16 jun The unexpressed wishes of patients and the best GIFT you can give to your employees and organisation

Introduction

As part of the project ‘Diagnosis: Transforming Western Healthcare’, we met Gerard van Grinsven at the Customer Excellence Event 2017. We talked with him about his experiences as the Chief Executive Officer (CEO) of the Henry Ford West Bloomfield Hospital. Coming from the Ritz-Carlton hotel chain, he was put in charge of creating a new kind of hospital, which focused on an integrated approach of healthcare and on hospitality. In this article, we shed light on some of the steps Gerard van Grinsven took to include both the patient and the employees in the transformation from the ‘Hospital’ to a ‘Community Centre for Well-being’. One of the driving forces behind this idea (and in the whole healthcare sector) was putting the patient first.

How did you put the patient first in this transformation?

For six months, three nights a week, I went to homes of people within the community. I lived with patients in their homes., I wanted to see how they cooked, how they lived and how they prayed. I want to hear what is really important to them. No tie, no jacket, no flip chart. Instead, I brought wine and food. When you break bread with somebody, your relationship with someone changes, and they will tell you much more than in a flimsy meeting room with a flipchart. In the first home I went to I was welcomed by ten people. In my final visits that number rose to sixty, as they invited all their family members. I was the talk of the town, but I learned a tremendous amount from all these sessions. Ultimately, that input helped to make changes in the physical environment of the hospital.

In the emergency room for example, we always create these little flimsy areas with little curtains, where we can hear the pain and suffering of the person next to us. After the home meetings, I decided we should have individual private rooms, with a more spacious layout. In one home I learned, if one Korean comes to the emergency room, the entire community comes over. We never had space for these people. You could say it is not important, but I find it important. Because it shows to these people: we listen, we care about you. The majority of the changes were not therapeutically. They were about wellness, about creating an environment where people want to come and feel better. To do this, we postponed the opening for six months and made the necessary changes. And it paid off significantly.
We created an environment that was welcoming. Not a typical traditional hospital where everything looks white, clean and intimidating. Not gloomy or an unpleasant environment to be in, but a warm and inviting place where community members feel at home. A place where they think: “Hey, I can go there and eat healthy food”. A place where we actually produce our own products for the patients, the staff and the community to buy, and we use it in our cooking. A place without deep fryers and freezers. So we created beautiful kitchens, in which we give daily cooking classes. Not just for patients, but also for the community. And let’s bring school kids in, so they can see the value of good food. We even organize weddings in our hospital. The patients with a view on the wedding, ask the nurses if they can be lifted in a chair to be closer to the window. Patients who can walk go to the balconies, to look at the wedding. It lifts their spirits. Often when we go the hospital, we pull family members away from their daily activities. By organising such events, patients feel like they are still a part of the community. At the end of the day, members of the community know where they want to go should they ever become ill: to our hospital.

How did you approach your employees to engage them in the transformation?

There were challenges. Not everyone believed or shared our vision. Some leaders do not understand that we are in the people business. I wined and dined physicians, early morning to late night. I told them: “I’m here for you, I have a lot of respect for you, I’m begging you, please give me the benefit of the doubt, and if it doesn’t achieve results, I will instantly adjust”. Overtime, reluctantly, they tried it. I was selling my vision: the chance to make a difference: I’m here to be disruptive, I’m here to challenge the status quo, I’m here to tell you we need to feel comfortable with being uncomfortable. I think because of the support I got from Nancy, and the board from Henry Ford, I managed to do things that others said were impossible!

For the culture of emotional engagement, you have to select people based on their talents, not their technical knowledge. This selection is crucial, because then you start with someone who might already be open for change. Secondly, you need to have a proper onboarding. The onboarding is not just half a day, not just a day, but a full week. And everybody, no matter who you were, was going to be there. And at 7 AM on Monday morning, I was waiting for my employees. I had a red carpet for them, and I was there to personally invite them in. And I went there every day. I came in to give maybe a 30 minute speech, just to make them understand what a great opportunity we have. And, to set a new tone in how healthcare could be delivered. Through that orientation, through that inspiration, through the selection process, we got believers. These people were willing to give it a chance, willing to move with it.
What I often see in the Netherlands, the style of collaboration of seeing eye to eye, and not upsetting anyone, does not work for me. In ten years, you will tell yourself: “Yeah, we made some improvement, but we are still a far way of where we want to be”. So who is going to lead this change? That is somebody who is willing to upset a lot of people, in a respectful manner. Somebody who is willing to say: “No, this is the vision and we’re not changing course. And I believe I am passionate about this. Because if you do not have that kind of driver, believer, then it is going to be very difficult. It will prove to be impossible to lift this system, change the status quo, eliminate the bureaucracy, to believe that change is needed, and that it is okay to let go of old habits.

How did you keep the transformation going after the initial start?

To keep the employees engaged in the transformation, we held returning meetings. After four weeks, everybody comes back in, and they meet with me, the CEO. I asked what we promised them in the onboarding. Did we actually deliver? If we did not deliver, what do you think we should do differently? I received really good feedback from a year of this continuous process. It was almost painful a times, but people loved it. They felt that somebody at the highest level was not sitting in meetings the entire time, was not disappearing throughout the day. He actually sits with us, he listens to us, and he wants to know what we have to say. If you do not emotionally engage your physician, housekeeping, the door attendant, which means delivering what is important to them, not to you, you will never get them to buy into the vision that you hope for.

You mentioned treating patients as individuals, with specific wishes. How does this return in treatment of employees?
The problem with many leaders is that we treat employees as if they are all the same. We are all wonderful people, we are all educated, we are smart. But each of us needs to be addressed differently to reach the highest potential of our talent, and unfortunately that is not happening.

For me, it starts with the T from Talent. It is not about skillset or experience yet, it is all about talent. How can I bring people on-board with natural talent? You cannot send people to a seminar: “go and learn to be compassionate or learn how to create relationships”. It starts with natural talent. Then you look at the F for fit. What is someone’s skills set? Combine the right skills with the right natural talents and you are able to put the right people in the right seat of the bus. Here is what many organisations do wrong: we should Invest the heck out of employees, but what do we do? We throw them in the deep end. We have a huge number of employees leaving in the first year, because we do not invest in them, we do not allow them to grow in the system. If we would invest in our employees, we bring out the talent in people. At last you have the G of Growth. You are all very smart and intelligent. Now it is your turn. You need to be empowered to grow. You need to feel responsible as an employee.

Now read this backwards.

This is the biggest GIFT you can give to your employees, and to your organisation. If you do this consistently, you do not have to worry about profits or outcomes, you have a culture where everybody is driving change.