1. Indianapolis Discovery Network for Dementia The ABC Medical Home - Creating a Culture for Success Catherine A. Alder, JD, MSW Project Manager, CMS Innovation Award – Dissemination of the Aging Brain Care Program Chief Administrator – Aging Brain Care Wishard Health Services

2. Indianapolis Discovery Network for Dementia 1.Organizational Culture Definition Origin Change 2.Culture of ABC Med Home 1.Visible/Invisible 2.What’s Working 3.Areas for Improvement 3. Change Vision 4.Feedback

3. Indianapolis Discovery Network for Dementia What is Organizational Culture? 1930 Hawthorne studies at Western Electric Company First systematic attempt to use concept of “culture” to understand the work environment Hawthorne Effect Common threads and properties have emerged from social research examining the concept: Shared Learned Affected by environment and history Adaptive Integrated Includes both what people do and what they think

4. Indianapolis Discovery Network for Dementia Components of Organizational Culture Group norms of behavior (visible) Underlying values, attitudes, assumptions, and beliefs that keep the norms in place (invisible) The Key to Changing Organizational Culture – Forbes (September 27, 2012)

5. Indianapolis Discovery Network for Dementia Where Does Culture Come From? “Culture usually comes from the values and behaviors of the founders or leaders of the organization. For whatever reason, they value certain things and behave in ways that seem to help the group succeed.” Conscious Unconscious The Key to Changing Organizational Culture – Forbes (September 27, 2012)

6. Indianapolis Discovery Network for Dementia “How does culture change? A powerful person at the top, or a large enough group from anywhere in the organization, decides the old ways are not working, figures out a change vision, starts acting differently, and enlists others to act differently. If the new actions produce better results, if the results are communicated and celebrated, and if they are not killed off by the old culture fighting its rear-guard action, new norms will form and new shared values will grow. The Key to Changing Organizational Culture – Forbes (September 27, 2012)

7. Indianapolis Discovery Network for Dementia ABC Medical Home at Wishard Health Services Staff (23.4 FTEs) 1 Medical Director 1 Program Manager 2 Social Worker Care Coordinators 3 Nurse Practitioner Care Coordinators 16 Care Coordinator Assistants 1 Data Office Specialist 1 Site Coordinator Space on the 6 th Floor Social Worker Office Nurse Practitioner Office 2 Work Rooms with “Drop Down” Space Conference Room

8. Indianapolis Discovery Network for Dementia

9. Indianapolis Discovery Network for Dementia Current Culture of ABC Medical Home UNDERLYING VALUES/ATTITUDES/ ASSUMPTIONS/BELIEFS RESPONSIBILITY DEDICATION TO MISSION AND PATIENTS! Growing Confidence in Self and Colleagues Comfort with Uncertainty Program Ownership UNDERLYING VALUES/ATTITUDES/ ASSUMPTIONS/BELIEFS RESPONSIBILITY DEDICATION TO MISSION AND PATIENTS! Growing Confidence in Self and Colleagues Comfort with Uncertainty Program Ownership BEHAVIOR FLEXIBILITY ADAPTIVENESS RESOURCEFULNESS INDIVIDUAL STAFF MEMBERS ARE DOING AMAZING WORK! Better Teamwork Better Conflict Resolution

10. Indianapolis Discovery Network for Dementia Change Vision for ABC Medical Home People gathered (talking, relaxing, working alone or together) Diversity (children, college students, workers, retired people) Lighting and tables (facilitates conversation), smell of coffee Friendly, accomodating staff (know customers by name) Personalized service Environmentally Conscious

11. Indianapolis Discovery Network for Dementia Focus on Diversity and Customer Service Not a franchise Diverse sites and customer base Management execs regularly visit stores to insure quality Customer feedback regularly solicited Flatter Organizational Structure Streamlines information flow from customer to employees and from employees to management Leads to more efficient and effective strategy Starbucks Culture and Values

12. Indianapolis Discovery Network for Dementia Social Networking Vehicle for customer input Creates open forum for discussion Employee Relations Open communication encouraged Each employee valued as a partner Managers visit frequently Organizational Ethics Mission statement is filter for decision making Employee training includes review of mission and vision Employees share in “Starbucks” experience Promoting Corporate Citizenship (Shared Planet)

13. Indianapolis Discovery Network for Dementia Questions 1.Is Starbucks culture the “right” culture for the success of the ABC Medical Home? 2.How do we change the culture of the ABC Medical Home?

14. Indianapolis Discovery Network for Dementia Acknowledgements Malaz BoustaniAnn Cottingham Michael LaMantiaKathy Frank Mary AustromDeb Litzelman John BedoyaLee Livin Chris CallahanChris Steinmetz The staff and patients of the ABC Medical Home at Wishard Health Services and IU Health Arnett