After undergoing open heart surgery 12 years ago—at a prestigious medical center, I should add—I awoke in my hospital room to experience a pain that can only be described as stunning. Eventually, a nurse responded to the frantic buzz of my call bell. Flooded with relief at the sight of someone who could help, tears streamed down my face. The moment was short-lived.
“I’m waiting for the doctor’s orders,” she told me. She explained that she could not give me anything to relieve the “discomfort” (hospital-speak for agony) until a physician saw me. “He’ll be here soon,” she assured me as she headed to the door. “Just rest.”
The pain, unfortunately, wasn’t interested in rest. It progressed.
I wanted to be a “good” patient, so I was compliant. The wailing, the non-stop grip on the call button—they were involuntary reactions, beyond my control. The noise caught the attention of the charge nurse and, God bless her, she had guts. She picked up the phone in my room. “Get Dr. Graham NOW,” she shouted. Then after a short pause: “Well, page him. We’ve got a big problem here. We have an open heart patient with no post-op pain med orders.”
She sat with me, holding my hand and wiping my brow with a cold washcloth until the student nurse she had summoned arrived to take her place. It was now the middle of the night. The on-call doctor did, finally, respond and wrote the orders for oral and intravenous analgesic drugs. More than five hours had gone by since I’d been wheeled out of the OR.
Freak occurrence? Sadly, no. I was one of 5 million people that year who suffered from a medical mistake while in a hospital.
Using PROPEL to change and save lives
I’m Dr. Tom Muha, an organizational psychologist. That experience prompted me to develop a coaching program that uses positive psychology to improve patient care by enhancing the team dynamics of the people who care for them. It’s a proven plan, launched at one of the country’s most renowned academic medical centers. It’s still in use there today, 10 years later, under my direction.
The hospital had me start on a unit with a history of “poor performance” (“abominable performance” would have been more accurate), where leaders and staff struggled with a dysfunctional work environment. Nurses were coming to work impaired, turnover was high, patient satisfaction scores were low, and the marks for patient safety measures were horrible. After a year-long initiative during which the leaders and staff learned to use my PROPEL program and its six positive psychology principles, the unit was performing at such a high level it garnered a “Best of the Best” award. Independent assessments found job satisfaction and staff engagement had both increased by more than 80 percent, and patient satisfaction had improved by 50 percent.
While my initial mission was to improve patient care, I discovered that my program (PROPEL) had other significant benefits, ones that are particularly important in today’s healthcare environment. By reducing staff turnover, PROPEL was saving money. By improving care, outcomes, and patient safety scores (now tied to reimbursement) PROPEL was increasing revenue. A trifecta of sorts—a win-win-win situation.
Since that launch, I founded The PROPEL Principles, LLC, a consulting practice dedicated to helping leaders in medical organizations enhance patient and staff satisfaction. I have been engaged as a speaker and consultant by other hospitals and healthcare organizations across the country, and there is no end in sight for the demand. According to Gallup research, 50 percent of hospital-employed RNs report being “disengaged” and 20 percent as “actively disengaged.” (These numbers are reflected in inpatient rehabilitation centers and nursing homes, too.) Add to that the exploding use of healthcare as the more than 77 million baby boomers hit their 60s and 70s, plus the staffing reductions caused by reimbursement cuts and you have a recipe for disaster—and a desperate need to turn things around.