About Eric Dickson, MD, MHCM

President and CEO, UMass Memorial Health Care Professor of Emergency Medicine, University of Massachusetts Medical School

Next Phase of Standards of Respect: Accountability

Since we launched the Standards of Respect last year, I’ve heard some leaders and caregivers share some skepticism on our ability as an organization to uphold these standards if we do not hold people accountable for their behaviors. Fair point.  I have struggled personally at times to hold people accountable for the standards – “do I call out disrespectful behavior when it occurs or wait and speak to the person at a later time?”.  Holding people accountable for their actions is not as easy as it sounds – but nothing worthwhile ever is.

In my opinion, we’ve had a great start on our Standards of Respect journey.  This past year, we have had almost 9,000 caregivers attend more than 400 Standards of Respect workshops, which is 71 percent of our entire system that is now aware of the standards. That’s a significant achievement, and I want to thank all of our caregivers who have attended, as well as the Organizational and People Development team in Human Resources for putting this training together.

The important next step is not just knowing what the standards are, but to live them and to hold each other accountable to them. Accountability. That’s the key. Last week, we launched the Accountability phase of our Standards of Respect work at our System Leadership Meeting. I stood in front of 250 of our system leaders and pledged my commitment to holding myself accountable to these standards, as well as those around me. I asked our leaders to do the same, and now I’m asking you.

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At our System Leadership Meeting, we launched the next phase of our Standards of Respect work, focused on Accountability

Disrespectful behavior should not be tolerated at any level of our organization. I want our caregivers to “See Something; Say Something” (to borrow a line from Homeland Security) when they experience or witness disrespectful behavior – and do so respectfully. I know this can be challenging, but we need to speak up and give feedback to those who aren’t upholding our standards of respect.

There’s a quote that became famous from former Lieutenant General David Morrison of the Australian Army in a video that went viral back in 2013. He issued a challenge to change the culture of the army. He said: “The standard you walk past is the standard you accept.” When we let unacceptable behavior take place, it’s as if we accept it, and we may not know in that moment the damage it can do to the people around us.

By the way, we’re not alone in this challenge. Organizations – particularly in health care – across the country struggle with this kind of disruption in the workplace. That is why we’ve been working with Dr. Christine Porath, who is an expert in this field, over the past year on our Standards of Respect. Dr. Porath talks about the human and financial cost to “incivility in the workplace” as she calls it. I highly recommend you read this article she co-wrote in Harvard Business Review and check out her Ted Talk. She also shared that we’re among the few organizations she has worked with that defined our standards and are training every single employee on those standards.

This is our number one priority in the coming year – to shift our culture to one that embraces respect for each other, regardless of our roles and despite the challenges we are facing on any given day. Having a tough day is no excuse for disrespectful behavior.  Neither is being too busy.  In the end, disrespectful behavior creates more work – not less.  Upholding our Standards of Respect is the right thing to do for each other.

And it is the right thing to do for our patients so that we can become the best place to get care. Yes, our patients are a part of this too. They can see and “feel” it when their caregivers aren’t working well together. And as we know, there is plenty of research that shows that disrespectful behavior, lack of teamwork and miscommunication in a health care setting can lead to medical errors and poor outcomes.

What I’m talking about is a change in our culture. A significant one – a change that I believe is necessary for our future success. I know we can do this because we’ve done it before. Six years ago, we embarked on a journey to create a new culture that is grounded engaging everyone everyday in continuous improvement using our idea systems.  And now, 70,000 front-line-staff ideas later, we are considered national leaders in the implementation of the Lean system.

Now, I’m asking you to join me in another transformation – to change our culture for the better by respecting each other, every minute of every day. I have asked our senior leaders to engage with their teams about this top priority, so you will be hearing more from your local leaders in the coming days and weeks, and this will be an ongoing conversation throughout the year.

I would like to close with another quote from former Lieutenant General David Morrison, of the Australian Army that I believe describes who we are at UMass Memorial Health Care and where we are in our journey as a system: “We are best when we show the courage to do what’s right, the initiative to welcome new ideas and perspectives, the respect to treat each other with dignity, and the teamwork to harness the contribution of each one of us.”

Thanks for taking great care of our patients and one another,

Eric

I also welcome your feedback on this important topic. Please feel free to send a message to me on this blog (under Leave a Comment).