Health organizations that are already overwhelmed by challenges must find a way to implement simple but systematic tools that will support a deep transformation from transactions to transcendental relations.

NRC Health 2022 Symposium speaker Jorge Ismael Torres, Culture Architect and co-author of Hardwiring Magic, says that effective Human Understanding and some simple operational and leadership tools can prepare healthcare organizations to engage and retain employees and improve and sustain overall performance results.

“Culture means to cultivate—agriculture, floriculture, et cetera,” Torres says. “This means that culture is a consequence of how well you prepare the ‘inputs’ like soil, seeds, and humidity, and of how well you take care of your plant daily. For example, if you want to have a culture of safety, you need to define the observable behaviors that mean that people are being safe. If you want a culture of excellence, then you must define the observable behaviors for being excellent. Are people always arriving on time? That one I can measure. Or if I see something on the floor, I pick it up. That’s something measurable. If I see someone, I smile—and I can observe that. Consequently, whenever a patient comes to your business and they see people behaving like that, they can see that this is a place that has a culture of innovation, safety, and compassion.”

Once you define these expected observable behaviors, he adds, you must establish reinforcement mechanisms in order to make sure that people behave as expected. Torres’s book Hardwiring Magic discusses simple mechanisms that help you measure and take actions to correct deviations—“Because what you don’t measure you can’t track, what you don’t track you can’t control, and what you don’t control you can’t improve… So you must measure in order to improve.”

The Beauty of Connection

Torres says the Fifth Revolution—the Humanistic Revolution—will be a period that will rehumanize society, elevating technology to serve humanity instead of driving it apart.

He explains that there have been four revolutions: the first, steam-power mechanization; the second, mass production due to electricity and combustion engines; the third, computers and automation with electronic systems; and the fourth, the one in which we are currently living—the age of information as a commodity, the internet of things. This four-revolution period of over 200 years is what some people call the dehumanization phase, because during this period human beings have lost track of the meaning of what it is to be human.

“Before the first revolution, human beings had a good sense of what being human is or was about,” Torres explains. “There was a strong sense of purpose and belonging—the community, the little towns. You had a clue, more or less, of what your life was supposed to be. There were expected outcomes; there was personal time for family, friends, the community, for a sense of spirituality.

“At the end of the day, people enjoyed the fruit of their work after sewing and harvesting. But suddenly, we removed them from their towns and took them to a big city, inside a plant, to pull a lever all day. So what happened is, people suddenly started losing their sense of purpose. Everything became a transaction—human resources, for example, implies that people are just another resource. This was when alcoholism, drug addiction, and depression started. Human beings became lost, without a strong sense of purpose.”

However, Torres says, sociologists, psychologists, and theologists believe that the newer generations are gravitating toward a fifth revolution, which is going to be called the humanistic revolution. This is not the same as humanism, he explains; humanism was a movement in which the divine and supernatural were replaced by human action. By contrast, the humanistic revolution is about reinforcing the essence and purpose of human existence and purpose with “the necessary logistics” or mechanisms that will help organizations transform from a mere transactional environment to a transcendental relationship between the organization and all of its members. “We must ensure that people discover what their why is,” Torres says.

“I didn’t know that my why was to help people,” he adds. “When I came to healthcare as a consultant, I was like, ‘This is the best industry ever,’ because out of all the industries I’ve worked for, this is the only one in which I have a direct impact on a person’s life, for the rest of their life. I thought, ‘I want to stay here.’”

How Healthcare Systems Can Be More Successful

Torres says that healthcare systems can create “magic” by ensuring that patient perceptions are better than their original expectations. They can do this by establishing a systematic approach to address four simple factors or “gaps.”

“Let’s talk about the first gap—customer expectation,” he says. “This is why I get so excited about Human Understanding as a solution. When I came to this industry at Mount Sinai, I got to work with NRC Health. I was like, ‘Oh my god, this is amazing. I wish I had NRC in my previous lives! It makes my life much easier, because I have the information I need to make decisions. If you don’t measure, you don’t track; you don’t control, you don’t improve. With NRC, we could ask what the expectations are from the get-go. And we’re moving again from scores, from transactions, now to relationships—which all goes back to Human Understanding.

“Now let’s talk about the second gap—processes. Once you have a clear idea of your patient’s expectations, then you can design simple and effective processes to address those expectations. This is why many people agree that processes should be a strategy, because if you don’t have the processes, you don’t have the recipe in place. It’s just John who knows the recipe—and if John dies or moves away, the recipes go away. When you investigate under the hood of a business, do you see a mechanism, a machine, a gear? Or do you see a couple of guys moving levers? Do we depend on people, or do we depend on a process? That’s why best practices are so hard to maintain: is it the best practice of someone? Or the best practice of a process? If you have a process in place, it doesn’t matter who manages that process; that person goes, another comes, but the process stays.

“Now let’s talk about the third gap, which is the hardest, because it’s about our team’s execution. Having a good recipe doesn’t ensure that your apple pie will be better than other people’s…it boils down to how well the chef consistently executes the recipe and how much passion and care the chef has while baking the pie. So it’s a matter of a) aptitude and b) attitude. Organizations must have reinforcement mechanisms to ensure great on-the-job training—aptitude—as well as programs and mechanisms that ensure consistent employee and motivation and engagement—attitude.

“The fourth gap is NRC’s specialty. Organizations must have precise information on what their customers perceive. Having NRC Health’s tools helps Mount Sinai get continuous feedback from our patients so we can address both processes—gap 2—and employee performance—gap 3—to customize each employee’s interaction with their patients and family members.

“Understanding starts with listening, trying to understand you,” he says. “Then comes the creation—using data to create a story, so you can tell a story that explains the data. And the conveying, the delivery—it’s like storytelling. You create culture constantly.”