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Dave Johnson on Collaborating to Solve Healthcare’s Big Challenges

Dave Johnson on Collaborating to Solve Healthcare’s Big Challenges

Hamilton Ray's picture
Hamilton Ray
April 20th, 2017

healthcare, collaboration, sketch, facilitation, workshop, all hands, facilitators, david johnson, 4sight, creativity, creative

We kicked off the year promising to deconstruct the process of meaningful change. And we noted that meaningful change requires designing strong and intentional solutions to address business challenges. Below is our fifth installment in our current series that focuses on how we support this design process through Collective Creativity.

Imagine bringing together over 20,000 stakeholders every year for a rousing event filled with music, poetry, skits, testimonials, big name speakers, and celebrations all focused on your organization’s mission and values?  Since 2001, Sharp HealthCare has been doing just that. In his recent book, Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare industry expert David Johnson describes the innovative efforts that Sharp’s and others are taking to transform healthcare delivery. I recently had the opportunity to catch up with Dave to discuss how best to foster collaboration in an industry as complex as healthcare.

Hamilton Ray: What are the big issues in healthcare that we can only solve by getting people to work together?

David Johnson: The single biggest issue is finding a way to collaborate with the patient. This is particularly challenging because it requires large companies, which may have spent decades operating under paternalistic models, to completely rethink their approach. They need to put themselves in the shoes of the patient – their customer. We are in the midst of a seismic shift and to-date only a few companies have found ways to successfully make the transition to a truly patient-centered approach.

Hamilton: In your opinion, what has enabled some companies to move towards collaboration and partnership with the patient?

David: In the case of existing companies, I think it takes a radical approach focused on realigning the entire organization around a single purpose, namely, the patient experience. This is what Sharp did.

Hamilton: For those not familiar, can you describe Sharp’s approach and how it emerged?

David: Sharp’s CEO, Mike Murphy, had inherited an organization that was struggling on all fronts: financials, operations, customer service, provider relationships, etc. Mike believed that if he could get all of Sharp’s employees aligned around a shared purpose they could turn the company’s performance around. So he came up with the idea of the Sharp Experience. As part of this, he introduced the Sharp Experience All Staff Assembly, an annual program held at a San Diego convention center that includes over 20,000 employees and stakeholders.

Hamilton: So the goal of the assembly is to get everyone functioning as one team?

David: Mike believes that everyone is part of the caregiver team whether they are a nurse, surgeon, administrator, or custodian. Often individuals in lower paid positions have the most direct customer contact so everyone needs to be invested in the patient experience.

During one of the Sharp Experience All Staff Assemblies that I attended, each employee was taken on an individual journey designed to remind them of how precious the opportunities are to make a difference in the world and how important it is to seize these moments. The second portion of the program built upon the individual journeys to bring everyone together in a collective commitment to improving the lives of Sharp’s patients.

Hamilton: And as you note in your book, Mike’s approach has completely transformed the organization according to all measures.

Can you describe some of the differences in how people work together—collaborate together—on a day-to-day basis to deliver what is now known as “The Sharp Experience”?

Dave: The social theorist, Barry Schwartz, once shared a powerful story about a hospital janitor being yelled at by a father who had just received bad news regarding his son’s health. The father mistakenly accused the janitor of failing to clean the floor in the very room he had just mopped. The janitor’s response was to apologize and clean it a second time. When asked later why he didn’t explain himself to the father, the janitor responded that he could see the father was suffering and rather than upset him further with an argument, he saw an opportunity to make this man’s day a little easier. As Schwartz points out, nowhere in the custodian’s job description is there anything about the importance of positively impacting the lives of other human beings yet that is just what this man chose to do.

I think that stories like this happen everyday at Sharp. And it is important to note that this occurs both because the janitor recognizes his or her role in advancing patient care and because management recognizes the importance of these contributions. The custodian is appreciated for making a judgment call in the moment to clean the floor for the second time; he is not criticized for inefficiency. When you are in a disrupting industry you need everyone to be pulling in the same direction.

Hamilton: Exactly, collaboration requires that every member of the team have the autonomy and authority to help move towards the common goal.

We’ve spent a bit of time discussing Sharp, but your industry experience is expansive, do you see other examples of successful collaborations in healthcare?

Dave: Another place where I see success stories is with new players entering the market. Because new entrants are not constrained by existing systems or behaviors, they can more easily align around patient care. But here again, mobilizing around a shared purpose is what facilitates collaboration.

Hamilton: Can you share a couple of examples these new entrants and how they are fostering collaboration?

David: A place like Cancer Treatment Centers of America, while controversial, evolved around the central mission of patient-centered care and their delivery model grew out of that goal. For example, patients are greeted by their multidisciplinary care team, caregivers and services are delivered to the patient rather than visa versa, and so on.

Iora Health is another player who entered the market with a very specific vision and it rallied its stakeholders around this. Iora seeks to break free of traditional fee for service reimbursement models in order to focus on ongoing enhanced primary care and human connection. One of the ways that Iora fosters collaboration is through the recognition that a patient’s health is multi-faceted and requires a network of individuals from mental health professionals to community members to specialists in a variety of fields to deliver holistic care. It is essential to involve the perspectives of multiple stakeholders.

Hamilton: Before we let you go, do you also see incentives playing a role in collaboration both within organizations and across multiple players?

David: When I look across the industry, whether at a closed system like Kaiser or a larger healthcare ecosystem, I think it is all about getting aligned around the real value that is needed. Martin Luther King, Jr. said “the arc of the moral universe is long, but it bends towards justice.” I think that the arc of healthcare is long, but it bends towards value.

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