Picture someone you trust. Now picture someone you trust at work. Are those trust levels the same? The opening exercise of the Culture of Trust training at Irwin Army Community Hospital helped civilian and military staff put into perspective how they view trust in the workplace.
The training reached all 1,400 employees between Aug. 29 and Sept. 1 and provided them the skills and guidance to move toward a more trusting work environment. IACH was selected as the first pilot site for the Culture of Trust because of the hospital's size and command involvement.
In September 2010, the Army Surgeon General authorized the formation of the Culture of Trust Task Force to support the Army Medicine's mission of improving patient health care and staff readiness.
"When we encounter a person at work who we don't get along with, we often try our best to avoid them. That makes our job harder," said Dave Cordell, chief management analyst and one of the 16 trainers for the COT. If trust levels are high in an organization, staff are happier at work and tend to work better together, he said.
"Trust impacts the organization and the people we serve and I think trust complements the Army values quite nicely," organization development specialist Brandy Boak said.
The four-hour course for staff and eight-hour course for supervisors established trust building blocks that will assist IACH in developing a standard, consistent and measurable level of trust.
The fundamentals of trust include being responsible for one's actions, having the power to make choices, knowing that all people have value and learning from mistakes rather than trying to hide from them. Trust behaviors discussed during the training were accountability, congruency, transparency, integrity, voice and engagement. Out of the six behaviors, the trainers focused on helping the staff at IACH regain their voice.
"Voice is the lowest scoring Trust behavior at IACH and the command team is supportive and willing to focus on improving it," Cordell said. Voice was defined in the training as having enough courage to speak up for what is right and taking a stand even when it is risky.
Laura Dukes, a medical technician at IACH, attended the 4-hour training and learned that it was her responsibility to her hold herself accountable for her actions. "It was very inspiring and the training broke through a lot of barriers with the employees. It's not really about making people change their beliefs but rather helping them change how they interact with staff and patients," she said. In the future, she'd like to see more training that teaches the staff how to hold each other accountable, she said.
Sgt. 1st Class David Beverly, tasking non-commissioned officer, attended the eight-hour training and enjoyed the hands-on exercises that helped identify potential trust issues that civilians and military staff may have while working together. "It's going to be a difficult idea to buy, and it will probably be hard for the old-school military personnel to transition," he said.
Claudette Elliott, PhD, director of the Trust Enhancement and Sustainment Task Force for the US Army Medical Command, said the feedback she received throughout the training was positive and that some course attendees were in a wait and see mode.
"I'm pleased to see that there is not a lot of resignation that things won't change and we've gotten good feedback about the training so we can fine-tune it for training at future sites," she said.
Dr. Elliott's hope is that people will take responsibility for both their performance and behavior. Personal accountability will be paramount to the continued success of the COT initiative. "The person is fine, the individual is perfect, it's changing our behaviors that change the atmosphere or culture of the organization," Elliott said.
Unlike other initiatives that end up as "a flavor of the month," the Culture of Trust Task Force will provide ongoing support and skill building with Army Medicine throughout the year, she said. This is an enduring mission that will see Army Medicine well into the 21st century.
"With Culture of Trust, we're not asking the staff to do more, we're asking them to do and think differently," she said. "It's much easier to come to work when you trust your co-workers." In the 23 years she has been working toward trust initiatives, she said this is the first time she has seen the necessary senior leader support.
Col. Mike Heimall, IACH commander said he looks forward to discussing with the staff what they are doing to improve trust within the organization and how the command team can support their efforts. The training reminded him that how people interact with others is a personal responsibility. "Often, changes in our personal behavior, instead of transferring blame to others, are sometimes the most important thing we can do to improve personal interactions," Heimall said.
Health care is a team sport and IACH has to work together closely, ensuring its processes are transparent and seamless to its patients, he said. "At the heart of any team activity is trust. Our patients trust us to take care of them and ensure they get the best care possible when they need it. Our team members have to trust each other to ensure they do their jobs," he said.
The training will assist the IACH team by unveiling gaps in communication and trust and how those gaps directly impact patient care and the patient's experience, he said. "Patients will notice an improved approach to meeting their health care needs," Heimall said. "We are placing the patient at the center of the health care encounter and ensuring everyone is working to meet their needs in a coordinated, compassionate, and caring fashion."
"I want the entire Fort Riley community to understand our commitment to providing the highest quality health care, accessible when it is needed, and delivered in a manner that gives the patient and their Family the best health care experience possible," Heimall said.
Through the Culture of Trust Initiative, Dr. Elliott "hopes to help enhance and sustain trust; where people are passionate about the organization they work for and the work they do. The trust level should be a seamless and outward extension of AMEDD personnel towards our patients, beneficiaries, stakeholders, co-workers and community.
"The training is just the tip of the iceberg; we have to change the way people think, the way they behave and then the culture," Elliott said. "It's a win win for both."
The Task Force is now headed to New York to work with the MEDDAC and DENTAC personnel on Fort Drum. Organizational Development Specialist, for the Culture of Trust, and Army Reserve Command Sgt. Maj. Sherman Fox- said his goal is to make sure that Army Medicine continues to succeed in service excellence. Army Medicine is committed to remaining relevant and trusted -- the keys to Army Medicine's long heritage of service.
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