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Poster Abstracts

Creating a culture of improvement for better care


Michelle Tierney

Southcentral Foundation, US
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Improvement and innovation is extremely important in the health care field. Being able to respond both to shifts in the industry, and the changing needs of patients, is critical for a health care organization to be successful. Southcentral Foundation (SCF), an Alaska Native customer-owned health care system, has implemented major reforms to both its improvement and innovation practices, and its overall system; these reforms have led to national and international recognition for health care quality, with SCF twice winning the Malcolm Baldrige National Quality Award, the United States’ highest presidential honor for performance excellence, in 2011 and 2017.

At SCF, change is driven by patients (who are called “customer-owners” at SCF). SCF constantly solicits their input, and engages with the community in a variety of ways on a regular basis, to gather their feedback and determine the changes and improvements they want to see made. Once the customer-owners have given direction for what to do, SCF implements change on an organizational level. SCF’s leadership encourages calculated risk-taking, innovation, and creativity on the part of employees to help bring about needed change.

SCF takes several measures to manage change and create a culture of improvement at the organization. SCF maintains the Functional Committee Structure, which allows for decision-making and responsibilities to be shared among the workforce rather than resting solely with leadership. Two of the four committees are devoted to improvement—the Process Improvement and Quality Improvement committees (the other two being Operations and Quality Assurance). The committees provide a mechanism for ongoing feedback across the organization, and help secure employee buy-in for needed change and innovation. They also ensure that all change made is in alignment with SCF’s mission and vision.

Each employee is also encouraged to find opportunities to innovate as part of their jobs. At SCF, each employee is evaluated based on four core competencies, one of which is improvement and innovation. Employees are encouraged to build an understanding of how their job duties contribute to SCF’s corporate goals and objectives, and look for ways to make meaningful improvements to services, programs, and processes that create new value for customer-owners and employees.


SCF has also built a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis into our strategic planning cycle to aid leadership in making educated decisions about organizational direction. And SCF maintains the Organizational Development department, which has improvement specialists and advisors who work with every division at SCF to continually improve performance.

In part due to its improvement and innovation practices, SCF has achieved a 97 percent customer satisfaction rate, as well as 95 percent employee satisfaction. This session will detail the methods SCF uses to foster a culture of continuous improvement, and the ways in which SCF supports improvement on an organizational level.

How to Cite: Tierney M. Creating a culture of improvement for better care. International Journal of Integrated Care. 2019;19(4):279. DOI:
Published on 08 Aug 2019.


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