Is a Case of the "Twisties" Preventing Your Hospital From Peak Performance?
4 Tips to Help Your Organization Stick the Landing... and Keep Sticking It
By Chris Feagin, MBA/MHA, PMC-VI
Like many others around the world, I learned a new term recently during the Tokyo Olympics... The "twisties". The term “twisties” refers to a phenomenon where a gymnast loses body control and spatial awareness while performing a routine.
As she performed her first vault routine in the Tokyo Olympics, Simone Biles quickly realized that she had a severe case of the “twisties”. Biles said she was not mentally prepared and had had trouble getting into the right mindset for the games and was not in the right head space.
Most gymnasts see this potentially dangerous situation stemming from a mental block. An inability to get into the right mindset prevents them from delivering their peak performance and from even performing at all.
I couldn't help but think about how similar this is to hospitals and health systems striving to achieve their own peak performance. So often, healthcare organizations pursue transformation and change without first establishing the right mindset. Without starting with and maintaining the right mindset, they essentially develop their own case of the "twisties", losing their bearing and direction and landing in a place that can hold back or even damage their organization's performance.
Change management isn't easy. So, what can your hospital do to prevent an organizational case of the "twisties"?
Start with the right type of mindset upfront
Whether it is an Olympic gymnast training to perform a gravity-defying dismount from the uneven bars or a hospital implementing a complex change such as the establishment of a new operational command center, change management requires the right mindset from the start.
A growth mindset begins with a belief that basic abilities can be developed and improved over time and embraces change and learning. The gymnast will never gain the ability to perform a double front dismount if they believe their skills, strength, coordination, agility, and other attributes to be fixed and unchangeable. Likewise, your hospital's change efforts can never be successful if there is not a belief within the organization that their abilities can be developed. In both cases, challenges must be embraced, effort must be seen as the path to "better", and there must be a willingness to learn from mistakes and feedback.
Align and commit to the change
Olympic gymnasts must determine their goals and then invest valuable time in training and quite literally "re-wiring their brains to perform complex movements with a high degree of reliability and precision". Preparing an organization for major change is no different.
What is your aim? What is your plan? How will you train to re-wire your organization and how often must you do it? What resources need to be aligned to make it happen? How will you ensure that the right amount of time and effort is invested?
Answering these questions is crucial to making change happen.
Execute and stick the landing!
Now that the growth mindset is in place and the plan for change has been accepted and committed to, it's time to perform. Whether you are leaping up to the uneven bars to begin your Olympic routine or flipping on the lights for the go-live for your hospital's new transfer center, you are ready.
Sustain and grow
You've now stuck the landing, but what is the path forward? Even a successful and decorated athlete like Simone Biles can have a setback and re-develop a case of the "twisties". Like the Olympic gymnast, the hospital may experience bad days, could reach a point where their performance is no longer improving, or may even fall back to "doing it the way we always have". Fortunately, there are ways to prevent these setbacks.
First, there should be immediate, real-time feedback on daily performance. Olympic athletes get immediate feedback from their coaches and teammates during training as they perform their routines and can make quick adjustments to improve their performance and save a routine.
In the hospital, this type of immediate feedback is often a challenge. Information is often buried several clicks deep in the EMR or housed across multiple systems that don't talk to each other. However, I have seen arrangements where this is not a problem. For example, the hospitals my company works with have real-time feedback on how they are doing day-to-day via their hospital command centers and can use that actionable intelligence to make the quick decisions they need to mid-performance.
Next, there also is a need for more in-depth coaching and long-term, retrospective views of performance which can drive future growth. For the gymnast, it is common for the coach to capture videos of training and performances which they can later review together to address negative trends, setbacks, and other issues regularly affecting performance.
I've seen something similar work for hospitals and health systems too. Our coaches at Care Logistics engage with hospital leaders on a quarterly basis in a "performance alignment" event where the hospital gets a detailed outside examination of their own performance trends, puts plans in place to address issues, and sets their new goals for continued growth in their performance improvement efforts. This regular coaching is key to sustaining and building upon improvements and helps keep the organizations aligned, committed, and in the right mindset to achieve performance excellence over the long term.
A case of the organizational "twisties" can derail even the best of hospitals from instituting the change needed to deliver peak performance to their patients and communities, but it doesn't have to be that way. By starting with the right mindset, aligning and committing your organization to change and growth, "sticking the landing", and putting the processes in place to sustain and improve performance, there is no reason your hospital can't stand on the podium of performance excellence with the best-performing hospitals and health systems of our country.