but the last two years have been record hiring years!

Why do people choose to work there? A number of the employees I talked to on my visit chose to commute to work at Overlake.  To what does she attribute their hiring and employee retention success?  

1 - Overlake’s reputation and culture

2 - Recruiting responsiveness and speed – some hospital systems might take two weeks to respond to an applicant; Overlake’s goal is two days.   

3 - Employee referral bonuses

4 - International recruiting, flex work options, and bonuses

Staff stays at Overlake because of:

1 - the culture - they feel recognized, included, and have a voice.

2 - the support of staff passions to further their education with a strong tuition reimbursement program subsidized by Foundation donations.

Creating a hospital and ED with a Caring-Difference-You-Can-Feel takes a lot more than a one-off magic bullet.

 It takes:

• An organization that walks its talk, means what it says, and follows through on promises.
• Clarity and commitment to the health of the community
• Inclusive of all stakeholders in providing input, guiding process, and decision-making.
• Collaboration and cooperation on and between all levels of the organization
• Transparency, honesty and integrity
• Working for the big picture rather than the ‘bottom line’

The results are:

• Responsivity to the community, staff, and first and foremost, the patients
• Quality of care and staff
• Staff retention and loyalty (vs shortages and high turnover)
• Safety and
• Ultimately a successful, financially sound institution that provides quality healthcare for its patients and community
• A Culture of Caring You Can Feel

I tell Overlake’s story because it can be done.  If it can be done anywhere, it gives me hope that maybe it can be done here in Thurston County.

Debra L. Glasser, M.D., is a retired internal medicine physician in Olympia. Got a question for her? Write drdebra@theJOLTnews.com