Hello everyone, this is Ray Pedden from the Center for Care Innovations. We’re thrilled today to be joined by Susannah Brower, who’s currently the operations manager at CCI.
As most of you know, CCI has developed a number of innovation hubs over the past three years and is now supporting over 30 community health organizations throughout California in this effort. Susannah is one of the key ingredients to supporting all the work that goes on at CCI. Susannah, welcome to the show and thank you for joining Health Pilots today.
Thank you. Go Warriors.
It’d be great to hear a little bit about yourself, and really what brought you to CCI, and what about CCI resonates with you in terms of what you’re doing here.
I’ve been at CCI for coming on about four years now, almost four years. I came on as a program manager, having recently come out of public health school. It really offered an opportunity to dig into the content of different programs that had surfaced during public health school, but also be able to work on them in a more tangible way because of the program management component to it. It really merged the academic interest as well as some of my hard skills around program management.
Before studying public health, I was always been in involved in some sort of safety net component or social justice organization. I was in the Peace Corps for two years in Peru, and during that time did work pretty closely with the local health department, with the local health clinic actually, on a lot of different programs or in supporting the teenagers in my rural community. That also sparked my interest, and so continuing on to a place like CCI had some kind of natural continuation from some of the work I’ve done previously.
Tell us a little bit more about what you do at CCI. I know it goes beyond the innovation activity, because that’s only a small part of CCI’s portfolio. What is everything that goes into how you support CCI in general?
My role here at CCI has changed over time, but I started as a program manager and was full time on programs for about three years. Then in the last six to eight months, I switched into an operations manager role, which is really a fusion of operations, specific projects, and program management.
On the program management side, I’ve had the opportunity to work on some really excellent patient engagement programs that we’ve been able to run because of Blue Shield of California Foundation.
In those I had a chance to dig into stuff like communications trainings across organizations for all staff, to building patient and family adviser groups, to co-designing projects with patients, to developing point-of-care surveys for patients that only have verbatim comments, literally taking note of the words directly from the patient and turning those into actionable projects.
That stuff has been really exciting to work on, and in a way, it’s not exactly categorized in our innovation portfolio, but I think we here at CCI all agree that the innovation portfolio is a fluid term, and that many of the stuff we’ve been doing is really quite new in many of the organizations that we have worked with.
Especially stuff like co-designing care, or improving care alongside a patient with them at the table as part of that improvement process. That’s some of the focus of what I’ve worked on.
I also had the chance to work on some of our bigger projects, which are a little more standard, I would say, in terms of expanding access to care with a little typical work on improving care teams and improving access to appointments and care for patients.
Most recently, I’m working on our employee engagement program, the strengthening clinics through aligned leadership. That’s a really exciting program, and I had put it in the innovation portfolio in the sense of gathering a lot of data, what’s exactly the experience of the employees in your organization, and then coming up with actionable changes around that to really focus in on your areas of opportunity.
Many of the stuff that we’re working on through our programs is also stuff that we hear at CCI work on internally, which leads me into what I’m doing a little bit more specifically now in the last six months, is working on building up CCI’s internal processes.
We’re in a formative part of our development, and we in the last ten months or so went from seven people to twelve people, which is a huge jump for that small of a number. It’s a really exciting period, where we’re having the opportunity to leverage everyone’s thoughts and ideas and building out CCI to operate better, but also has the challenges that come along with growing and the growing pains of trying to learn how we can streamline our processes without becoming a brittle, rigid organization where we can’t innovate and we can’t redesign things if they’re not working.
Why is all this so important today, not just for healthcare in general but operationally at CCI, making sure that we’re not a brittle organization, making sure that we can adapt and change? Why is this so important today, as opposed to say several years ago or some time ago?
That’s a great question, Ray. It’s been said a million times, and I do repeat it, that whether it’s healthcare or any other organization, but especially in light of the Affordable Care Act, that health organizations, the way our system has been set up, it’s rarely that the customer has been at the center of the experience.
That’s changing so much with the Affordable Care Act, as patients have so many more options as to where to receive their care. When I think about the way we operate at CCI, there’s a lot of things that I draw parallels between the challenges that we face and the projects that we’re working on with what our partner health centers are working on.
In no way are they the same challenges, because there are many challenges that we don’t face that we know others are in the healthcare industry, but we’re working towards this end goal of serving our customers in the best way possible.
It’s really important to me that we keep looking at these every process we have, and if it’s not working to take a step back and to redesign it. When I think about most specifically a process that we worked on recently at CCI, and we see this coming out a lot in our employee engagement program, is our performance management system here at CCI. It was archaic, everyone hated it. It was not effective. It was a annual review loaded with anxiety and tons of paperwork, and here it was a mainstay of our employee development, but it really had very little value and was more just a nightmare in many senses and just created a distance between staff and their managers.
What we are able to do, and part of this is the ability that we’re so small, but we’re able to take a little time and step back and work with our whole group to identify the pain points, and then to zero in on what would improve it. In that process, we are able to overhaul it completely and turned it into a one-page list of questions and small check-ins every trimester that don’t need to be recorded, but that are really an opportunity for staff to talk with their managers in an informal way, but to check in on their goals for their year and how they’re progressing on that.
The reason I bring up that example is because something like performance management is a mainstay in employee experience, and can be I think really impactful if it’s negative on the way an employee does their work.
Something like that, having the ability to step back, to innovate, to redesign, test it, which we’re able to do, get tons of feedback, I think is really going to improve the employee experience and, more importantly, really improve the ability for employees to reflect and to thrive, as we like to call our program.
Something like that, I think of that happening in the health center setting, which some groups have done, and how pivotal that can be in an employee’s experience, and create such a positive experience for an employee who’s serving patients in resource constrained settings, and often are stretched on their bandwidth, can have a really positive impact on the way that people work together to serve their patients.
Given all that you’ve been through with CCI, and given changing from a program manager to an operations person, obviously your public health background gave you some insights into human resources as you get into employee performance kind of measurements.
Given that, where do you think CCI, what’s the roadmap for CCI for in the next three to five years, do you think? In other words, where would you as the operations manager, as doing program management, as getting involved in things like employee engagement, patient engagement, what’s the roadmap for CCI over the next three to five years, do you think?
It’s tricky to say. In a sense, because I’m not involved in the programs as much anymore, although I do hold on to that one employee engagement program, in many ways my thoughts immediately go to how do we at CCI operate, and what does that look like in the next three to five years? How do we interact with all of our partners in the field, and how do we keep getting their valuable input on the work that we do and the direction we should go? What maximized the opportunities for improvement among the partners?
Something that I think that we have not nailed down yet, and there’s no silver bullet, but is the way we interact on a more regular basis with our cohorts. I think that we’re slowly exploring that, whether it’s learning that the webinar format has so many restrictions, but what I really like CCI to do is keep exploring the technology out there of how do we create a virtual learning platform in a virtual community to most effectively collaborate.
Again, I don’t know the answer. I know we’re trying things out with webcams that comes a little bit closer in creating that in-person experience without actually being in person. I’m really excited to see the different tools that could come out there, because I spend a lot of time thinking about, how do we keep people engaged? How do we keep them sharing ideas, when we know how stretched everyone is and how many competing priorities they have?
I think a lot about that. I think CCI itself, in the way we operate, we’ll see a lot more streamlining of the way we do things. What I really do want to see as well is we need to streamline as we’re growing, and we need to standardize some of the ways we do things, but not to get to a point where we can’t be flexible and nimble when we need to be, and in fact create a space where that flexibility can come out without a big production.
That’s the golden ticket that I’m looking for, is how do we build out processes that work but are continually getting input from both our internal team as well as external partners of how effective those systems are, and being able to innovate around those systems on a fairly simple way and fairly simple way, and to move forward with an improved process.
What you’re really saying is the roadmap for CCI is taking what we’re learning in patient center design, if you will, taking the lessons learned in redoing the whole employee evaluation process within CCI from an operations standpoint, and applying those same principles to how we work with our clients, i.e. the community health centers, the community health organizations, and others, that CCI supports in the field.
Taking those principles, taking those learnings from those kinds of specific applications, and now turning it around and doing the same thing with the same principles with our clients. That’s the roadmap, and staying nimble and innovative and all the rest of that along the way.
Yeah, absolutely. I think a lot about that co-design process that we set up a program around, and in listening to the experiences of our health center partners in the cohort, and the challenges and the successes that they had around doing that, around engaging the patient.
In many ways, I see and feel a lot of that similarity, in a much smaller scale, but in the way that we try to [inaudible], the way that we try to focus on improvements. It’s always easier just to forge ahead and do it on your own, but it doesn’t in any way mean that it’s better, and often it’s not.
For example, when we’re redesigning in our website, for example, or some kind of communication strategy, or the way we set up our program pages, the way people access links for our program, it would be easy to go right ahead and create a nice website and then [inaudible] on it and let everyone go there; but the way we’re going to be most effective in sharing resources and encouraging collaboration is by bringing in our partners in the field who are actually the end users to find out what is most effective.
What are they most likely to click on when it comes to a resource? How did they get there? What are barriers from them getting there? What are barriers from them sharing their ideas with others? That’s, you summed it up really well, is exactly what we’re trying to do and keep doing.
You have to remind yourself, it’s really easy … We talked about innovation all day long, we talk about co-design, but as small and as nimble as we are, we often have to remind ourselves to walk the talk here as well.
What advice might you give for others who want to become involved in CCI, the kind of work that CCI’s doing, even if it’s not within CCI, to be an evangelist for what the Center for Care Innovations is all about?
Chris Conley from Gravity Tank, I remember him saying at one of our safety net innovation network meetings, said, “If you’re looking for ways to …” Actually, I’m probably butchering what he said, but what I took away from it was if you’re looking for ways to innovate, look for the work-arounds that are set up in your organization. Those are areas of great possibility to create a much better system. That really spoke to me. As a process person, I envision all these post-its up on the wall of someone having a work-around. That can lead you towards where a place to start, a project to start on.
When I think about it, when I think about if you’re a group out there and you’re not necessarily one of our program, or even in the healthcare space of thinking, “How do I on a very basic level start to improve what we’re doing,” whether it’s “innovation” or just improving a process, is to look for a really clunky work-around that is happening. For me, happening, I would say, happening many different forms for different people.
Take a look at that, and then start to deconstruct it and figure out what’s happened, why is there a work-around. Break down the process, and then build it back up with the input of those end users. Don’t look at the work-around and create a solution, hand it to them and walk away, but really schedule a special meeting and sit down together and get input on what are the pain points, and what are some possible solutions. Start to work with those end users through every process, through every step of the process, of improving it.
That, to me, seems like a really simple way to start, of breaking down a work-around and creating a better process. Then testing it, and then coming back continually and saying, “Does it work?” In that, really seeing who steps forward as leaders. Whose brain works like that? Do they like creating new solutions around a process that’s sort of working, but not really?
Cool. Well, I really appreciate you taking time today. I know everybody listening is going to take away different things from the conversation, and it’ll be important to everybody as they continue their journey, wherever it’s going to take them. If people want to talk to you and learn more, how would you suggest they get a hold of you or engage you in a conversation to learn more about what they’re doing, and have them gain help from you in terms of whatever their journey might be?
I’m definitely available on email or phone, so the easiest way is just to go to our website and look at our staff page. My email is listed there, and I’d be happy to start a conversation.
Terrific. Well, I think you very much today. To everybody listening, you can find a summary of the conversation with Susannah and relevant links on the episode page. If you’re not listening to this on our website, please visit www.TheInnovationHubs.org to find the show notes and all our other episodes. Thanks for listening, everybody. We’ll see you again in the next episode.