Linking Training to Care: Leadership at Fallon Clinic Reshapes the Learning Organization to Bridge Training Excellence and Patient Satisfaction
When Randi Nichols joined Fallon Clinic as chief human resources officer in 2004, she identified several opportunities to enhance functions within HR.
One of these functions was in the area of training. Training as it existed at the clinic was expensive, ineffective, and lacking in strategic linkage to the business goals of the clinic. One of Randi's first hires was Gary Segal as senior director of learning and organizational development (L&OD). In the past five years, Gary and his colleagues have worked to build programs that address the needs of the clinic and contribute to Fallon Clinic's earning recognition as one of the "Best Places to Work in Healthcare."
Founded in 1929, Fallon Clinic is a multilocation, multi-specialty, group medical practice that employs more than 1,700 people. Approximately 350 of these are medical providers--doctors and advanced practitioners--and the rest work as nurses, therapists, lab technicians, and administrative and clerical support personnel. Collectively, clinic locations handle approximately 1.5 million patient visits per year.
One major change Nichols and Segal implemented was to move the computerized technical training department from under the IT umbrella and into the HR division. Nichols, who is now the executive vice president of human resources and operations support services, explains, "Our objective was to reinvent the training department. We were given full latitude to build a world-class learning organization."
While the L&OD team had the latitude to make the changes necessary to transform the training function at Fallon Clinic, it was critical that success could be demonstrated. Segal has built a training system that relies heavily on metrics, so that measurable improvements of all kinds could be clearly demonstrated to executive leadership.
Before measurement, however, comes needs assessment. On an ongoing basis, Fallon Clinic seeks to determine where in the organization additional or enhanced training would have the most value. The L&OD department conducts an annual enterprisewide needs assessment through employee surveys and face-to-face meetings with leadership and employees at all levels. Learning solutions are then designed, developed, and delivered by the department's staff, which is divided into two groups--technical training, and management and leadership training.
To this end, Segal's team has built an innovative learning program that is rooted in a few well-founded assumptions: There are certain staff and clinician behaviors that are key to patient satisfaction; and the best way to assess what a patient's experience is like at Fallon Clinic is to see that experience through the patient's eyes. Thus, the "Patient Shadowing Program" was created. As the name implies, members of Segal's team and others within the organization accompany consenting patients on their doctors' visits to observe the patient-staff experience firsthand.
The observation criterion used in the shadowing program is based on data from ongoing patient satisfaction surveys. To date, more than 15,000 patient surveys have been conducted. Patients are questioned about overall satisfaction with the provider (doctor or advanced practitioner), staff, office environment, and telephone interactions, and about whether they would recommend the provider to family and friends.
Rating templates list relevant behaviors associated with positive patient encounters. Volunteers from across the organization (selected for their strong interpersonal, communication, and feedback skills) are recruited and receive classroom training on the use of these templates.
Shadow coaches contact a provider's scheduled patients on a given day and request permission to observe their entire visit, from registration to check-out, recording their observations using the templates. …