The Power of Partnership

Transforming Health Care Through Partnership with Julie Kennedy-Oehlert

Cherri Jacobs Pruitt and Riane Eisler with Julie Kennedy Oehlert Season 2 Episode 7

Learn how the ECU Health System in eastern North Carolina uses Partnership-based practices to create a healthy, healing and sustainable health care systems that helps empower the community. 

ECU Health System

System Innovation: A Holistic Approach to Disrupting with Love and Human Caring, Julie Kennedy Oehlert and Kathleen Sitzman

The Real Wealth of Nations: Creating a Caring Economy, Riane Eisler

Transforming Interprofessional Partnerships, A New Framework for Nursing and Partnership-Based Health Care, Riane Eisler and Teddie M. Potter

The Chalice and the Blade: Our History, Our Future, Riane Eisler

The Power of Partnership: Seven Relationships that will Change Your Life, Riane Eisler

Center for Partnership Systems

center@partnershipway.org

Center for Partnership "Join Us" email link  

Resilience, Rising Appalachia

Support the show

Speaker 1:

Welcome to the Power of Partnership podcast. I'm Rianne Eisler, President of the Center for Partnership Systems. This podcast brings you voices from the partnership movement people using partnership practices to build a world that values caring nature and shared prosperity. The Power of Partnership Podcast is hosted by Sherry Jacobs-Pruitt, a health policy and partnership scholar. Today, Sherry interviews Julie Kennedy-Ullert, author and chief experienced brand officer of the ECU Health System in North Carolina, on how innovative partnership-based practices in healthcare settings can positively shape the patient experience and well-being of communities. And now on to today's POP podcast.

Speaker 2:

Welcome, julie to the Power of Partnership podcast. I'm so excited to be interviewing you today.

Speaker 3:

Thank you for having me. I'm pretty excited too. I'm pretty passionate about Rian's work.

Speaker 2:

Great, and let's start about that passion. Can you talk about how you first learned about Rian's work and how it's impacted your work and the way you view the world?

Speaker 3:

Yeah, so I was going to school at University of Minnesota and I was in the Doctorate of Health Innovations and Leadership Doctorate in Nursing and that was the field I was studying and they had a session where Rianne was going to speak and I had been kind of, you know, I was a consultant before that.

Speaker 3:

I'm a nurse by trade and I had been, you know, a little bit adrift, I would say, and I wanted to get a doctorate but I didn't really know what I wanted to do. Many people listening probably know that vibe and I listened to Rianne speak at a conference and it was kind of like. I was like like the whole domination partnership is the struggle of healthcare, because a lot of times physicians and nurses are trained in a domination hierarchy. We don't mean it to be that way, but it is and then they transition that into the healthcare setting and I was just so stunned of how applicable cultural transformation theory was to healthcare and the possibilities of implementing that in healthcare settings to make healthcare better for patients, families, the communities, the team members, and it was just like a huge light bulb went off and really I have been doing that work ever since within the healthcare setting.

Speaker 2:

Lovely. So let's talk a bit more about the work that you're doing in the healthcare setting. So you are the chief experience officer at ECU Health in Eastern North Carolina. Can you talk a little bit about what a typical work week is like for you or what projects you're working?

Speaker 3:

on now. Yeah, so as the chief experience and brand officer, I have strategic responsibility for patient experience, team engagement, workforce well-being and workplace safety for the health system. So strategically that's my role. I also oversee marketing and communication, though that's a little bit of a departure from a traditional chief experience officer role. I have a large analytics arm. I do a lot of work with design and design thinking. I have patient education and patient and family advisors, and then I have an operational arm where I oversee EVS, environmental services, food services those are entry-level workers language access services and hospitality for the health system. I also am responsible for orientation and onboarding, reward and recognition.

Speaker 3:

So it's kind of a large portfolio, but I think sometimes people can think about oh, that all makes sense from the cultural standpoint of how do we interact with each other, what are the relationships like, how do we get the results based on relationships? And so for me, I get to do a lot of really cool work. So some of the things I'm working on right now really important is workplace safety. So the whole country is more polarized, if I might say. And so goes the country, so goes healthcare. So we have patients that have behaviors that might be physically or verbally abusive to team members. We sometimes have issues between team members. Family members might also be abusive to team members, and so really there's a whole body of work, team members, and so really there's a whole body of work, and it's so, if you think about it, so much important work where cultural transformation theory can help us, because it doesn't do any good to have a power over structure when you're trying to keep people safe.

Speaker 3:

So working on workplace decreasing, workplace aggression or workplace safety really involves setting expectations for everyone, healing environment for everyone. How do we want everyone to behave? What will we tolerate? And then what do we do? If we have incidents of workplace aggression, how can we care for the people who are victims of that? How do we listen to our team members so that we can help them stay safe? How do we create an environment that's safe for everyone? How do we listen to our team members so that we know what to do as an organization? So there's a lot, a lot of work that has to get done to help healthcare be safer. And the other thing I want to mention that people don't often think about I think 73% of workplace violence happens in the healthcare setting. So that's weighted toward healthcare and only about a third of workplace aggression actually reported. So you have to really be a safe emotionally safe partnership culture so that people will report, so that people will keep each other safe, so that people will, if they see something, say something. So, again, that's a large body of work, and my guess is most healthcare organizations are actively working on their safety and their environments. So I do a lot of work in those areas. I'm working on a new welcome day, which is orientation. How do we bring people into the healthcare system and orient them to our culture? That really includes what we do for them, for workplace well-being and things like that Really a different approach.

Speaker 3:

I want you to know about our health system. That doesn't really fly anymore. It's more of what can I do for you. As you all know, there's a nursing shortage. There's a shortage of all healthcare workers, so we have to be our best partners when we're attracting and retaining talent. And then I'm also working on behavior standards. So we have values Most healthcare organizations have values, but we want to create some behavior standards that are an always behavior for us within the organization that's tied to our values. So those are some of the things that I'm getting to work on oh, and I'm getting I'm also working on hospitality. I'm a big fan of hospitality. Hospitality is a partnership model. It's where you authentically welcome and care for people, you empathize with them, you help them on their healthcare journey, and so I'm doing a lot of work right now with how do we introduce, sustain and really bring hospitality to life at ECU Health. So those are some of the fun things that I get to work on as a part of my role.

Speaker 2:

And so how do you communicate that need to create that environment? So you talked about values. How overt is partnership, or the recognition of moving away from domination paradigm? How overt is that in your values?

Speaker 3:

strategic framework and we have imperatives around our strategic framework and those are experience, quality, finance, equity and inclusion and well-being. And so that's our strategic imperatives, and those are informed by two theoretical frameworks One is high reliability and the other is cultural transformation theory. And so cultural transformation theory has its living, breathing living breathing position here, because we started it at the very highest levels. So we use a cultural transformation theory visual, from domination to partnership. We teach it in orientation, we teach the concept in our organizational development, psychological safety. We use the lexicon.

Speaker 3:

I was in a meeting the other day and one of the physicians said we really can't be so power over. So we use the lexicon and we actually use power over and power with though we sometimes use domination and partnership as well, but we use the lexicon a lot. It's a part of the fabric of the organization because really, cultural transformation theory helps us speak to dynamics that some people don't have the words to speak to, and so once you teach that lexicon and teach what that means, people understand it and then they can use it in situations where things feel power over to them or they want to have power with relationships. So it's pretty integrated into our culture. We do have a couple of visuals that we use and they are in everything. So they're in the beginning of presentations, they're on our brochures, so it's pretty integrated into our strategic fabric.

Speaker 2:

Can you speak about the patient experience with the ECU system?

Speaker 3:

So we don't teach here. We don't teach the lexicon to our patients, though at other places I've worked we actually have taught the lexicon to patients, but here my hope is that they feel the outcome of that, and there's a couple ways you can notice that. So if patients fear retaliation for reporting something, or if they fear retribution, they're probably in a more power over environment, because, right, healthcare has lots of different microsystems, right. So, again, power With is an aspirational way that we are constantly working. So they probably feel it when they don't feel like they'll be retaliated against. They feel like we have empathy for them, that we do not judge them based on their beliefs, that we do not judge them based on their beliefs or how they look or how they act. So hopefully, the outputs of a partnership culture is their experience, though they don't know the lexicon like the team members do.

Speaker 2:

How was that experience in the previous role that you referenced around teaching it to patients?

Speaker 3:

So interesting, so we taught it to. In the last place I worked, we taught it to our pediatric patients, and so we had this instance with our residents and our teen peds patients, because they're almost the same age. So the residents or the medical students would try to tell the teenage patients what to do, and the teenage patients were like, yeah, I'm not doing that. And so they were very power over with each other. And so we taught the patient to be able to say don't have power over me, have power with me. Can't you understand that you have to have power with me to help me with my disease, but not just dictate to me. So we taught it to the pediatric patients and I thought it went very well.

Speaker 3:

I just haven't done it here because it hasn't come up. I think that it is an interesting thing to teach that to patients, especially in this current environment, because patients really want to be partners in their healthcare. They do not want power over relationships with their providers, they want power with relationships. They want to be an active partner in all their healthcare decisions. That is clear from everything that the patients are telling us all across the US. So it'll be very interesting to see how partnership models play out for health care going forward.

Speaker 2:

So let's talk about measuring the cultural transformation in a health care system. I mean, this is really not business as usual per se, at least in the United States, and so how do you make that case to leadership to go that extra step or allocate funding for the extra work to support this partnership-based foundation?

Speaker 3:

So that's the beauty is that partnership power with cultures achieve results that healthcare is already trying to achieve and it's not extra work, it's work that helps achieve outcomes they already want. So you can measure process measures and you're so right that this takes a different kind of measure, but it's not so far off. What people already do. You just have to look into the machinery to find trust is there. I can associate that with a relationship and how that relationship is structured. If there's fear there, I always say if there's more fear, there's more domination, right, so there's a lot of proxy measures and then you can associate those with the outputs.

Speaker 3:

So, fear of reporting errors, that's one. Recruitment and retention and people that leave their job because of their manager right, there's another, and recruitment and retention is really big right now. Fear of reporting safety events. You can think about people who don't report their leader or they don't feel like they can talk to their leader, teams that don't work well together and teams that are at each other's you know, kind of at each other's throats. That's a bad way to say it, but you can think about that from a domination versus partnership hierarchy. Psychological safety is a big one. I mean psychological safety is cultural transformation theory and can be used as such. So there's a lot of metrics that people desperately want to achieve in healthcare that are associated to how those relationships are structured to get to that relationship. It's way more of a clear line than people think and once an organization understands it, those lines are very clear.

Speaker 2:

You are listening to the Power of Partnership podcast. If you would like us to share your partnership story or if you would like to become a proud sponsor of the POP podcast, please contact us at center at partnershipwayorg. And now back to today's episode. Are you seeing any data that seem to indicate that the ECU system is doing better than other systems, rural-based systems that don't have cultural transformation theory at their foundation?

Speaker 3:

A couple of things I think that are very telling is we did a lot of work right before the pandemic on empathy and empathizing with each other. Empathizing with patients we had empathy salons and we also did a lot of work on having partnership relationships with each other. Empathizing with patients we had empathy salons and we also did a lot of work on having partnership relationships with each other right with each other, because as our relationships go, so do the relationships with patients. So when we went into the pandemic, our patient experience did not decrease. Everyone else's dropped in the whole nation, ours did not, you know, because, remember, the pandemic was very polarizing for health care and our team engagement did not drop either. So as the whole nation was seeing decreases in team member engagement, our team member engagement continued, it continued and it never dropped. So how?

Speaker 2:

innovative is your role. Are there other health care systems that you know of that have a chief experience officer, a role similar to yours?

Speaker 3:

Well, I'm very lucky. I work for a great organization that believes in innovation as a pathway to getting better for our communities and for our team members and patients, so my role is pretty innovative. You can see by the structure that even the structure is innovative, and really we try to stay in the thinking, because, of course, this is a partnership model, too, of listening, so listening to our communities and doing what they think we should do listening to our team members, listening to our patients, and so if you're a good listener, you have to be innovative, because healthcare traditionally hasn't always listened, and so I think it's very my role is very innovative. Also, I feel like innovation is bred sometimes in places that have less resources. So we're a very resource constrained environment, and if you don't have a lot of resources, that doesn't mean you can't get things done. That just means you have to be creative about getting them done, because I think what we now know which I think is very much about relationships and the wisdom of cultural transformation theory is that patient experience is an outcome of team experience, and so when healthcare is figuring that out, they know they have to put both of those experiences together, like I have.

Speaker 3:

Strategically. Some people still have it siloed, but it's coming right Because the human experience and how the relationships are structured within that microcosm, it doesn't matter if it's the structure between tumors or patients, they all feel it. So on a unit, the team engagement and the patient experience is going to be similar. And so how I check that actually is, I ask the same questions to patients as I ask for team members. So if I want to say, are we creating a caring environment that helps you heal, that's a pretty partnership-based question. I ask it and it's a Gene Watson human caring question, so it's a Caritas question. So I ask it for the patients. But I also ask it to the team members. So I say to the patients do we create a caring environment for you? But then I say to the team members, does the system create a caring environment for you? And if they're the same, I know that that culture is a nice partnership-based little ecosystem.

Speaker 2:

Can you speak a little bit about the rural nature of ECU Health and so if the partnership, cultural transformation, feeds into the community in a larger way?

Speaker 3:

Yeah. So I do believe though I don't know that we have measures as well into the community. But we do a lot of community work, we do a lot of partnering with our communities. Our communities have told us over and over we don't want you to just give us things, we want to have dialogues with you, we want to, you know, we want to have jobs, we want to be a part of you. We are the biggest employer in Eastern North Carolina and so I don't think we yet have measures, even the population health measures to show relationships.

Speaker 3:

But we did this really interesting thing here which I'm pretty excited about is we took the Watson, caritas, human caring questions. They're very partnership based and we geomapped them into our communities. So we look at our social determinants of health in the communities and then we overlay these questions, which is do we create a caring environment that helps you heal? Do we value your faith and beliefs allowing for hope? Do we have trusting relationships with you? Pretty partnership-based questions and we geomap them so we can see where we might not have those great partnerships and then we can do things. We can have pop-ups there, we can do more education there, we can do relationship building there. But again, I don't think that the US and population health has caught up with that yet, though I'm pretty sure that people are very clear that a lot of the population health and a lot of the social determinants of health have an element of relationships in them. I just think we're not quite there yet with our metrics play. It's good though it's.

Speaker 2:

There's innovation coming in that regard nice and, hopefully, recognition that the domination paradigm is another social determinant of health yeah, because, because it is yeah yeah, so what are your thoughts on how replicable your role is in other health care systems, for instance, health care systems that are urban-based instead of rural?

Speaker 3:

I think it's very replicable. I think it's not this place. I think it's about the willingness of the organization to think about different ways to structure relationships, different ways to structure relationships, different ways to structure goals and different theoretical frameworks that they apply strategically, that go down into the organization. So because we use cultural transformation theory at the highest levels of the organization, it makes it easy for us to cascade. We use measures to measure it proxy measures, but we still use them, and so I think it's very replicable. And the other thing I want to say is that I think that it also is the path to healthcare being more joy-filled and having better well-being and less burnout, because when you have purpose and you have strong partnership relationships, that is your mantle to protect against burnout, because people get burned out when they work and work and don't have purposeful relationships.

Speaker 2:

They don't feel like they're making a difference, and so I feel that it's not only replicable, I think it's the path forward for healthcare right now think it's the path forward for healthcare right now, and so let's talk a bit about your book that was published this year System Innovation A Holistic Approach to Disrupting with Love and Human Caring.

Speaker 3:

Yeah. So that book is a labor of love, for sure, and it was authored by myself and Kathleen Sitzman. We are both nurses by trade and it really is a different way to look at system disruption and we use two theories we use Gene Watson's human caring theory and we use cultural transformation theory, which we introduce in the book. And this book is a text and it's really a leadership companion book and our hope is that, as you're thinking about leading in healthcare, that this is the book you'll pick up and say, oh, there's a different way of doing this than maybe domination, fear-based top-down leadership, and it really talks about the application of cultural transformation theory and Gene Watson's human caring theory. And then it really has really practical things you can do to bring those frameworks alive in your own organization, and it's really a system view. So these are things you can scope through the whole system, and the interesting thing about it is is that these things generally are things that people would love to do because they're heartfelt and they they develop great relationships. So so it's got lots of tactics in it.

Speaker 3:

And then what we did at the end which I just love about this book is we looked at nursing voices in healthcare and we actually comment on their voices. We take these quotes from nurses that Dr Sitzman collected. She does an international moot and she teaches human caring theory. So we took these voices of nurses during the pandemic and then we talked about how cultural transformation theory and human caring theory. So we took these voices of nurses during the pandemic and then we talked about how cultural transformation theory and human caring could actually be the antidote for what they were feeling and what was happening to them during the pandemic, and that's what we added to the last chapter. It's a very user-friendly book, but it really was designed for people who know in their hearts that love and human caring can be the disruptor for health care or any business right now.

Speaker 2:

Lovely. Well, I'll definitely include a link to that book in the show notes for today. Are there other resources or next steps you would recommend to our listeners.

Speaker 3:

I have to give a shout out to Rand Iser's the Real Wealth of Nations, because it's very applicable to healthcare, and then also a book that I used a lot when I was in my doctoral program, which is Transforming Interprofessional Partnerships, by Rand Iser and Teddy Potter, and that book is a healthcare textbook as well, and so all three of those are great resources for thinking about implementation of cultural transformation theory wherever you work.

Speaker 2:

And I will remind our listeners and inform those who may not be aware that episode five from season one of the Power of Partnership podcast is Teddy Potter, who co-authored the book that Julie just mentioned with Rianne Eisler, and so that's an episode devoted to that book's um overview about domination in the healthcare system. So if you haven't listened to that episode, it's great. Um, healing healthcare is what it's called. Uh, julie, thank you so much. This has been, this has been so wonderful. I want to ask you if you have any final words that you'd like to share with our listeners.

Speaker 3:

I do, because I everyone is talking about innovation right now, including my book on system innovation. You will not get great innovation in a domination power over culture. Shift to a partnership, loving power with culture, your team members, if you're a leader, your co-workers. They can't innovate if there's too much fear in the culture, there's too much judgment, there's too much hierarchy. We need to innovate healthcare so badly. Healthcare has to be so much better for you, for me, for the people we love, for the people of the United States, and it has to be better. And so, in order for us to innovate and get the very best from our people, we have to move into a partnership model, because that's where innovation happens. So that's my wish for healthcare, but it's actually my wish for anybody in any of their roles that they get to work in an environment that is partnership-based, that isn't judgmental, that's full of love and empathy, so that they can bring their best to whatever they're doing.

Speaker 2:

Beautiful. Thank you so much. I'll also be including in the show notes, of course, a link to the Center for Partnership Systems where you can access any of our learning resources, and you can also reach out to us if you wanted some support exploring how you can incorporate partnership as a foundation for your organization. Thank you for listening to the Power of Partnership podcast. We're grateful to Rising Appalachia for the use of resilience as our Power of Partnership theme music. If you would like us to feature your partnership story or if you would like to be a proud sponsor of the Power of Partnership podcast, please contact us at center at partnershipwayorg. We hope you enjoyed this episode and will leave us a review on your favorite podcast channel. And don't forget to subscribe to be notified when new episodes are released. Every other Tuesday I'm Cherry Jacobs Pruitt. See you next time on the Power of Partnership podcast.

Speaker 4:

I trust the movement. I negate the chaos, uplift the negative. I'll show up at the table again and again and again. I'll close my mouth and learn to listen.