Cast & Curious

Tag: Leadership & Management

Leadership in health care involves influencing and motivating medical personnel to contribute to the success and effectiveness of medicine, patient care, and health care practices.

  • Practical Digital Transformation in Resource-Limited Healthcare Settings

    Practical Digital Transformation in Resource-Limited Healthcare Settings

    Welcome to today’s #HealthXPh discussion on making digital health work in real-world settings. I’m @bonedoc, an orthopedic surgeon who’s been practicing in the Philippines for over twenty years, focusing on workflow redesign and systems improvement. Today we’ll explore three critical questions facing clinician-innovators everywhere, plus dig into some cross-cutting challenges you’ve all been asking about.

    Our format: #HealthXPh chat is an hour long conversation of healthcare professionals on #bluesky moderated by a host who chose a topic for the week and write the anchor post as a back rounder for the participating audience. The convo revolves around three main questions which the participants answers by appending #healthxph to their bluesky posts. I’ll kick off each question with my perspective, then open it to our panelists and the audience. Jump in anytime—this is a conversation, not a lecture.

    T1: Starting a New Procedure or Pathway

    “When introducing a new interprofessional procedure or pathway, how do you start it—who you brief, what you measure on day 1, and what safety stop builds trust?”

    My approach—the “concentric circle briefing”:

    Week -2: Brief your champions first— residents who’ll execute, head nurse, relevant specialists. Ask them: “What could go wrong?” Their concerns become your safety stops.

    Week -1: Brief department head and quality officer. Show them your safety metrics and stopping rules. In my experience, showing you’ve thought about failure wins more support than showing success.

    Day 1: Five-minute huddle before each case. One sentence about what’s different, one about what stays the same, and one clear safety stop: “If X happens, we return to standard protocol immediately, no questions asked.”

    What I measure on day one:

    • Time metrics (procedure duration, turnover time)
    • Safety events (any deviation from expected course)
    • Team confidence score (1-5 scale, anonymous, after each case)

    The safety stop that builds trust: When we introduced a new minimally invasive approach, our safety stop was: “If we can’t achieve adequate visualization within 15 minutes, we convert to open.” We triggered it twice in our first ten cases. Those conversions built trust because we’d named it upfront.

    Additional Questions for participants:

    • What’s your go-to safety stop for new protocols?
    • How do you measure team readiness, not just clinical outcomes?
    • Has anyone tried something different than my “concentric circle” approach?

    Open to audience: What’s stopped you from piloting a new procedure? What would make you feel safe to try?

    T2: The Digital Tool That Made Adoption Inevitable

    “Name a simple digital tool (or tweak) that saved clinicians time in your setting; what made adoption inevitable rather than optional?”

    My example: Viber/Facebook/Socmed-based imaging and appointment system

    Prior to the pandemic, our residents spent 20 minutes per patient hunting for old radiographs. We implemented:

    • OPD clinic Viber/FB messenger account (free, works on any phone)
    • Computers with Xray viewers on every OPD clinic.
    • Networked Photos of X-rays/CTs immediately after reading, tagged with patient name and date
    • Automated appointment reminders through Messenger chat bot (free)
    • One-page Google Form (8 required fields) replacing 3 pages of handwritten notes

    What made adoption inevitable:

    • Visible time savings within the first week: Residents could retrieve imaging in seconds rather than hunting through filing rooms. When you save meaningful time, you don’t need a mandate.
    • Solved a pain point, not an administrator’s wish: This came directly from a resident saying they spent more time looking for films than looking at patients.
    • Zero training required: Everyone already knew Viber/FB Messenger. The Google Form auto-populated from existing patient lists.
    • The critical tweak: We made the old way harder than the new way. We reduced printing of duplicate imaging reports. Want an old X-ray? You could walk to the basement filing room or open Viber. The path of least resistance became the digital path.

    That’s the secret: Don’t make digital adoption optional and easier. Make it inevitable because the alternative wastes time everyone wants back.

    Questions for participants:

    • What’s your “app moment”—the simple tool that just worked?
    • How do you make the old way harder without alienating your team?
    • Any free/low-cost tools that surprised you with their adoption rate?

    Audience challenge: In the chat, drop your “simple tool that saved time” story. Let’s crowdsource a resource list.

    Question 3: Reliability Practice for Early Wins

    “Which one reliability practice (checklist, escalation rule, huddle) yields the biggest early win, and how do you prevent drift after week 3?”

    My answer: The 10-minute morning safety huddle wins fastest—but only if you protect it fiercely after novelty wears off.

    What the huddle looks like:

    • 8:00 AM sharp, every day, standing room only (keeps it short)
    • Three questions per patient:
      1. “What could kill this patient today?”
      2. “What’s the plan to prevent it?”
      3. “Who owns each action item?”

    Why it yields early wins:

    Research supports this approach. Studies in pediatric ICUs have found that implementing daily huddles leads to high knowledge of practice changes among staff and is time-efficient. One surgical unit study showed daily safety huddle compliance increased from 73% to 97%, with hundreds of safety issues addressed, the majority pertaining to infection control and medication errors.

    The benefits I’ve observed include:

    • Reduced communication errors: When nurses hear the plan directly from physicians, miscommunication decreases dramatically
    • Faster learning for juniors: First-year residents learn escalation patterns much faster because they hear senior decision-making out loud daily
    • Culture shift: Practicing “What could go wrong today?” makes discussing “What went wrong yesterday?” natural rather than accusatory

    Preventing drift after week three (where most initiatives die):

    The HUSH project across 92 wards in five UK hospitals found that successful embedding of patient safety huddles took an average of 19.6 weeks—this tells us sustainability requires intentional effort.

    My anti-drift strategies:

    1. Anchor to an unchangeable event: Not “8 AM-ish,” but “immediately after night team sign-out.” Link it to something that must happen anyway.
    2. Measure one metric publicly: Track a specific outcome (like communication-related safety events) on a visible whiteboard. When the metric trends unfavorably, the team self-corrects.
    3. Rotate the facilitator: Every week, a different person leads—consultants, fellows, senior nurses. This prevents it from becoming one person’s initiative.
    4. Build in kill switch reviews: At week six and week twelve, ask: “Is this huddle still useful, or is it theater?” Permission to kill it if it doesn’t work paradoxically keeps it alive because people trust you’re not wasting their time.
    5. Assign a “huddle keeper”: One senior resident or nurse educator protects the time slot, sends brief reminders, and tracks attendance patterns (not to shame, but to notice issues like “Anesthesia hasn’t attended in two weeks—should we adjust timing?”).

    Questions for Participants:

    • Huddles, checklists, or escalation rules—what’s worked best for you?
    • How have you sustained reliability practices past the three-week mark?
    • What’s your experience with “good theater” vs. actual behavior change?

    Audience poll: In chat, vote: 1 = huddles, 2 = checklists, 3 = escalation rules. Which has given you the biggest early win?

    Cross-Cutting Discussion: The Questions That Keep Coming Up

    Let me address a few questions that cut across all our topics, then we’ll open this wide.

    “An innovation you wish you had earlier”

    Run charts. For fifteen years, I made changes based on intuition and anecdotes. “I think infection rates are better.” “It feels like patients mobilize faster.” I was probably right—but I couldn’t prove it, so I couldn’t scale.

    Then I learned to plot a simple run chart: time on X-axis, outcome on Y-axis, median line for baseline. Nothing fancy. Excel, not SPSS.

    Example: I charted “days to full weight-bearing after hip fracture fixation.” The baseline median was clear. After implementing a standardized mobilization protocol, the median dropped noticeably. The chart showed the shift visually. I took it to a department meeting. Skeptics couldn’t argue with the trend.

    If I’d discovered run charts earlier in my career, I would have scaled effective changes faster and abandoned ineffective ones before wasting everyone’s time.

    Panel question: What tool or method do you wish you’d discovered a decade earlier?

    “Best starter step for a resource-limited setting?”

    Start with workflow mapping before you touch any technology.

    Too many clinics install tablet systems only to discover they’ve digitized a broken workflow. Now you have a broken workflow that requires charging cables.

    The starter step that works:

    1. Pick one bottleneck – The place where patients wait longest or staff frustration peaks
    2. Map current workflow on a single sheet of paper—boxes and arrows, every step the patient takes
    3. Time each step for 10 patients with a stopwatch (don’t estimate—actually measure)
    4. Find the stupid steps – There’s always at least one step that makes everyone say “Why do we do that?”
    5. Eliminate one stupid step – Choose the one with the highest annoyance-to-elimination ratio

    Real example: A clinic I advised had patients filling out identical forms twice—once at registration, once when the nurse called them back. The reason? “Because we always have.” No one could remember why it started.

    We eliminated the second form. Saved several minutes per patient. Cost: zero. Time investment: one afternoon of observation and discussion.

    That single change built enough trust that when we proposed a digital registration system months later, staff agreed immediately. We’d proven we weren’t academics imposing theory—we were colleagues eliminating waste.

    Start with a paper map and a stopwatch. Technology comes later, after you’ve fixed the workflow it will be automating.

    Panel question: What’s your “starter step” recommendation for teams with limited resources?

    “What evidence is good enough to spread a change beyond the pilot?”

    I’ve struggled with this because the academic in me wants a randomized controlled trial, but the clinician in me knows patients can’t wait years for publication.

    My current framework—you need three things (not one perfect thing, but three good-enough things):

    1. Safety data showing no new harms – A run chart of adverse events, comparison to your own baseline. This is non-negotiable. Even if your intervention improves efficiency, if there’s any signal of increased complications, you stop and investigate.
    2. Outcome improvement visible to skeptics – Not necessarily p<0.05, but something anyone can see: “Patients mobilize earlier,” “Staff spend less time on documentation,” “Complications decreased.” If the improvement is real, it shouldn’t require statistical contortions to demonstrate.
    3. Consensus from people who will implement it – You need key stakeholders—nurses, residents, other consultants—to say “This worked for us, and we’d recommend it.” Their endorsement is evidence.

    My threshold: If I have a run chart showing improvement, zero safety signals, and several colleagues saying “This made my work better,” I’m comfortable spreading to the next unit carefully.

    I don’t wait for publication. I don’t wait for external validation. I spread it with the same safety stops, the same monitoring, and with the understanding that the next unit might discover it doesn’t work for them—and that’s acceptable.

    Perfect evidence takes years. Good-enough evidence takes weeks. In resource-limited settings, we often can’t afford to wait for perfect.

    Panel question: Where do you draw the line between “not enough evidence” and “good enough to scale”?

    “How do you protect mentoring time—what do you stop doing?”

    This might be the most important question, because mentoring is how change spreads, yet it’s first to get crowded out by clinical demands.

    What I stopped doing:

    1. Stopped attending committees that don’t make decisions: I tracked output for several months. Some committees were productive; others spent entire meetings on updates that could have been emails. I resigned from the unproductive ones and freed significant time monthly.
    2. Stopped seeing patients who should see my colleagues: I screen referrals now. Complex revisions, unusual presentations, medico-legal situations—I refer those. Straightforward cases in healthy patients? I can manage those excellently. I supervise and teach, but don’t need to be the primary surgeon. This freed substantial OR time that I redirected to teaching and simulation.
    3. Stopped writing lengthy notes when structured templates work: I created templates for my most common cases with dropdown menus and checkboxes for routine documentation. I customize only when the clinical situation requires it. This saves meaningful time daily—time I’ve redirected to direct teaching and case reviews.

    The principle: Audit your time for one week. Every hour, note what you did. At week’s end, ask: “Which activities only I can do, and which could be done by someone else, by a template, or not at all?” Then ruthlessly cut or delegate everything in the latter category.

    Mentoring doesn’t happen when you find time. It happens when you make time by stopping things that don’t matter.

    Panel question: What did you stop doing to make space for mentoring? What’s been hardest to let go?

    “Give one example of de-implementation”

    The beloved practice I retired: Routine daily post-operative radiographs after uncomplicated ORIF.

    For many years, we X-rayed every ORIF patient on post-op day one, even if we have intraop and immediate post op xrays. It was protocol. It was what I was taught. It felt responsible.

    Then I examined the data. Research supports this reassessment: A Harvard Medical School study found postoperative radiography after primary TKA was of low clinical utility yet resulted in considerable healthcare costs and unnecessary radiation burden. A UK study of hundreds of total knee replacements found only two patients with significant abnormalities on post-op X-rays, neither requiring further treatment. Research from Brigham and Women’s Hospital found that almost 100% of scans after total knee arthroplasty had no impact on clinical management while costing substantial money and administering unnecessary radiation.

    In my own practice review, the yield was similarly low. Meanwhile, we were consuming resources on largely unnecessary imaging, delaying mobilization while patients waited for radiology, and exposing them to radiation with minimal benefit.

    How I communicated the change:

    1. Presented data to my team first – Not “We’re stopping X-rays,” but “Here’s what the literature shows and what our own X-rays have actually revealed”
    2. Proposed new protocol: X-rays only when clinically indicated—unusual intra-operative findings, concern for malalignment, or patient symptoms. Not “never,” but “when needed”
    3. Piloted on my own patients first for several months while partners continued routine imaging. Tracked any missed findings. Found none. This gave me data to demonstrate safety.
    4. Presented department comparison: My patients mobilized earlier on average (no waiting for routine X-ray) with equivalent complication rates. Plus we saved imaging resources that could be redirected.
    5. Adopted department-wide with continued monitoring. Complication rates remained stable. Mobilization times improved. We redirected some of the saved resources to enhanced physiotherapy.

    What replaced it: Enhanced clinical examination skills. We trained residents to recognize signs of component malalignment or other complications through careful physical examination. We maintained high suspicion—if anything felt concerning, we imaged promptly. But “routine” disappeared from our vocabulary.

    Communication principle: When you retire a beloved practice, don’t criticize the people who established it. They did it because they cared about safety—the same reason you’re proposing to stop. Frame it as “We’ve learned something new and the evidence has evolved” not “We were wrong.” Data, not judgment. Pilot first, prove safety, then spread.

    Panel question: What practice have you retired? How did you overcome resistance? What replaced it?

    Synthesis: Pilot Small, Mentor Widely, Document & Share

    After twenty years of trying to improve healthcare while delivering care within it, successful transformation comes down to three principles:

    1. Pilot small. Don’t redesign the entire hospital. Fix one workflow. Implement one tool. Change one protocol. Prove it works in your unit before asking anyone else to try it. Small pilots fail fast and cheap. Large initiatives fail slow and expensive.

    2. Mentor widely. Your innovation dies with you unless you teach others. Spend as much time mentoring as implementing. Protect that time ruthlessly. The change that spreads is the change that has champions in every unit, not just yours.

    3. Document and share. Write down what you did, what worked, what didn’t. Share it—at meetings, conferences, blogs, professional networks. Don’t wait for perfect data. Share the run chart, the safety protocol, the inefficient step you eliminated. Other clinicians in other resource-limited settings need to know what you learned.

    Digital transformation isn’t about technology. It’s about people, processes, and the patient care they enable. The most sophisticated electronic health record means nothing if your workflow is broken. The simplest communication tool means everything if it helps your team deliver better care.

    Start small. Build trust. Measure what matters. Spread responsibly.

    Open Discussion: Let’s Learn From Each Other

    Now it’s your turn:

    For Participants:

    • Which of these three questions resonates most with your current work?
    • What’s one practice you’re piloting right now?
    • What’s your biggest barrier to spreading change?

    For audience (in chat):

    • Share one “simple tool that saved time” in your setting
    • Vote on which reliability practice (huddles/checklists/escalation rules) you want to hear more about
    • Drop your questions for the panel—we’ll tackle as many as we can

    Remember: We’re all learning together. There’s no perfect answer for resource-limited settings, only better experiments. What worked for me in the Philippines might need adaptation for your context—and what works for you might be exactly what I need to learn next.

    Let’s make this a conversation, not a presentation. Who wants to jump in first?

  • Creating a Learning Culture: Strategies for Continuous Education

    Creating a Learning Culture: Strategies for Continuous Education

    Introduction

    In our last medical association’s meeting, a colleague asked about how are we progressing on cultivating a culture of continuous learning in our specialty’s training institution. He expressed concerns about rumors the current generations of would be doctors (his son was one of these MDs) seem to have a different notion of continuous learning and work habits despite the availability of huge amount of medical information. He added that most physicians in practice now, would jump at opportunities for continuous learning. As a student practitioner of distant education, this got me rethinking- yes how are we progressing in this area?

    In the dynamic field of healthcare, continuous education is paramount. For Filipino medical professionals, fostering a culture of lifelong learning is essential to stay abreast of medical advancements and to provide the highest quality of patient care. This pre #Healthxph chat blog post delves into the significance of continuous learning, the challenges faced within Philippine medical institutions, and strategic approaches to cultivate an environment that promotes ongoing professional development.

    I. The Importance of Continuous Learning in Healthcare

    Continuous learning in healthcare ensures that medical professionals remain updated with the latest clinical practices, technologies, and research findings. This ongoing education is crucial for:

    • Enhancing Patient Care: Up-to-date knowledge leads to improved diagnostic accuracy and treatment efficacy.
    • Professional Competency: Regular training helps maintain and elevate clinical skills.
    • Adaptability: Healthcare is ever-evolving; continuous learning enables professionals to adapt to new protocols and technologies.

    II. Challenges to Continuous Education in the Philippines

    Despite its importance, several barriers hinder the implementation of continuous learning in Philippine medical institutions:

    • Resource Limitations: Many institutions lack access to updated educational materials and training programs.
    • Time Constraints: Heavy workloads often leave little time for additional learning.
    • Financial Barriers: The costs associated with courses and seminars can be prohibitive.
    • Technological Challenges: Inadequate infrastructure for online learning, especially in remote areas, limits access to educational resources.

    III. Strategies to Foster a Learning Culture

    To overcome these challenges, institutions can implement the following strategies:

    A. Leadership and Institutional Support

    • Prioritize Education: Leadership should emphasize the importance of continuous learning.
    • Allocate Resources: Budgeting for educational initiatives demonstrates commitment.(optumhealtheducation.com)

    B. Leveraging Technology for Education

    • Online Platforms: Utilize webinars and e-learning modules to provide flexible learning opportunities.
    • Mobile Applications: Implement apps that offer accessible learning materials.

    C. Mentorship and Peer Learning

    • Mentorship Programs: Pair experienced staff with junior members to facilitate knowledge transfer.
    • Collaborative Learning: Encourage case discussions and journal clubs to promote shared learning experiences.

    D. Incentivizing Continuous Education

    • Recognition and Certifications: Acknowledge achievements to motivate staff.
    • Financial Assistance: Provide subsidies or financial support for courses and seminars.

    IV. Case Studies and Success Stories

    A. Emerging Clinical Nursing Education Series (ECNES)

    The ECNES is a program designed to enhance the quality of clinical nursing education in the Philippines. It offers targeted seminars delivered by Filipino nursing educators, equipping nurses with essential practical skills and competencies.(findnetwork.org)

    B. Optum Health Education Global (OHEG)

    OHEG provides free, self-paced continuing education courses to Filipino nurses. These courses are internationally and locally accredited, supporting nurses in maintaining active licenses and advancing their careers.(Inquirer Business)

    C. University of the Philippines College of Nursing (UPCN)

    UPCN has been redesignated as a World Health Organization Collaborating Center for Leadership in Nursing Development. This designation underscores its role in providing leadership in nursing education and development programs.(Facebook)

    V. Actionable Steps for Medical Institutions

    1. Conduct Needs Assessments: Identify specific educational gaps among staff.
    2. Develop Structured Learning Plans: Create programs tailored to address identified needs.
    3. Implement Flexible Learning Options: Offer both in-person and online courses to accommodate varying schedules.
    4. Establish Evaluation Metrics: Regularly assess the effectiveness of educational initiatives.
    5. Foster a Supportive Environment: Encourage open communication and feedback regarding learning opportunities.

    VI. Discussion Questions

    I hope to read your thoughts on fostering a learning culture at the #HealthXPh chat this Saturday, May 31, 2025 9PM Manila time.

    These are our guide questions:

    [su_box title=”Creating a Learning Culture: Strategies for Continuous Education .”][su_list icon=”icon: hand-o-right”]

    • T1. How can institutions effectively integrate technology to enhance continuous learning among healthcare professionals?
    • T2. What role does mentorship play in fostering a culture of continuous education, and how can it be effectively implemented in our institutions?
    • T3. In what ways can we address the financial and time constraints that hinder healthcare professionals from pursuing ongoing education? [/su_list] [/su_box]

      Conclusion

      Cultivating a culture of continuous learning within Philippine medical institutions is vital for the advancement of healthcare professionals and the improvement of patient care. By recognizing challenges and implementing strategic solutions, institutions can create an environment that encourages lifelong learning and professional development.

      FAQs

      1. What is a learning culture in medical institutions?
      A learning culture in medical institutions refers to an environment that encourages and supports continuous education, skill development, and knowledge sharing among healthcare professionals.

      2. Why is continuous education important for healthcare professionals?
      Continuous education ensures that healthcare professionals stay updated with the latest medical advancements, leading to improved patient care and professional growth.

      3. How can technology facilitate continuous learning in healthcare?
      Technology enables flexible learning through online courses, webinars, and mobile applications, making education more accessible and convenient for healthcare workers.

      4. What role does leadership play in fostering a learning culture?
      Leadership sets the tone by prioritizing education, allocating resources, and modeling the importance of continuous learning within the institution.

      5. Are there successful examples of continuous learning programs in the Philippines?
      Yes, programs like the Emerging Clinical Nursing Education Series (ECNES) and platforms like Optum Health Education Global (OHEG) have successfully promoted continuous learning among Filipino healthcare professionals.

  • Leading Change When “Change” Isn’t the Norm

    Leading Change When “Change” Isn’t the Norm

    “If there is one thing that will definitely change about our complex healthcare system, practices and behaviors aren’t one of these”

    One comment I get whenever I talk about “learning organization” as a way for healthcare institutions to adapt to the new normal is this- “I really like the change concepts your saying, but what else can I do if many in my organization doesn’t embrace that change philosophy?”

    Rina is a new resident physician assisting more senior residents attending and treating fractures at one healthcare institution. Yet to learn the finer details of cast application and monitoring, her team leader instructed her to apply cast on a young patient who had recently incurred a forearm fracture after a fall from a height. The senior resident added that she “read about techniques of applying and monitoring cast” from the recommended textbook. When an emergent call from ER summoned her senior to attend to another patient, Rina eagerly went on applying the cast to the patient’s forearm alone and unsupervised, with only her recently “acquired” cast application techniques, and a single experience of seeing one senior resident applying a cast in their last team duty. She sent home the patient after advising the parent about cast monitoring she learned from the book she read.

    Less than two hours after, the patient was brought back to the ER in pain and crying. “My arm hurts! like it is being squeezed and twisted! ” complained the patient. Suspecting that the cast its too tight, Rina instinctively cut the cast in half (bivalved) using a cast cutter. Patient immediately reported relief, but Rina was shaken by the experience. She felt she did what is the right for the patient and still ended up with a potential complication.

    Rina brought her experience in one group mentoring discussion with an attending consultant. “Is there a certain level of competency which a resident possess to be able to apply cast and prevent this complication from happening?” she asked. “If you are referring to how many times did the resident applied cast to the same extremity in a number of patients in the past, there’s no ballpark figure” said the consultant. “The incidence of that complication is less than a percent. What we know is that you have to have some high index of suspicion to catch the prelude to a complication” the consultant added.

    Rina then talked to several ward nurses and patient companions about their knowledge of cast monitoring and what they actually do in the wards and at home. “We write on the monitoring sheet what our clinical inspection would tell us, but I’m not quite sure about what’s the exact results do we refer to the residents on duty” said one nurse. One parent told her that although pain and tightness in the casted extremity is a danger sign, “we’re leaving”we live far away from the hospital it is usually too late when we arrive back in the hospital.

    Rina is currently doing a research on a better protocol for cast monitoring and preventing such devastating complication before it happens. Since the incidence of such devastating complication is low (as we all believe it to be based on foreign literature) and local literature about this complication is scarce, she lamented that her experience and research will just be buried in anecdotes again. I smiled. “Just keep on doing what you are doing” I said to Rina . “Maybe your research results will change behaviors, practices. Maybe it won’t, but at least you will have made things better for you, your patients, and then some”.

    “Do what Rina did” is my reply to the comment -“I really like the change concepts your saying, but what else can I do if many in my organization doesn’t embrace that change philosophy?” Start small, talk to like minded people, research, recommend a change policy, do it, even if others won’t. Maybe your new policy will change behaviors, practices. Maybe it won’t, but at least you will have made things better for you, your patients, and then some”.

    So what would a healthcare professional do when you want to change behaviors and practices in your organization yet many doesn’t espouse the change philosophy? This will be the topic of our #HealthXPh chat this Saturday May 27, 2023 9PM Manila time. Here are some guide questions:

    [su_box title=”change behaviors and practices in healthcare industry”]
    [su_list icon=”icon: hand-o-right”]

    • T1. Do you have any experience in the past urging you to change practices and behaviors in your healthcare organization?
    • T2. What healthcare change initiative did you do and what were the results?
    • T3. What advice would you give a colleague or health advocate when it comes to changing behaviors and practices in healthcare? [/su_list] [/su_box]

      Please join #HealthXPh chat Saturday May 27, 2023 9-10 PM manila time. Reply to the guide question above via twitter and append #HealthXPh to all your tweets! See you there!

      (Image by wavebreakmedia_micro on Freepik)

  • How Change is Ushered in Healthcare

    Pre pandemic, it is said that among service industries, change is predictably most difficult in the healthcare profession. There are several reason for this, but because processes in healthcare are already often complex, and sometimes ambiguous, embedding a new culture happen at a very slow pace. Take the pre pandemic research to standards of care policy change and implementation. It usually takes a decade for new promising research result to become standards of care in clinical medicine. This is even longer in the field of surgery.

    Interestingly, it took us a pandemic to change some of our long held beliefs and practices. Vaccine development and approval for public use for example, took a lightning speed compared to pre pandemic process development and implementation. The use of telemedicine as an adjunct to clinical care also took a “boost” during the pandemic. There’s a saying that necessity is the mother of all inventions, but I guess we cannot wait for another pandemic like scenario to usher change in healthcare. Thus, whatever ushered the lightning speed changes to the healthcare industry during this pandemic, is worth reflecting and replicating. This will be the topic of our tweet chat this Saturday Feb 25, 2023 9:00PM Manila time.

    [su_box title=”Ushering change in the healthcare industry”]
    [su_list icon=”icon: hand-o-right”]

    • T1. What ushered the rapid behaviour changes observed among healthcare professionals during the pandemic?
    • T2. What ushered the rapid process change observed in the healthcare industry during the pandemic?
    • T3. What leadership or management culture that ushered the rapid behavior and process change in the healthcare industry? [/su_list] [/su_box]

      To join the tweet chat, just introduce yourself, answer the above guide questions on prompt and append the hashtag #HealthXPh” to your tweets. See you!

      Image by wavebreakmedia_micro on Freepik

  • Social Media’s Role in Bridging Healthcare’s Generational Gap

    At the height of COVID-19 pandemic, a nurse posted a video of them dancing inside an empty emergency room with a big bold text caption complaining their work isn’t valued. That video went viral and although there were multiple and vastly diverse interpretations, the video posting didn’t go well with the health care organization’s (HCO) leadership and resulted to tumultuous reorganization within.

    One HCO leader complained in one conference that their “younger” HC provider seemingly had a different work ethic, behaviour, loyalty and respect for older peers. She continued that the government should mandate that the diaspora of healthcare workers be stopped immediately as our healthcare system is collapsing because of worker shortages.

    T1: Is there a generational gap in the healthcare workforce?

    The Gap.

    There’s no denying that the workforce now mostly consist of the younger generation of healthcare workers- the millennials. These young healthcare workers are adept at digital technology and would rather work and interact with their peers collaboratively. Contrast that with the existing HCO leadership and structure. Most HCO leaders are Baby Boomers whos used to running a top down, highly structured, regulated and bureaucratic organization. The above mentioned stories exemplifies the “clash” happening if this “gap” isn’t bridged. A gap that is making the shortage in our healthcare workforce- nurses in particular, worse.

    There are myriad of reasons for the continued shrinking of our healthcare workforce. Generational gap though rather correlational than a direct cause, is just one of these factors. The COVID-19 pandemic highlighted the gap even more, pressuring the already volatile and complex healthcare system, widening the generational misunderstanding between HCO’s workforce and its leaders. In the words of one famous motivational keynote speaker, this shift or gap is a “cycle”. The shift is the same as what other older generation experience during their time, when they were rebelling with their predecessor generation. Understanding this shift is key to solving this gap and communication may be the only doable course of action for now.

    T2: What is the role of social media in bridging this healthcare workforce generational gap?

    Health Is Social.

    I wasn’t surprised when our HR reported one of the more effective hiring platform we have right now is social media. Even the previously held “word of mouth” campaigns are now spread on social media. Initial hiring activities and engagements takes place on social media. Most healthcare workers keep tabs of the various HCOs social media pages as a way to scout for potential opportunities.

    The first story above highlights another generational difference often misconstrued by older generations- the young workers need for constant recognition and multiple technologies. Older HCO leaders may take this as counterproductive to work and are often suppressed in the workplace as a bad work ethic or behavior. Many HCO leaders neglect that part that the new generation needs constant feedback and communication and will be valuable assets if their team effort are reinforced and recognized.

    Internally, many millennials prefer to work in a flat organization, engaging in a more collaborative approach rather than a strictly structured system our healthcare system is built. The young healthcare leaders build networks and interact with thru social media. As many HCO leaders now knew, most “unofficial” work related discussions are happening over social media. And we’d rather look at this as a problem rather than an opportunity to engage.

    T3: What social media strategy will you recommend in bridging this healthcare generational gap?

    Strategy for an opportunity.

    Personally, social media role in bridging this gap is to connect or engage the seemingly different generations. Thus, socmed strategy primarily deals with this objective. I knew one baby boomer HCO leader say sorry to a millenial HCW via messenger, initiated a face to face meeting with the team, listened to their concerns and proactively set up a group page within the hospital socmed platform to work collaboratively and find solution to these concerns. Another multinational HCO hired an external social media manager, integrated it into its HR HCW engagement team and increase the younger generation participation in hospital patient and employees initiatives. An even more proactive baby boomer HCO leader trained himself social media tactics and used the various platform to connect and provide feedback to his peers.

    Taking on social media as a tool does have it setbacks though. In healthcare, patient information privacy should be protected. While many social media platforms are free, a deliberate attempt to harness its power needs some serious investments both in human capital and finances.

    The role of socmed in bridging generational gap now is even clearer than before. The COVID-19 pandemic highlighted this and will weigh considerably even in a post pandemic healthcare. Taking advantage of this opportunity will be the topic of this Saturday’s #HealthXPH tweetchat 9PM Manila time. Join us by live tweeting your answers to these guide questions and appending “#HealthXPh” to your tweets.

    [su_box title=”Generational Gap in Healthcare Profession”]
    [su_list icon=”icon: hand-o-right”]

    • T1. Is there a generational gap in the healthcare?
    • T2. What is the role of social media in bridging this healthcare generational gap?
    • T3. What social media strategy will you recommend in bridging this healthcare generational gap? [/su_list] [/su_box]

      See you all at the #HealthXPh chat!

      Image by Drazen Zigic on Freepik