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Episode #14 Are You Sacrificing your SELF for OTHERS?

Introduction to Episode:

Is there anyone who is not trying to manage the relationship between SELF and OTHERS?

In today’s podcast we discuss the SELF and OTHER Polarity.  This one show’s up in all aspects of life. 

We can feel the tension between SELF and OTHER at work as clinicians and leaders.  The SELF and OTHER tension can also be felt at home as parents or in our marriages or relationships. 

This is NOT going away!

Do you often feel like you are being forced to make a choice?  To choose between yourself and caring or focusing on others?

Maybe you feel the stress of trying to get to a 50/50 balance between both.

Good news!  It’s not an either/or choice!  You can also forget trying to find a 50/50 balance! 

This is a polarity and all it requires is awareness and vigilance to create a dynamic balance and leverage the tension.

Listen as we talk about what this SELF and OTHERS polarity looks like and how to leverage it.

Go here to download the SELF and OTHER Polarity Map® and Reflection Worksheet.


Episode Summary Points:

·         This is a critical polarity for every person’s well-being

·         If you aren’t taking care of you, you can’t take care of others

·         It’s a both/and choice

·         Unhealthy relationships with self and other are at risk

·         Starts with self-awareness

·         What it looks like when you over focus on others

·         Positive outcomes of focusing on self

·         Negative consequences of over focusing on self

·         What it can look like when you take care of self

·         Making conscious choices

·         Potential action steps to gain or maintain positive outcomes of both self and other

·         Vigilant monitoring of current state

 

Key Points:

·        It’s not an either/or choice

·        Both are equally important

·        Dynamic balance is all about choices

·        Engage others to help you

 

 CLICK HERE to download the SELF and OTHER Polarity Map and Reflection Worksheet.

Previous Related Episodes

Episode #4:  Recognizing the significance of Caregiver Burden with Dr. Erin Craft-Otterbacher

Episode #6:  The Holy Grail:  Managing Taking Care of Self AND Taking Care of Others with Dr. Diane Bradley

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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens! 

We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #13 The Role of Directive and Shared Decision-Making in Person-Centered Care

Introduction to Episode:

 “Patients are the co-pilot in the airplane called better healthcare” Ben Moulton

This is a very interesting episode because today we’re talking with Dr. Glyn Elwyn a physician/researcher and Ben Moulton a lawyer/patient advocate about the Directive and Shared Decision-Making Polarity.

This polarity can show up in different contexts, leaders and employees, parents and children, but today we are discussing this polarity within the context of decision-making between the provider and patient/family.

At the heart of person-centered care is partnering with individuals and their families in planning, developing and monitoring care in a way that best meets their needs and is considerate of their preferences.   

To be person-centered individuals need to not only act in a person-centered manner but also think in that way.

Historically the provider was the expert and had the answers and directed the care and patients/families were followers or passive participants.

Today there is a desire to have decision-making be an experience where the expertise of the provider along with the values, beliefs and needs of the patient/family are leveraged. 

The challenge is providers and patients and families aren’t always equipped to engage in shared decision-making.

Glyn and Ben share with us what is happening nationally in support of shared decision-making and how decision aides can prepare both providers and patients/families to participate in the shared decision-making process.

During This Episode We Discuss:

·         There are times when it is reasonable to be directive

·         Medicine is full of situations with multitudes of choices

·         Use tools to help ground conversations in fact

·         There is a downside to directive decision-making

·         True informed consent is shared decision-making

·         Physicians are not typically trained in shared decision-making

·         Downsides of shared decision-making

·         A tool is a catalyst but requires the right attitude, motivation, and skills to use it

·         Need culture, buy in, and leadership to advance shared decision-making

 References:

Spatz, E. S., Krumholz H. M., & Moulton, B. W. (2016).  The new era of informed consent: Getting to a reasonable-patient standard through shared decision- making. JAMA, 315(19): 2063–2064. doi:10.1001/jama.2016.3070

King, J. & Moulton, B. (2013).  Group Health's participation in a shared decision-making demonstration yielded lessons, such as role of culture. Health Affairs, 32(2):  294-302.  doi: 10.1377/hlthaff.2012.1067  

Spatz, E. S., Krumholz, H. M., & Moulton, B.W. (2017). Prime time for shared decision-making. JAMA, 317(13): 1309-1310.

King, J. & Moulton, B. (2006). Rethinking informed consent: The case for shared decision- making. American Journal of Law & Medicine, 32: 429-501. 

Sirovich, B., Gallagher, P., Wennberg, D., & Fisher, E. (2008). Discretionary decision-making by primary care physicians and the cost of the U.S. health care. Health Affairs, 27(3): 813-822. 

NQF Issues Vital Guidance to Improve Shared Decision Making Between Patients and Healthcare Providers

Links:

Option Grid™ Decision Aids

https://health.ebsco.com/products/option-grid


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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens! 

We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #12 The Upside and Downside of Health Information Technology

Introduction to Episode:

This polarity is a “BIGGY” listeners!

Today we are talking about the technology platform and practice platform polarity.

We have 20 years of experience with this polarity.  We’ve used health information technology at the point of care as clinicians, lead implementations of technology and practice frameworks in hospitals, developed evidence-based content to integrate into the electronic health record and participated on one of the first design teams for the electronic health record.

We recognized early on that health information technology needs to be intentionally designed to support professional practice and patient-centered care.

During this episode Michelle and Tracy share lessons learned over the past 20 years and discuss today’s realities.

Healthcare needs a strong technology platform and a strong practice platform if we expect to provide safe, efficient, person-centered, quality care.

As a generation, today’s healthcare leaders were the pioneers that took the first steps to implement health information technology in healthcare.  Now when leaders step back, it gives them an opportunity to look at what’s been learned and where we are nationally in leveraging this polarity.

 

Episode Summary Points:

·         If we look at the challenges with the electronic health record, as problems to be solved, there is great risk.

·         National trends and initiatives influenced the technology platform and practice platform

·         21st Century Cures Act

·         NAM Action Coalition- Clinician Burden

·         Thinking of technology as a problem to fix is a risk

·         Exponential growth happens when you have common universal standards

·         Universal standards provide a structure or framework for the technology and practice platforms

·         We are not experiencing exponential growth in practice because of the lack of universal standards

·         Millions of dollars invested in health information technology and there is not always a return on the investment

·         Clinicians are experiencing dissatisfaction with the health information technology and moral distress

·         There are positive outcomes associated with technology

·         Pay attention to and monitor the interdependent relationship between these two poles

·         Call for course correction nationally to strengthen the practice platform

·         Describe positive outcomes and negative consequences of both poles

 

 Teaching Points:

·         Health information technology is never going away!  We are the generation to implement it and for some it is their

only experience.  We will always need to leverage the technology platform and practice platform polarity.

·         Be vigilant in monitoring the interdependent relationship and where the attention is in the organization.

·         You will not achieve safe, efficient care if this polarity is not well managed and it can have very negative impact on

clinicians.

·         Pay attention to any opportunities to course correct

References:

Care-Centered Clinical Documentation in the Digital Environment:  Solutions to Alleviate Burnout

Troseth, M. R. (2017).  Interprofessional Collaboration through technology, Nursing Management, 48 (8):  15-17 doi: 10.1097/01.NUMA.0000521583.55623.c0

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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens! 

We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #11 Why we need an I in Team!

Introduction to Episode

Have you ever heard of the phrase, “There is no I in team”?

Well, there is an “I in Individual”, and teams are made up of individuals. So, there is an I in Team! 

Nationally leaders are looking to team-based care as one of the solutions to poor quality care.  There is an emphasis on moving away from individual autonomous care to team-based care.  What leaders don’t realize is individual and team is a polarity that needs to be leveraged.

 “Individual and Team” represent an interdependent pair of values that are very powerful when leveraged well. 

We often don’t see individual and team through a polarity lens, which is why it is important to shine a light on it and explore its significance during times of complex change in healthcare.

During this podcast we explore this crux polarity within the context of the clinical healthcare team.  It is a significant polarity today with the national focus on improving the quality of care and moving to value-based care. 

Value-based care calls for collaborative team-based care.  However, most of the current workforce is not prepared to practice as a team.

Tracy and Michelle share their experience as interprofessional clinicians and colleagues.  They give insight on ways to leverage and manage the Individual and Team polarity over time to achieve sustainable outcomes. 

 

Episode Summary Points:

·         Why we need an I in team

·         There is a common goal when working as a team

·         Major influencing factors have shifted the focus to team-based care

·         There is lack of progress in achieving the IOM recommendations

·         Moving from volume to value-based care increases the tension, especially when using a problem-solving lens

·         Majority of current workforce is not prepared to practice as a team

·         Everyone has a preference pole

·         Leveraging Individual and Team helps to achieve the Quadruple Aim

·         Using a problem-solving lens is preventing progress and achievement of sustainable results.

 

Teaching Points:

·         Individual and Team represent two different poles, both are equally important

·         Be aware of your preference pole especially if you are a leader in a power position because you can heavily

influence how the individual and team polarity is experienced.

·         Listen for “from-to” statements, it may indicate a polarity exists

 

Click Here to download the Individual and Team Polarity Map and Worksheet

 

References

Institute of Medicine (U.S.), Committee on Quality of Health Care in America (1999).  To err is human: Building a safer health system.  Washington, DC:  National Academy Press. 

Institute of Medicine (U.S.), Committee on Quality of Health Care in America (2001). Crossing the quality chasm: A new health system for the 21st century.  Washington, DC:  National Academy Press. 

Institute of Medicine (U.S.). Greiner, A. & Knebel, E. (2003). Health professions education:  A bridge to quality. Washington, DC: National Academy Press. 

Miller, H. D. (2009).  From volume to value: Better ways to pay for healthcare.  Health Affairs, 28 (5):  1418-1428. 

Burwell, S. M.  (2015).  Setting value-based payment goals:  HHS efforts to improve U.S. healthcare.  New England Journal of Medicine, 372: 897-899.

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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens! 

We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #10 Unleashing the Power of the Margin and Mission Polarity in Complex Care

Introduction to Episode:

In this episode we focus on an over-arching healthcare polarity.  The Margin and Mission Polarity.  Everyone in healthcare is impacted by this polarity. 

Both Margin and Mission must to be present for the system to be sustainable and provide the healthcare we need.

Today we are looking at this polarity within the context of complex care and social needs.

During this episode we talk with Lauran Hardin. Lauran is a leader at the National Center for Complex Care and Social Needs. The center is the home for complex care and is transforming care for people with complex health and social needs. 

Lauran is guiding and coaching leaders every day out in the field to manage this polarity.  Her stories and insights are enlightening and inspiring.

Lauran shares with listeners why it’s important to understand the importance of the margin and mission polarity when creating programs that impact utilization and revenue.

Powerful change and transformation can occur when you understand and marshal the power of both sides of the margin and mission polarity.  Lauran shares some stories that will leave you with a feeling of hope.

Join us to learn from Lauran as she shares case studies and outcomes from the world of complex care and social needs.

 

Episode Summary Points:

·        People with complex and social needs typically require more frequent services without sustainable results

·        Additional polarities at play are competition & collaboration and medical care & whole person care

·        Bring diverse perspectives into one connected whole focused on the same agenda

·        There are benefits for individuals and communities in mastering polarities

·        5% of the population represents 50% of the cost in the healthcare system

·        Honor both sides of margin and mission to facilitate change

·        To reduce barriers to new programs or interventions it is important to keep the margin and mission polarity in mind

·        Develop partnerships with CFOs and the financial side of the business to create solutions together to keep

organizations and systems in balance

·        Leverage relationships and dialogue to lean into the tension

·        Grieve loss of previous dreams or when it hasn’t worked in the past but continue to anchor to the new dream and

approaches

·        Need to come to the table together and channel the power of polarities

·        Shed old beliefs… it doesn’t have to be win or lose, either/or it can be both/and

·        Discomfort is taking on a new skill- the more practice the more we can build strong transformation

 

Teaching Points:

·        Keeping the focus on the shared or greater purpose reduces resistance

·        Recognize your preference pole and be willing to let go

·        Understand diverse opinions are normal and can be channeled and harnessed for the greater good

·        Open yourself up to the rightness of the opposite perspective

 

Resources:

 

Lauran Hardin’s TED Talk: What Matters Most- (Lauran’s TED talks is being edited.  We will post the link as soon as it’s available)  https://tedxmidatlantic.com/speakers/ 

Camden Coalition for Healthcare Providers  https://www.camdenhealth.org/ 

Articles Authored by Lauran Hardin:

 Competing healthcare systems and complex patients: An inter-professional collaboration to improve outcomes and reduce healthcare costs

 JAMA Forum: Bringing It Home: The Shift in Where Health Care Is Delivered

 

Previous Related Episodes

Episode #2

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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens! 

We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #9 Interprofessional Collaboration:  The Upside of Hierarchy

Introduction to Episode:

Relationships are a critical element of interprofessional collaboration. 

In today’s episode, we discuss hierarchy and partnership within the context of interprofessional collaboration in the healthcare setting. 

There is a long history in the evolution of the health professions and how they work together that is rooted in social class and gender differences.

There is extensive literature describing the status inequities and power imbalances between physicians, nurses and other health professionals that exist today.

Historically these differences resulted in a hierarchical power structure within healthcare with the physician in the most superior position of the structure.  Interprofessional collaboration and team processes challenge this hierarchical power structure.

Health professionals bump up against the tension between hierarchy and partnership every day as they try to work in collaborative ways.

When we experience hierarchical relationships as negative or as a problem, it’s natural to want to move away from the experience and toward the opposite, a more partnering relationship.   

There is an upside to hierarchical relationships that we are at risk of losing if we over emphasize partnerships. 

We need both hierarchical and partnering relationships to establish a healthy interprofessional collaborative culture. 

 

Episode Summary Points:

·         Long history of cultural, class and gender issues underlying current interprofessional collaboration challenges

·         Power authority within hierarchical structure of healthcare is challenged by interprofessional team processes

·         Lack of clarity on professional boundaries

·         The term hierarchy brings up negative feelings/emotions

·         Discuss this relationship using neutral terms vertical (hierarchy) and horizontal (partnership) relationships

·         Cardiac arrest as an example of leveraging hierarchy and partnership (vertical/horizontal) polarity

·         When in the downside of hierarchical (vertical) relationship it is often seen as a problem to solve

·         Positive outcomes of vertical (hierarchy) relationship

·         What’s at risk if you over emphasize horizontal (partnership) relationships

·         Action steps to achieve positive outcomes of both vertical and horizontal relationships

·         Focusing on the shared purpose can help relieve tension and open people up to positive attributes of each pole

Teaching Points:

·         Both types of relationships are necessary to establish an interprofessional collaborative culture

·         Engage in dialogue to uncover the “rightness” of each type of relationship

·         Recognize your preference pole and blind spots

·         If in a position of power be aware how your preference can influence how well or poorly this polarity is leveraged

·         Use Polarity Thinking™ framework and language to explore current realities and reveal a complete picture of reality

References:

Alexarian, J.A., Kitto, S., Rak, K.J., & Reeves, S. (2015). Beyond the team:  Understanding interprofessional work in two North American ICUs. Critical Care Medicine, 43(9):  1880-1886 

Goldman, S., Reeves, S., Wu, R., Silver, I., MacMillan, K., & Kitto, S. (2016).  A sociological exploration of the tensions related to interprofessional collaboration in acute-care discharge planning.  Journal of Interprofessional Care, 30(2):  217-225.  doi:  10.3109/13561820.2015.1072803 

Hall, P. (2005). Interprofessional teamwork:  Professional cultures as barriers. Journal of Interprofessional Care, Suppl 1:  188-196. 

Hewitt, G., Sims, S., & Harris, R. (2014).  Using realist synthesis to understand the mechanisms of interprofessional teamwork in health and social care.  Journal of Interprofessional Care, 28(6):  501-506.  doi:  10.3109/13561820.2014.939744 

Lingard, L., McDougall, A., Levstik, M., Chandok, N., Spafford, M. M., & Schryer, C. (2012).  Representing complexity well: A story about teamwork, with implications for how we teach collaboration.  Medical Education 46: 869–877 doi:10.1111/j.1365-2923.2012.04339.x 

Orchard, C. A., Curran, V., & Kabene, S. (2005).  Creating a culture for interdisciplinary collaborative professional practice.  Medical Education Online, 10(1):  4387.  https://doi.org/10.3402/meo.v10i.4387

Wesorick, B. (2016). Polarity Thinking in Healthcare:  The Missing Logic to Achieve Transformation. Amherst, MA, HRD Press, Inc.

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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens! 

We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #8 Patient and Clinician Safety from a Patient’s Point of View

Introduction to Episode

We were so excited to have Vicky Schmidt join us for this episode.  Vicky has experienced some of the very best of care and some of the worst care over the past 18 years.  She is a patient advocate for person-centered care and has shared her story with thousands.

During this episode Vicky helps us shine a light on the patient and clinician safety polarity from a patient perspective.

This is a significant polarity in healthcare and on the minds of clinicians and healthcare leaders everywhere.

The greater purpose of managing the patient and clinician safety polarity is to create a culture of safety for both those that give and receive care. 

Looking at safety in healthcare through the eyes of someone who has been engaged with and experienced healthcare from across the continuum was enlightening and informative.   

Episode Summary Points:

·        The importance of knowing the patient and family story

·        What patient safety means to patients

·        Signs of safety from a patient’s perspective

·        If clinicians are not supported, the patient isn’t either

·        The patient as part of the team

·        The patient voice in care

·        Education is empowering

·        Positive outcomes from clinician safety

·        Downsides of over focusing on patient safety to the neglect of clinician safety

·        Why it’s important to listen to and acknowledge what patients know about themselves as part of the care

process

·        Patient’s “feel” the environment

·        The significance of the relationship between patients and their caregivers

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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens! 

We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #7 What you’ll want to know about solving the staffing problem

Introduction to Episode

Is there ever a time when “staffing” is not being addressed?

Having adequate staff is a critical component of healthcare.  It is more significant than in any other industry probably.  In other industries when someone doesn’t show up for work or you have a few vacancies you may be able to shift things and it’s not that big of a deal or you are able to make things work.  In healthcare, when there are staffing issues, the potential for harm to others increases and satisfaction is challenged both for patients and for clinicians.

There is no one solution or silver bullet to addressing staffing problems!  There is a “short game” and a “long game”.  In the short game you are finding solutions to the problem of not having enough staff and in the long game you are managing the polarities that are beneath the staffing problem as a proactive strategy to avoid experiencing the problem.

During this episode Tracy and Michelle talk about the recruitment and retention polarity that lies beneath the staffing problem.  Managing and leveraging this polarity is the “long game” approach to staffing challenges.

 

Episode Summary Points:

·        Staffing challenges are both a problem and a polarity

·        National influencing factors include workforce challenges, burnout, financial constraints, shifting priorities and

location of services

·        Multiple polarities underlying the challenge of staffing

o   Patient Needs and Staff Needs

o   Mission and Margin

o   Proactive and Reactive approaches

o   Recruitment and Retention

o   Local needs and Global needs

·        Great leaders and clinicians concerned about the safety of patients and clinicians

·        Risks of over focusing on retention when feeling tensions and stress

·        Positive outcomes of recruitment and retention

·        Negative consequences of over focusing on recruitment or retention

·        Simultaneous action steps to gain or maintain positive outcomes of both recruitment and retention

·        Early warning signs indicating you may be over focusing on one pole to the neglect of the other

 

Teaching Points:

·        Staffing is a problem and polarity

·        There are multiple additional polarities that can be managed when addressing staffing

o   Patient Needs and Staff Needs

o   Mission and Margin

o   Local and Global Needs

o   Proactive and Reactive approach

·        Managing the Recruitment and Retention Polarity is a long-term strategy to managing staffing issues

·        Measure the outcomes of this interdependent relationship not just the independent outcome

Recruitment and Retention Worksheet and Polarity Map®

Download here

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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens!  We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #6 The Holy Grail:  Managing Taking Care of Self AND Taking Care of Others

Introduction to Episode

In this episode we focus on a personal level polarity that we believe is universal.

We venture to say that there isn’t anyone who isn’t or hasn’t been impacted by this polarity.  Clinicians especially, because taking care of others is at the core of our roles and responsibilities. Some individuals become clinicians because of their desire to care for others or to serve others or because they feel called to do so. 

In healthcare today, leaders and clinicians are facing significant challenges such as increasing suicide rates, burnout and moral distress.  In addition, some of us are members of the “sandwich generation”, taking care of kids and parents!   Because this is a polarity, we know it won’t go away, so learning to leverage it is the best option for all. 

Taking care of self and taking care of others occurs in many different contexts.  We experience it as healthcare clinicians, as parents, and as leaders.

During this episode we talk with Dr. Diane Gilbert Bradley about her experiences with managing and leveraging the “self & other” polarity as she navigated her way through medical school, being a rehab medicine physician and as a corporate executive.

Dr. Bradley’s advice to others:  look at taking care of self and taking care of others through an abundance lens.

 

Episode Summary Points:

·        Competition in Medical School on many levels moves you to focus on self to be the best but also focused on

learning to serve others

·        Preference for the OTHER pole lead to choices around specialty of Rehab Medicine

·        Downside of preferring the OTHER pole drove decision making and risk taking

·        Feeling the tension of the downside of a pole can be the impetus for change or escape

·        Over time realized need both focus of self and other

·        Actions can serve both SELF and OTHER Poles

·        Pendulum effect moving from focus on one pole to the focus on other

·        Conscious choices, intentionality and permission to focus on both

·        Self-aware enough to know there was a problem but paralyzed with inability to change it

·        Power of leveraging polarities in designing your life 

·        Extended sabbatical enabling learning of new skills and volunteering on boards

·        Intention regarding how to spend time and design life

·        Awareness of early warning signs and indicators of over focus

 

Teaching Points:

·        This is a crux polarity in any and all relationships

·        Be aware of early warning signs-both with personal and professional relationships

·        This is continuous-not a problem to solve-you will always be working on managing self and others

·        Context and beliefs can influence how you experience this polarity


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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens!  We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode #5 Interprofessional Education and Interprofessional Collaborative Practice: Why isn’t it sustainable?

Introduction to Episode

Both of us have spent a good portion of our careers developing and helping organizations implement tools, processes and infrastructures that support interprofessional education and collaborative practice.  As you might guess this is a topic that is near and dear to our hearts. 

The Institute of Medicine (IOM) reports, To Err is Human:  Building a Safer Health System (1999); Crossing the Quality Chasm: A New Health System for the 21st Century (2001) and Health Professions Education:  A Bridge to Quality (2003), served to heighten the awareness of concerns about safe, quality, cost-effective care within the United States healthcare system.  These reports also reinforced the need for interprofessional education (IPE) and interprofessional collaborative practice (ICP).  IPE and ICP represent an interdependent pair.  Both are necessary to prepare the future and the current workforce to work collaboratively.

More recent reports indicate the traditional cultures and practices in healthcare settings do not support ICP (Brandt, Kitto, & Cervero, in press) and those who have experienced IPE go into practice settings that do not support what they have learned.

Achieving the national goals of safe, quality, efficient, effective care will require a healthcare workforce prepared and supported to work collaboratively.  Managing the IPE and ICP polarity is key in achieving sustainable outcomes.  Leveraging strong partnering relationships between practice and education leaders may be one way to manage the IPE/ICP polarity and support current and future workforce preparation.

 

Episode Summary Points:

·        Practice settings are not supporting sustainability of IPE

·        Gordian Knot as representation of interprofessional education and collaborative practice (IPECP) as an

intractable problem

·        Infinity loop is a representation of the ongoing tension between IPE and ICP

·        Positive outcomes from focusing on IPE and ICP

·        Negative consequences from over emphasizing IPE to the neglect of ICP

·        Negative consequences from over emphasizing ICP to the neglect of IPE

·        Interdependent relationship between IPE and ICP

·        IPE and ICP partnering relationships

·        Simultaneous action steps to strengthen IPE and ICP outcomes

·        IPE and ICP early warning signs of negative consequences

·        Greater purpose and deepest fear for leveraging the tension between IPE and ICP

·        Equal importance of IPE and ICP

·        Tension between IPE and ICP cannot be eliminated, it must be managed

·        Education and practice partnerships as essential to establishing shared responsibility

 

Recommended Resources: 

Brandt, B., Kitto, S., & Cervero, R. M.  Untying the Interprofessional Gordian Knot: The National Collaborative on Improving the Clinical Learning Environment 1-12. DOI: 10.1097/ACM.0000000000002313

Brandt, B. (2015, March). Interprofessional education and collaborative practice:  Welcome to the "new" forty-year-old field.  The Advisor. Retrieved from https://nexusipe.org/resource-exchange/interprofessional-education-and-collaborative-practice-welcome-new-forty-year-old

Golom, F. D. & Schreck, J. S. (2018).  The journey to interprofessional collaborative practice.  Are we there yet?  Pediatric Clinical North America Journal, 65: 1–12. https://doi.org/10.1016/j.pcl.2017.08.017

Health Professions Accreditors Collaborative. (2019). Guidance on developing quality interprofessional education for the health professions. Chicago, IL: Health Professions Accreditors Collaborative.

Institute of Medicine (U.S.), Committee on Quality of Health Care in America (1999).  To err is human: Building a safer health system.  Washington, DC:  National Academy Press.

Institute of Medicine (U.S.), Committee on Quality of Health Care in America (2001). Crossing the quality chasm: A new health system for the 21st century.  Washington, DC:  National Academy Press.

Institute of Medicine (U.S.). Greiner, A. & Knebel, E. (2003). Health professions education:  A bridge to quality. Washington, DC: National Academy Press.

National Academies of Sciences, Engineering, and Medicine 2019. Strengthening the Connection Between Health Professions Education and Practice: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press.https://doi.org/10.17226/25407.

Hendricks, S., LaMothe, V. J., Halstead, J. A., Taylor, J., Ofner, S., Chase, L.,  Dunscomb, J., Chael, A., & Priest, C. (2018). Fostering interprofessional collaborative practice in acute care through an academic-practice partnership, Journal of Interprofessional Care, 32(5):, 613-620, DOI: 10.1080/13561820.2018.1470498 To link to this article: https://doi.org/10.1080/13561820.2018.1470498

Weiss,  K. B., Passiment, M., Riordan, L., & Wagner, R. for the National Collaborative for Improving the Clinical Learning Environment IP-CLE Report Work Group. Achieving the Optimal Interprofessional Clinical Learning Environment: Proceedings from an NCICLE Symposium. http://ncicle.org. Published January 18, 2019. doi:10.33385/NCICLE.0002


Practice Education Partnership Guide

Download here

 

Interest in IPE/ICP Polarity Research

Click here if you are interested in exploring research opportunities related to managing the IPE/ICP polarity.



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If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens!  We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to review, select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode 4: Recognizing the Significance of Caregiver Burden

Introduction to Episode

We were so excited to have Dr. Erin Craft-Otterbacher join us for this episode.  Erin is a new Family Practice DNP graduate. She is a very bright, knowledgeable young lady who we know you will enjoy learning from.

During this episode Erin helps us shine a light on caregiver burden and the need to manage the tension between the needs of the caregiver and the needs of the care recipient.

Managing the tension between this pair of needs is an emerging and significant polarity in healthcare.  The polarity is universal.  Most of us have had caregiver experiences or even care recipient experiences. Today, more and more middle-aged adults are becoming members of the “sandwich generation” and feeling the squeeze and burden of caring for aging parents and children at the same time. 

Can you relate to this tension?

The over emphasis on care recipient needs to the neglect of the needs of the caregiver can lead to significant and negative consequences for both the caregiver and the care recipient. 

Healthcare systems, for the most part, do not do a very good job of recognizing the needs of caregivers.  Only about 16% of caregivers are asked about their own self-care.  The burdens they feel and carry, if unaddressed, can lead to devastating outcomes for them and for those they are providing care for. 

There is a call to recognize the significant and highly valuable role caregivers play in care delivery as we deal with a growing aging population because caregivers play such an essential role.  Another reason to recognize the value of the caregiver is it is extremely important to the economic health of our country.

 Episode Summary Points:

·        Polarity Thinking™ as a mind frame and way of seeing the world

·        Underneath the problem of Caregiver Burden was the caregiver needs and care recipient needs polarity

·        Caregiver burden could potentially impact sustainability of the healthcare system

·        Recognition of the role and value of the caregiver to sustain individual and system health

·        Positive outcomes of supporting the needs of the caregiver and needs of the recipient of care

·        Negative consequences of over emphasis on one pole to neglect of the other

·        Polarity Map® as a tool to make polarities apparent and predictable

·        Macro and micro level action steps to strengthen outcomes from addressing the needs of both

·        Opportunities to leverage the Polarity Map® as a “wisdom organizer”

·        The Polarity Map® can function as a care planning tool

·        Recognizing early warning signs of over emphasis is important

·        Why it’s essential to leverage the tension between caregiver and care recipient needs

 

Recommended resources:

National PACE Association 

https://www.npaonline.org/


AARP Family Caregiving

https://www.aarp.org/caregiving/

 

AARP Caregiver Life Balance

https://www.aarp.org/caregiving/life-balance/?intcmp=AE-CAR-SUBNAV-CLB


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 Are you subscribed to our podcast?  If you’re not, we want to encourage you to do that today.  We don’t want you to miss an episode.  We have many great sessions lined up, including some amazing healthcare leaders who have great experience in applying Polarity Thinking™ in healthcare.  Click here to subscribe in iTunes!

If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens!  We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to access, and after listening select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”  


 Episode 3:  Patient and Clinician Satisfaction:  It’s not an Either/or Choice

 

Introduction to Episode

Today we are exploring a major crux polarity in the healthcare system that is often looked at as two separate or independent issues.  The topic today is the patient satisfaction and clinician satisfaction polarity.  While this pair appears to be opposites, they have an interdependent relationship.  Achieving positive sustainable outcomes cannot be accomplished by focusing on one or the other  – heck no!  It’s a both/and opportunity. 

In this episode we will discuss the current realities surrounding this polarity.  Why an over-emphasis on patient satisfaction actually got healthcare leaders into trouble over time and how the Triple Aim may have contributed to our current realities. 

This episode invites you to consider your own experience as a healthcare leader and/or practicing clinician and expand your thinking to see patient and clinician satisfaction as a “good tension” that can be leveraged to create organizations that are the best for patients to receive care and for clinicians give care. 

Podcast Episode Summary 

·        External factors: burnout, suicide, moral distress, regulatory pressures

·        Burnout is a problem – underneath that is the polarity of patient satisfaction and clinician satisfaction.

·        Triple Aim to Quadruple Aim – what did we learn?

·        National Academy of Medicine – Action Collaborative on Clinician Well-Being and Resilience

·        Leveraging the tension between patient satisfaction and clinician satisfaction

·        Action steps to improve patient satisfaction and clinician satisfaction

·        Recognizing the early warning signs of over-focusing on one over the other

·        Be vigilant!

Recommended Resources

Berwick, D.M., Nolan, T.W. & Whittington J. (2008) The Triple Aim: Care, health, and cost. Health Affairs, 27 (3):759-769 

Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12(6):573-576. 

Ahmed, F., Burt, J., Roland, M. (2014).  Measuring patient experience:  Concepts and methods.  Patient, 7: 235-241. 

Janicijevic, I., Seke, K., Djokovic, A., & Filipovic, J.  (2013).  Healthcare worker satisfaction and patient satisfaction-where is the linkage?  HIPPOKRATIA, 17(2):  157-162. 

Naidu, A. (2009).  Factors affecting patient satisfaction and healthcare quality.  International Journal of Health Care Quality Assuranc,e 22(4):  366-381.

National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience https://nam.edu/initiatives/clinician-resilience-and-well-being/

MissingLogic is a network organization of NAM’s Action Collaborative.  Read our commitment statement here.



Follow us on Social Media!

 Subscribe & Review in iTunes

 Are you subscribed to our podcast?  If you’re not, we want to encourage you to do that today.  We don’t want you to miss an episode.  We have many great sessions lined up, including some amazing healthcare leaders who have great experience in applying Polarity Thinking™ in healthcare.  Click here to subscribe in iTunes!

If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens!  We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to access, and after listening select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.” 


Episode 2: Barry Johnson & Bonnie Wesorick: Living Legends

Introduction to Episode

We are so grateful to have two “living legends” as our first guests on the podcast, Dr. Barry Johnson and Bonnie Wesorick.  They are both phenomenal leaders whose life’s work has been to bring Polarity Thinking™ to the world.  We are blessed they are our mentors, colleagues and friends! 

During the interview Barry shares how the original Polarity Map® emerged in 1975 and how the work has expanded globally.  Barry partnered with Bonnie Wesorick in the 1990’s as she recognized the significance of managing polarities to achieve healthcare transformation. Bonnie shares her journey in supporting a consortium of over 400 healthcare organizations in applying Polarity Thinking™ and how that led to the development of the first healthcare specific Polarity Assessment™.

 

Episode Summary Points:  

·        Polarity Thinking….the beginning

·        Polarity Mapping – how we see invisible polarities

·        The Infinity Loop – represents the energy between polarities

·        “And” thinking supplements “Or” thinking – a polarity itself

·        Healthcare Frameworks and Models to make sense of the whole

·        We must know reality in healthcare

·        Paradigm Shifts to Polarity Interdependent Pairs: Moving from “From-To” to Both-And”

·        How the Polarity Assessment Tool measures key healthcare polarities in real time


Recommended resources:

Johnson, B. (1992).  Polarity management: Identifying and managing unsolvable problems.  Amherst, MA:  HRD Press. 

Wesorick, B., & Shaha, S. (2015). Guiding health care transformation: A next- generation, diagnostic remediation tool for leveraging polarities. Nursing Outlook, 63: .691-702. http:// dx.doi.org/10.1016/j.outlook.2015.05.007.

Wesorick, B. (2016) Polarity Thinking: The missing logic to achieve healthcare transformation.  Amherst, MA: HRD Press.


www.polaritypartnerships.com MissingLogic, LLC is proud to be a strategic partner of Polarity Partnerships!

 

Follow us on Social Media! 

Subscribe & Review in iTunes 

Are you subscribed to our podcast?  If you’re not, we want to encourage you to do that today.  We don’t want you to miss an episode.  We have many great sessions lined up, including some amazing healthcare leaders who have great experience in applying Polarity Thinking™ in healthcare.  Click here to subscribe in iTunes! 

If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens!  We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to access, and after listening select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”


Episode 1: Introduction to Healthcare’s MissingLogic Podcast

 Welcome to Healthcare’s MissingLogic!   

In this introductory episode, Tracy and Michelle share their 30+ years experience with healthcare transformation and how they are “mad as hell” about the wasted time, money and resources spent on addressing the same challenges over and over.  It is hard to take when you know it doesn’t have to be that way.   

As healthcare clinicians, leaders and educators we are excellent problems solvers, so why do we face the same challenges over and over?  It’s because not every challenge is a problem that can be solved!  Some challenges are polarities and polarities can’t be solved, they need to be managed and leveraged.    

Healthcare’s “missing logic” is recognizing that problem solving is not enough and healthcare leaders need to look at their current challenges through a new lens! When you misdiagnose a polarity as a problem you are 100% guaranteed to fail over time.  Healthcare leaders must compliment their problem solving skills with Polarity Thinking™ to recognize, leverage and manage polarities so they can achieve sustainable positive outcomes. 

Tracy and Michelle invite you to join them in the movement to make Polarity Thinking™ mainstream in healthcare and listen to them each week as they discuss the crux polarities in healthcare.


Episode Summary Points:

 ·        Why are we here and what do we have to say?

·        What is a polarity?

·        Breathing as a polarity metaphor

·        Both/And Thinking approach

·        Problem Lens & Polarity Lens

·        Healthcare’s crux polarities

·        Culture, conflict and resistance

·        All polarities work the same and are 100% predictable

·        We are  “moneyball” of healthcare challenging the status quo

 

Recommended resources:

 www.missinglogic.com

 

Follow us on Social Media! 


Subscribe & Review in iTunes

Are you subscribed to our podcast?  If you’re not, we want to encourage you to do that today.  We don’t want you to miss an episode.  We have many great sessions lined up, including some amazing healthcare leaders who have great experience in applying Polarity Thinking™ in healthcare.  Click here to subscribe in iTunes! 

If you found value in this episode, please leave us a review on iTunes! Our mission is to start “a movement” of leaders who address the chronic challenges in healthcare through a Polarity Thinking™ lens!  We want to share the wisdom in the podcast with healthcare leaders everywhere! Just click here to access, and after listening select “Ratings and Reviews” and “Write a Review” and tell us what your favorite part of the podcast is.”