by Anthony Cirillo

There is a movement afoot. Some call it culture change. Hospitals call it patient-centered care. The long-term care industry calls it person-centered care. Whatever you call it, for the most part it's not working. Everyone has an opinion. Here is mine.

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Chris Cornue certainly pointed to one reason: the trust issue. If there is not trust in an organization, people will not follow. But it also goes deeper than that. See what you think of this analogy.

Healthcare workers are like firefighters: They do dirty jobs, look death in the eye every day and celebrate the joys of life, too--rescuing a kitten or delivering a baby. So why does the firefighter culture thrive? Low attrition? People clamoring to get in? Firefighters face their mortality every day and they have created a culture where they can talk about it, release it, joke about it and move on. The fire house is their community, their home.

Healthcare workers do their job and take it home with them. When they are burned out, they leave. Firefighters are treated like heroes; healthcare workers not so much. So part of it, in my opinion, is building cultures that recognize this and help people release the fear and anxiety. That is not part of any rewards and recognition system. It goes fundamentally deeper.

The other reason these programs fail is that there are just too many darned rules. Culture change 101--here is the six step process blah, bla, blah. What you need to do is use tools, not rules. Create a context so that the healthcare worker understands the feeling that needs to be achieved with any experience. For example, when a pain management specialist looks to achieve comfort as opposed to pain management, they see the patient's world in a new lens. Yes it's about clinical care, but it also is about the environment--what are people looking at when receiving pain medication?; what colors and smells surround them? etc. You don't have to make a list for the pain management person to do this. Once they understand, they will be empowered with great ideas to achieve the desired state.

And finally, culture change has always been the program of the day. What is disturbing is how some organizations think that marketing can own the experience. To do so is fundamentally flawed thinking. Then you truly have a program of the day that will be ignored by most.

The bottom line is that trusted leadership recognizes the fragile life-and-death nature of healthcare and allows staff to celebrate and grieve and become empowered to change it, to make it better.

Anthony Cirillo, FACHE, ABC is president of Fast Forward Consulting, whose team consults globally with healthcare facilities in experience management and strategic marketing. Anthony's background includes work with a Wall Street healthcare startup, Fortune 500 companies, broadcasting organizations and hospitals. He obtained his graduate degree from the University of Pennsylvania. His article entitled "The Chief Experience Officer" became the basis upon which the Cleveland Clinic started an office of patient experience and hired the first ever hospital chief experience officer in the country. Contact Anthony at Cirillo@4wardfast.com, 704-992-6005, www.4wardfast.com</a>.