Podcast: CareCulture President's Perspective on Service-Centered Healthcare Culture

Listen to the podcast below to hear CareCulture President Lawrence Bean, MD, FACEP, MBA share the inspiration behind CareCulture's unique, service-oriented approach to transforming emergency departments.

Podcast Transcript

What is CareCulture all about?

First and foremost, we serve each other, we have integrity in what we do. We take ownership of our mistakes and we look at every problem through a lens of, “how can I do something better for the person in front of me.” If you build a culture around that you can adapt to anything else. Everything else is fixed around that. We wanted to build a business around this culture because we believe it is much more lasting. It endures any changes in technology, in environment, in healthcare in general. No matter what happens with Medicare, Medicaid, payers, insurance. None of that matters. What matters is taking care of the patient and taking care of each other, so we have a great place to go work every day.

What inspired you to embrace this culture/philosophy?

Where this all started for me was where I grew up. I grew up somewhere where there was a lot of violence, a lot of drug use, children were turned into adults very young. But the thing that I saw was we were all people and that we all have needs and that sometimes the people who appear the scariest have the biggest needs and that they can be changed through compassion and kindness and it really happens every day and a lot of them are in a lot of pain and seeking comfort.

I knew early on that I wanted to do something with my life that provided comfort to people who were in pain. And relief to people who were suffering and hope to people who were hopeless. And my introduction to that was kind of a divine intervention. A friend of mine had a physician drop off a mission trip that they were doing into the Dominican Republic, he asked me if I had a passport and wanted to go. I discovered something on that trip, a sense of renewal and of purpose and vision that I did not know previously existed. It was serving the people that had need—just like we were doing in the emergency department—but it was so much more need and they had so much less. I couldn’t truly realize how much need they had without seeing it and being a part of it. The gratitude that they, in turn, expressed was like nothing I’d ever seen either. It was very fulfilling on multiple levels, personally gratifying, but also definitely fulfilling that sense of purpose. I came back talking about it non-stop. I immediately went to Eugene (now CEO of CareCulture) since I knew he thought the same way I did about things; he and I went together Armenia and after that [service] became a huge part of our lives. It became integrated into our larger vision.

What inspired you to start CareCulture?

We saw a really high level of burnout amongst ER providers. We saw a lot of unhappiness in clinical interactions…the interactions between providers and nurses, between providers and techs and the rest of the hospital staff. We felt there was something that could be done to change that.

Amazingly, there were days that everything was different. Some days I would be [working in the emergency department] and things would be really rough. I knew I had a good purpose. I knew I was there for the right reason, I knew these were people that needed serving. I knew I was where I should be. But they were rough days. Then, an amazing day would happen right afterword. So, you start asking yourself, “why was yesterday so bad and why was today so great?” You start looking at the people around you and you start seeing patterns develop. One pattern that developed was when Javier was on and when Eugene was on, it was a great day. Over time we figured out what the difference was, why it was so much better when we were with each other. It’s not just our friendship. It’s actually what drew us to each other and the reason we knew we would get along. And that is, this mentality of serving. Of serving each other and serving all the people around us. We hadn’t yet defined what it was that made the days great when we were together. We knew we liked each other, but why did it change the entire environment of the ED? Why was that so much different.

Our EVP (executive vice president) over our ED noticed we had something special when we worked [together]. He had worked side-by-side with us a couple times and knew there was something about our culture. He asked us to go to EDs that were struggling and help them work out some of their problems. We would go to these places and it was always a problem with flow or some technical issue, but we chose to dig and ask “why is this happening?” It was followed by, “I’m doing what’s best for the patient.” And someone else saying, “No. I’M doing what’s best for the patient.” And we sat around and discussed that and said, you know, it’s interesting that that phrase, “I’m doing what’s best for the patient.” Is being used as a weapon against someone else in a disagreement. We’re all there to do what’s best for the patient. The further we dug, [we discovered the issue] was conflict [between] two very well-intentioned people or multiple well-intentioned people over how best to do their job.

Why do you believe in CareCulture’s service-focused approach?

The patient always benefits when you fix [conflicts] during the delivery of care. This finally really turned the corner for us and we knew you have to focus first on serving each other. We know we’re all there for the patient. But if you focus first on serving each other, you can no longer use that as a weapon against each other, we’re all going to do what’s right, and you can have disagreements without beating each other up… It’s changed everything.

We’ve applied this approach at multiple places and every time we did it, it worked. It fixed all these operational metrics…things that were technical seemed to immediately improve when you applied this one philosophy. That philosophy shone through all the other stuff that was going on, all the bad attitudes that might be around…when just a couple of people start serving each other and serving even the people that aren’t serving them, you serve them and your kind to them and that starts to rub off and change the mentality of everyone around you. There’s nothing complex about it. It’s not hard to implement into any healthcare facility. Into any healthcare setting. There’s no barrier to it. It’s just a very human fundamental principle: I’m going to serve the person in front of me to the best of my ability.

You don’t have to solve every little problem that everyone has. You have to teach people to solve their own problems. The way you do it, the core principle behind that: start with asking the question, “how can I serve this person that I am conflict with?” We knew we both came to work today to heal this patient, to make their lives better. Why are we in conflict? What can I do to serve this person that will at its core fix this problem between us?

CareCulture is a movement. CareCulture is a group of people who are trying to change the way medicine is practiced. In the hospital specifically, but also everywhere. We are focused on serving each other first and knowing the patient will benefit from the work that we do. The better a team functions, the more efficient and high quality care the patient will receive. So, we focus first on the team and on serving each other and building the team and building each other up and creating an environment where everyone loves coming to work. Every problem within the healthcare team is solved with this solution. We’ve yet to find one that doesn’t get fixed with it.