Indianapolis Discovery Network for Dementia

The ABC Medical Home - Creating a Culture for Success

Catherine A. Alder, JD, MSWProject Manager, CMS Innovation Award – Dissemination of the

Aging Brain Care ProgramChief Administrator – Aging Brain Care

Wishard Health Services

Indianapolis Discovery Network for Dementia

1. Organizational Culture• Definition• Origin• Change

2. Culture of ABC Med Home 1. Visible/Invisible2. What’s Working3. Areas for Improvement

3. Change Vision

4. Feedback

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What is Organizational Culture?1930 Hawthorne studies at Western Electric Company

• First systematic attempt to use concept of “culture” to understand the work environment

• Hawthorne Effect

Common threads and properties have emerged from social research examining the concept:

• Shared• Learned• Affected by environment and history• Adaptive• Integrated• Includes both what people do and what they think

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Components of Organizational Culture

• Group norms of behavior (visible)

• Underlying values, attitudes, assumptions, and beliefs that keep the norms in place (invisible)

The Key to Changing Organizational Culture –Forbes (September 27, 2012)

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Where Does Culture Come From?“Culture usually comes from the values and behaviors of the founders or leaders of the organization. For whatever reason, they value certain things and behave in ways that seem to help the group succeed.” • Conscious• Unconscious

The Key to Changing Organizational Culture –Forbes (September 27, 2012)

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“How does culture change? A powerful person at the top, or a large enough group from anywhere in the organization, decides the old ways are not working, figures out a change vision, starts acting differently, and enlists others to act differently. If the new actions produce better results, if the results are communicated and celebrated, and if they are not killed off by the old culture fighting its rear-guard action, new norms will form and new shared values will grow.

The Key to Changing Organizational Culture –Forbes (September 27, 2012)

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ABC Medical Home at Wishard Health Services

Staff (23.4 FTEs)• 1 Medical Director• 1 Program Manager• 2 Social Worker Care Coordinators• 3 Nurse Practitioner Care Coordinators• 16 Care Coordinator Assistants • 1 Data Office Specialist• 1 Site Coordinator

Space on the 6th Floor• Social Worker Office• Nurse Practitioner Office• 2 Work Rooms with “Drop Down” Space• Conference Room

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Indianapolis Discovery Network for Dementia

Current Culture of ABC Medical Home

UNDERLYING VALUES/ATTITUDES/

ASSUMPTIONS/BELIEFSRESPONSIBILITY

DEDICATION TO MISSION AND PATIENTS!

Growing Confidence in Self and Colleagues

Comfort with UncertaintyProgram Ownership

BEHAVIOR

FLEXIBILITYADAPTIVENESS

RESOURCEFULNESSINDIVIDUAL STAFF

MEMBERS ARE DOING AMAZING WORK! Better Teamwork

Better Conflict Resolution

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Change Vision for ABC Medical Home

• People gathered (talking, relaxing, working alone or together)

• Diversity (children, college students, workers, retired people)

• Lighting and tables (facilitates conversation), smell of coffee• Friendly, accomodating staff (know customers by name)• Personalized service• Environmentally Conscious

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Focus on Diversity and Customer Service• Not a franchise• Diverse sites and customer base• Management execs regularly visit stores to insure quality• Customer feedback regularly solicited

Flatter Organizational Structure• Streamlines information flow from customer to employees

and from employees to management• Leads to more efficient and effective strategy

Starbucks Culture and Values

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Social Networking• Vehicle for customer input• Creates open forum for discussion

Employee Relations• Open communication encouraged• Each employee valued as a partner• Managers visit frequently

Organizational Ethics• Mission statement is filter for decision making• Employee training includes review of mission and vision• Employees share in “Starbucks” experience

Promoting Corporate Citizenship (Shared Planet)

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Questions1. Is Starbucks culture the “right” culture for the

success of the ABC Medical Home?

2. How do we change the culture of the ABC Medical Home?

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AcknowledgementsMalaz Boustani Ann CottinghamMichael LaMantia Kathy FrankMary Austrom Deb LitzelmanJohn Bedoya Lee LivinChris Callahan Chris Steinmetz

The staff and patients of the ABC Medical Home at Wishard Health Services and IU Health Arnett