August 8, 2014
Danielle Bobek, RN
Rhode Island has been a highly fragmented and silo’d health care market. Care New England (CNE), a not-for-profit health care organization, is addressing this barrier to exemplary health care. After a fifteen-year history as a federation of independent operating units, CNE has begun transitioning to a research, education, and fully integrated health system offering primary, acute, and tertiary services. CNE launched a transformation process called transforming together to integrate, partner, and create a health care system, delivering patient and customer focused care. The executive leadership team (ELT) launched transforming together by redesigning the governance structures and processes, adopting health care role model governance practices, setting the stage for major organizational change. The ELT established a structure of cross-functional representative councils to lead integration, performance management, and strategy implementation across CNE.
Mission, Vision, and Values In order to advance innovation, a clear statement within the mission, vision, and values is necessary (Porter-O’Grady, 2010). It is also important to define an organization’s commitment to innovation as an integral part of the work of an organization (Porter- O’Grady, 2010). The mission of an organization incorporates the desire to provide a service that is viable and able to meet defined goals (Porter-O’Grady, 2010). The vision statement is a continued expression of the desired service and the level of achievement necessary to achieve the mission (Porter-O’Grady, 2010).
CNE demonstrates an understanding of the importance of the mission, vision, and value statements as evidenced by a highly participatory, process that enabled the entire workforce to identify their own personal values and measured the gap between their own values and CNE’s organizational values. After this process the ELT took the information and developed the following mission, vision, and values for the system. The mission of CNE is dedicated to building an exemplary health care system. The vision is that CNE will be recognized nationally for quality care, academic excellence, and innovation. The values are Accountability, Caring, and Teamwork (ACT).
CNE has a set of strategic objectives that in-turn set the strategic direction; the objectives are causally linked to achieve the mission, vision, and values. There are aligned initiatives managed by either the ELT or Councils to achieve each of these objectives. The main objective is that of clinical excellence. This is directly related to the mission of building an exemplary health care system. In order to achieve clinical excellence an organization needs to give the best patient experience, deliver the best value, and improve health. When an organization provides clinical excellence they are recognized nationally by achieving certain distinctions, this is in alignment with the vision of CNE to be recognized for the quality care it provides. In order to provide clinical excellence there are certain processes that must be followed, these include improvements in care coordination, cost reduction, working collaboratively, and delivering the best in class quality, ultimately this translates to improvement in patient safety as well. In order to do this every member of the organization will need to incorporate the ACT values into their everyday work.
Culture entropy is the amount of energy in an organization that is consumed in unproductive work (CNE, 2014). It is a measure of the friction, and pent up frustration that exists within an organization. Cultural entropy is measured as a percentage of the negative or limiting values in the current culture. In the 2013 culture assessment 30% of the values defining the