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How BayCare is fast-tracking its cultural transformation

 

BayCare’s technology-enabled “culture-first” approach to business transformation

No health system has ever before seen or experienced the waves of technology change now roaring toward them.  And they’re approaching at a pace that few, if any, health systems are equipped to handle.  I recently described these waves as three human empowerment platforms that will empower — rather than burden — clinicians and organizations to achieve this quadruple aim: better health, better experience, lower costs, and improved productivity and work experience for clinicians.  That’s right, these technology platforms will work for clinicians and health organizations instead of the other way around.

These three human empowerment platforms — intelligence, engagement, and collaboration — will pick up where Electronic Health Records left off and drive the digital transformation of existing experience and cost structures for consumers, payers, and providers. For the first time, personal, effective and affordable health and care will be within reach in our lifetime.

But that won’t happen unless health system leaders intentionally transform their cultures to enable these waves to disrupt their organizations from the inside out. I’ve only been able to find a handful of health systems that are taking the steps they need to take full advantage of the speed and tsunami-like force of these waves.

One of those organizations is Clearwater-based BayCare Health System. Why? Because their leadership realizes that the present analog change management methods are no match for the speed and force of change that’s coming. According to Ed Rafalski, BayCare’s Chief Strategy and Marketing Officer, adapting to the coming speed of change requires a completely new corporate culture. The following is a transcript of my interview with Ed and BayCare’s Chief Technology Officer, Scott Patterson.

Interview with BayCare’s Ed Rafalski, Chief Strategy and Marketing Officer and Scott Patterson, VP Chief Technology Officer

Schmuland: Ed, would you mind starting us out with a brief thumbnail description of BayCare as an organization and your future vision?

Rafalski: Sure. BayCare is a leading not-for-profit health care system in the Tampa Bay and West Central Florida regions that connects individuals and families to a wide range of services at 15 hospitals and hundreds of other sites of care, including primary care, imaging, lab, behavioral health, home care, and wellness. Our mission is to improve the health of all we serve through community-owned services that set the standard for high-quality, compassionate care.

Humanity at Work” is our brand promise that describes our prescription for the future of health care. We believe that the health care model of the future needs to recognize and respect each patient’s humanity and show real compassion and real empathy while meeting the needs of every community and every individual.

Today’s quality & safety culture: No match for coming change

Schmuland: In my conversations with executives at the Microsoft Executive Briefing Center, I routinely warn them that the committee-style cultures they have in place won’t handle the speed and force of change behind the coming technology innovation waves, and how wildly different these human empowerment platforms are from anything the industry has ever before experienced. Most executives are very proud of the culture of quality and safety they’ve built in their organizations over the last decade. I look at those cultures and say, you’re going to need a new culture to handle the coming changes and technology waves. How do you see it?

Rafalski: We’re in total agreement with that. To enable digital transformation to do its work, we first need a new culture of speed, innovation, and collaboration that pervades our entire organization from the top of the org chart to the bottom and side to side. Our strategic vision and growth targets require us to act faster, require team members to have an innovation mindset, and require that we collaborate at the speed of thought — not the speed of memos and meetings. We must turn continuous process improvement into continuous value improvement, because we now must find ways to deliver on better quality, safety, experience, and outcomes, at a lower cost point.

Better change

Schmuland: The founder of VISA, Dee Hock, famously said, “The problem is never getting new ideas into your head.
It’s always getting old ideas out.” How do you go about establishing this new culture of speed, innovation, and collaboration in months when you have an existing culture in place that probably took over a decade to evolve? How do you pull every team member out of their current cultural comfort zone and into one that can move at the speed of thought and challenges everyone to be innovators?

Rafalski: For us, there were two critical success factors that made what we thought would be a hard and long cultural transformation easier and faster than we expected: a new, visionary CEO who started two years ago, and Microsoft Stream, the intelligent video platform included in Office 365. We knew that the old methods of change management — town hall meetings, newsletters, and even email — were too slow and wouldn’t appeal to our growing millennial workforce. Video is now a popular medium for both millennials and boomers, and the great thing about video and Microsoft Stream is that it makes it easy for everyone in the organization to create, find, and share videos securely on the device that works best for them — whether a desktop, tablet, or phone. While other methods of communication are still critical, this adds an additional communication channel to meet the needs of all of our team members that is fast and engaging.

Schmuland: Sounds like you have an innovative CEO who placed culture as a priority. What was his approach?

Rafalski: Immediately, our CEO wanted a way to systematically get out in front of our 28,000 team members to help them understand the “why” behind the new strategy and to make it all personally meaningful for every one of them. BayCare is a 20-year-old federation of separate entities, each of which has its own subculture, and we needed a singular culture. So, we needed a medium that was familiar and accessible to everyone. We launched a monthly CEO video series about two years ago, and now that series has its own channel on Microsoft Stream. We’ve internally branded Microsoft Stream as BCTV, and are creating videos that are not only educational, but also fun and engaging.

Soaring engagement

Schmuland: Are you seeing an uptick in your employee engagement rates with Microsoft Stream compared to your prior methods of communication like email and conference calls?

Rafalski: Since we started embedding videos, we have more than tripled our open rates with emails sent by our CEO to team members and management.

But the impact of Microsoft Stream on employee engagement has turned out to be much bigger than just view rates. I’d say Stream has caught on like wildfire because everyone has seen firsthand the power of video in the CEO series. As a result, we now have eight subscribe-able channels because groups across the company like nursing, mission, and team resources have come to us asking for their own video channel on BCTV.

The most recent one came from our nursing leadership, which wanted help launching a new company-wide patient safety campaign. Their vision is for every quality and safety committee within every organization to use the same quality and safety channel to communicate best practices and they also want a companion group chat forum to make it easy for anyone in the organization to raise concerns and invite open discussion. Two years ago, they would have asked for a newsletter article and an article on the intranet homepage for their communications. So, Stream is not just helping us drive this new culture of speed, innovation and collaboration, but it’s also going to raise our culture of safety to a new level as well.

Schmuland: Scott, with demand that’s spreading like wildfire, how do you support the production, editing, and posting of all these videos? Do you have a production studio?

Patterson: We think of BCTV as our own company YouTube with light quality oversight. We do have a production facility, but we encourage everyone to make their own videos using their high res webcams or smartphones. We give channel leaders a two-page best practices guide and if they want to add slides, diagrams, screenshots, or do a demo of some kind, most of everything they need is built into PowerPoint 2016. To make sure our internal videos aren’t viewed by outsiders, we use the multi-factor authentication that’s built into Office 365. This allows our employees to find and view videos when they’re at home or on their smartphones when they’re mobile.

Thinking bigger

Schmuland: Ed, where do you go from here and how do you build on the success you’ve already experienced? I get the feeling that this is just the beginning of a much bigger vision for streaming video.

Rafalski: The list of ideas and possibilities grows every day. We’re now working on training videos, like proper handwashing technique to reduce hospital-acquired infections.

And we have several new channels on our roadmap. We have a podcast series for consumers on topics of interest to them that we’d like to turn into an external BCTV channel. We’d like to add an internal news channel — like the weekend news — so team members who are on vacation or busy with other things never feel like they’re missing anything because they’ll be able to tune in and catch up using a short weekend segment summary. We’d also like to use it to engage and inform our credentialed physicians, especially those in our clinically integrated network. A majority of our physicians on staff are not employed by BayCare, so we’d like to find a way to make them feel as much a part of the organization as those who are employed. We’re also exploring a BCTV channel for our Emergency Department and outpatient waiting rooms. Another thing we want to do is index the spoken text in all our videos and make them discoverable by voice commands.

What’s also been fun to watch is how team members, on their own, are discovering a lot of other innovative tools inside Office 365 that they never knew existed. They’re coming to us with ideas on how they can use Microsoft Teams and Forms, for example, to collaborate across the organization and improve their team performance.

Schmuland: What advice would you offer to your peers who might be considering video as a vehicle to transform culture and drive innovation and collaboration across the company?

Rafalski: Think bigger about video than just a more modern communication medium. For us, BCTV has evolved into this unexpectedly powerful, multi-purpose platform to drive employee engagement and human connection, and virally transform our culture.

The great thing about videos is that they make everyone in the company, including the leadership team, become more human to everyone else. Videos give employees a true sense of leaders’ personalities, because they see the emotions and conviction that just don’t come across in other media. When people see our CEO on BCTV, they approach him like they know him and often repeat back some of the catchy quotes they’ve heard. Video removes the mysteries and breaks down the walls of the C-suite by showing our leaders as the real and caring people they are.

BCTV is virally transforming our culture because most of the videos that we’re seeing teams produce are tying the purpose of their video — the “why” — in some novel way back to our brand promise, “Humanity at Work.”  This means that our own team members are now organically driving the permeation of our culture across the organization in a way that conventional marketing programs couldn’t. We know that it’s the culture of an organization, even more than business strategy, that determines how the business grows and transforms. So, to deliver on the promise of value-based care, every health system will need this new culture to respond and adapt quickly to change, innovate, and collaborate in new ways that will disrupt their organizations from the inside out.

This blog was written by Dr. Dennis Schmuland in collaboration with Dr. Edward Rafalski, Ph.D., MPH, FACHE; and Scott Patterson.  

Dr. Rafalski is is currently the Chief Strategy and Marketing Officer for BayCare Health System in Clearwater, FL. Mr. Patterson is Vice President and Chief Technology Officer for BayCare.