The Bottom-Line Benefits of TEAM LEADERSHIP TRAINING - Proven Pathway to Minimizing Errors and Maximizing Quality

As of the first months of 2014, a multiplicity of new studies have begun validating up to fifty percent reductions in Wrong Surgeries (wrong site, wrong medication, wrong patient, retained object) throughout hospitals and healthcare settings. The engine of change in virtually all these results is a steadily and universally applied program of Team Leadership Training for the entire medical team involved in any form of surgical intervention at the patient's beside, in the OR, the cath lab, ER, or the physician's office. Going far beyond the basic exposure to Team Stepps and aviation's Crew Resource Management, Team Leadership Training creates proven and professional Collegial Interactive Teams, but must be built on complete cultural change. This lecture lays the groundwork for why this is such a powerful and certain way to improve the performance of not just surgical interventions, but virtually all medical interactions. The hallmark of a mature Collegial Interactive Team is a leader who knows how to bring out the best performance and best participatory ownership in each member of the team. A trained CIT leader - often a physician - knows how to eliminate all communication barriers by making it completely safe for any member to speak up, and by creating and maintaining an atmosphere of mutual respect, constant learning, and non-hierarchical interchange. While these principles, techniques, and methods have never been taught in medical schools, nursing schools, or traditionally used in medicine, the dramatic and positive effects of appropriately inculcating such team leadership go directly to the bottom line, inclusive of significant improvement in morale.

The 8 Major Dysfunctionalities of America’s Healthcare Non-System

Bore-sighted at the subject of “Healthcare Reform” and how far we have to go from this first, very tentative and imperfect step of 2009, this lecture covers in completely up-to-date fashion not only the national shift in insurance methods, but the particulars of why the overarching goal of reform will never work without changing from fee-for-service community. Healthcare must transition, and fast, to a true system that is compensated more when needed less by an increasingly healthy population. The role of doctors and nurses and hospitals should be to improve health. The present system, however, cannot stay afloat financially if the number of patients needing its services drop significantly. Therefore, we have an upside down non-system that will only reward practitioners and hospitals if the public health does NOT improve (and the numbers of patients do not diminish). How we change that system into the “Firehouse Model” in which healthcare is compensated on an increasing basis for decreasing health problems resulting from their efforts is a key focal point of this talk, since the future of American Healthcare literally depends on finding the right answers (and methods).

Ending the Medical Apartheid

Aimed at physicians, this lecture targets the traditional 4-thousand year history of keeping physicians separated from the rest of the healthcare community in ways that are ultimately the prime cause of poor communication, failed teamwork, toxic staff relations, and patient safety disasters. The bottom line is that it will be forever impossible to have a safe and effective medical care system until Medical Apartheid is ended. In dozens of lectures during the last year, John Nance has guided doctors in how to overcome this traditional prejudice, and how to redefine themselves as team leaders with no loss of authority but a significant gain in effectiveness and respect by simply changing the way they relate to their own potential for mistakes, as well as the mistakes of others. This has been, in the majority of instances, a career-changing presentation.

Charting the Course: Launching Patient-Centric Healthcare:

An Urgently Needed Dynamic and Cutting-Edge Program for Healthcare Leaders and Physicians. In many respects American healthcare over the past two years has resembled a disparate fleet stuck in port during a series of mega-storms. Now, however, the waiting game is over. With the President's re-election and the Senate still in the hands of the Democrats, the Affordable Care Act is clearly here to stay. You might say the storm clouds have cleared, the seas have calmed, and it's time to leave the harbor - despite general apprehension and confusion over which course to follow. True, there will be battles and adjustments ahead, especially regarding Medicaid. But the overall seismic movement from a fee-for-service world to one in which measurements and reimbursements - and survival - are based on the quality and effectiveness of outcomes is frankly unstoppable. The tectonic move from "No Margin, No Mission," to "No Outcome, No Income" cannot be stopped. Equally unstoppable is the reality that hospitals, healthcare systems, and doctors are going to be forced to live on lower reimbursement thanks to congressional paralysis. Getting ahead of this tsunami by knowing what to change is going to be monumentally challenging, but vital. In essence, the puzzle is how to keep enough cash flowing while altering the DNA of the profession - a process akin to rebuilding a ship while you're sailing it. And there are miscues and false solutions everywhere. Without an error-free, injury-free use of best practices giving the best clinical results, no amount of improved food, decor, or follow-up calls will yield a great patient experience, acceptable score or payment. Institutions must find, new meaningful, and clinically-effective tactics that flow from a crystal clear philosophy and solid underlying strategy. The healthcare system that will emerge and succeed will not necessarily be based on ACO's, medical homes, or any other nationally-directed idea, but it will be one that understands how to include, empower, motivate, and inspire the people who are the organization, as well as deal happily with the inevitability of human and systemic mistakes

Surviving the Affordable Care Act Earthquake: How To Incite the Changes You Need - in Time!

Whether we measure it in terms of reimbursement, patient safety, service quality, market share, or provider satisfaction, there's no question that the landscape of healthcare delivery is being as violently reshaped as if a great earthquake were roiling the terrain. This program is designed to provide an energizing wake up call to: To spark, inspire, and incite the cultural and clinical, financial changes you need to surf this tsunami. It is, in other words, designed to be a powerful aide to your efforts to get your "army" marching in the right direction, and for the right reasons. The Return On Investment is immediate, especially considering how little time remains to make changes that depend on the buy in, and true ownership, of your rank and file. The greatest threat to any healthcare institution right now is failing to infuse the appropriate sense of urgency in your people, physicians included.

Whether your prime target is financial belt-tightening, significant and immediate HCAHPS improvement, patient safety overhaul, or adopting a new model of reimbursement in a non-fee-for-service world, your success - and perhaps your survival - absolutely depends on your people understanding two primary things: (1) The overall urgency of the situation and immediate need for significant cultural change (no more business-as-usual); and, (2) The fact that your surviving and thriving depends on an unprecedented level of personal and professional accountability in which virtually everyone is an owner of both the problems and the solutions. Lighting these fires is the intent and the effect of this presentation.

Unifying Your People - For any human institution facing the destabilizing and demoralizing effects of externally imposed culture change, the most effective defense will always be unanimity: Breaking down the silos and parochial differences to pull together against a common challenge. While the tactics and structural changes necessary for the organization to survive are always the desired product of careful planning, the equally important motivational force comes from the collective determination of all members to pool their resources to be a leader of, not a victim of, the healthcare revolution.

Believing in ZERO HARM! And Saving the Patient Safety Revolution from the Quicksand of the "good enough" zone.

If you're worried about your institution's Patient Safety Revolution hitting a wall on this 20th anniversary of the original IOM Report (To Err is Human, 1999), you're thinking ahead, and you're on target: Too many healthcare institutions are seeing their hard-fought progress toward zero unnecessary harm and high quality care seriously slowed and sometimes wholly derailed by several powerful forces, and once sidetracked, it's hard to get the train moving again.

Despite massive, sustained efforts, statistics still validate the staggering level of harm: 440,000 wholly avoidable patient deaths annually in American Hospitals (Dr. John James; Journal of Patient Safety, 2013), and over 4-million injured. It's enough to make hard working, sincere healthcare leaders at all levels lose both heart and hope, which can trigger a backslide toward Cottage Industry medicine and the way we've always done it.

The heart of the problem, believe it or not, is a toxic assumption: "Medicine is far too complex to ever allow complete elimination of avoidable patient harm." Not only is that assumption dead wrong, the very key to maintaining the Safety and Quality momentum you've fought so hard to achieve lies in your belief system. As other inherently dangerous industries have realized (on their way to High Reliability), if you don't truly believe that sustained zero harm is achievable, you'll never even get close.

With the rapidly growing importance of the Patient Experience as a priority centered around High Reliability status, safety and quality have now become a matter of financial survival. Yet there is a critical aspect of High Reliability that is too often missed: High Reliability is a philosophy, not a set of tactics and strategies, and that philosophy begins and ends with a sophisticated understanding of how human systems fail, and how to build systems that safety absorb the failures that can't be prevented.

Without the proper training and mentoring, pressured folks on the front lines (as well as their leaders) can conclude that their level of safety and quality is "good enough", which means acceptance of a certain minimal number of avoidable deaths, injuries, and near-misses from medical mistakes and human error. To patients and families with the misfortune to fall into that zone, however, "good enough" is chillingly unforgiveable.

This fresh, up to date and highly useful presentation is based on the past few years of John J. Nance's practical research and consulting, and it will give you a current, real-world picture of the massive profession-wide challenges as well as provide immediate takeaways. It will also reinvigorate your team's drive, dedication, and enthusiasm by affirming the inestimable value of their contributions and showing them what they can achieve.

The Board’s Pivotal Role in Patient Safety

The average board of directors of the average American hospital is facing a forced revolution, including the threat of the Sarbaines-Oxley law that - if expanded by Congress to include hospital boards - could impose individual personal liability on each director. It is not enough for a board to be concerned about patient safety, boards are primarily responsible for each and every medical decision made in their institutions, and contrary to traditional practice, and handing clinical responsibility to the physicians does not discharge the board's obligations, and can expose the institution to ruinous lawsuits. It is difficult for boards to focus on clinical matters affecting patient safety and quality outcomes when the traditional role has been keeping the ship afloat financially. But that's where the seismic changes are occurring in governance. Boards must accept the responsibility for clinical decisions and guidance as much as for financial stability, and this is a painful reality.

In addition, Board training and progressive education is increasingly necessary as the complexity of providing healthcare becomes more apparent and more tied to board performance. In fact, the time demands and level of expertise now required of boards nationwide may require changing the concept of hospital board membership as an unpaid public service to one of at least partial compensation. In other words, we may need to pay board members to exercise the massive time commitment required of them. No CEO or other member of the C-suite in a hospital can provide the appropriate control and oversight of physicians without massive board resolve and participation, especially in the area of instituting and using best practices uniformly. In fact, the very existence of a hospital, large or small, will depend in the near future on how fast its board can mandate and guide the clinical staff to adopt and thoroughly inculcate the best procedures and practices medicine can provide.

This very dynamic lecture will change the way your board looks at its duties, and will delve deeply into the cause-effect relationship of the board’s actions or inactions and the right of their hospitals patients to be free from unreasonable risk of inadvertent harm. With patient safety disasters (i.e. medical mistakes) now the 4th leading cause of death in the United States, these issues must be faced and acted on, not just debated. This is a pivotal wakeup call presentation best utilized in off-site board retreat settings.

Why Hospitals Should Fly - The Ultimate flight Plan to Patient Safety and Quality Care

This presentation builds on the reality that American Healthcare is, in fact, a gigantic and complex Non-System, and that to achieve real patient safety and quality of care in such a chaotic environment requires building healthcare for the first time into a coherent, interactive system. Inclusive in this revolutionary approach is the fact that the American hospital cannot serve the patient’s best interests as long as it continues in the tradition of Ben Franklin (the creator of the first American hospital) as an institution built only for doctors, not patients. The hospital must become a true unified entity in which even the outside physicians consider themselves an integral and proud part of the team - rather than independent practitioners merely renting space for their patients in a farmer’s market. In addition, this lecture, in building on (not merely teaching) the book's thesis highlights the essential role of the physician as a leader (rather than a commander) in orchestrating the amazingly effective shift to Collegial Interactive Teamwork based on open communications, caring and trust. How the hospital board and C-suite become essential to this process of change - and how it can all be torpedoed by any leaders who refuse to understand the broader human effects of each cost-cutting decision - are major changes in the way we view the internal workings of healthcare governance. This presentation - recommended for 1.5 to 2.5 hours - not only explains why, but rallies the troops for immediate change.