1. Benchmarking air pollution levels – Health and socio-economic impact, and solutions

    May 18, 2019 by BPIR.com Limited

    Article contributed by Dr. Almas Tazein, BPIR.com Limited


    Somewhere in the middle of a city suburb, she lay dispassionately, watching the hazy sky from her sanatorium window, inhaling oxygen from a metallic chamber piped next to her. She desperately needed immaculate fresh air. It would be a concurrent treatment for salvaging her progressing lung disease. But the cityscape couldn’t care less to give it to her. It was a luxury that she could not afford.

    How many of us cringe before leaving for work every morning? No, not because of an impending meeting with the bosses. But because in a few moments we’ll be meeting the black angel of misery, wrapped in smoke, dust and poisonous gases. And, we surrender to it.

    Were we humans created to bear all of this every day? No. We weren’t. Not even for a single day.

    And if we’re sitting inside our cars and homes, there is a high probability that after knowing the facts here, we won’t be as comfortable.

    • Here, we will uncover how this hovering perennial challenge called air pollution detrimentally influences our health, environment, and ultimately human productivity.
    • Also, the international gold standards against which we can gauge our pollution status.
    • THE SOLUTION TRIAD – educate oneself with the best international performers in air pollution crisis management.


    Ralph Waldo Emerson, the 19th century
    American essayist and lecturer once said, “Our chief want is someone who will inspire us to be what we know we could be.”

    In the 21st century, we call it, benchmarking.

    Satellite measurements by Nasa researchers show that the Earth’s surface has been warming globally with 17 of the 18 warmest years on record occurring since 2000.

    How Are Air Pollution and Climate Change Linked?

    United Nations recalls that ‘cities and pollution contribute to climate change. According to UN Habitat, cities consume 78 per cent of the world’s energy and produce more than 60 per cent of greenhouse gas emissions’.

    Black carbon (soot) is a component of air pollutants, generally comes from vehicle emissions, especially diesel, burning wood for cooking, or coal for home heating.

    Because of its dark colour, black carbon is very good at absorbing sunlight, leading to an overall effect of warming the climate. It is estimated that it is second only to carbon dioxide (CO2) in its contribution to global temperature increases (Bond et al, 2013).

    Based on a study by Marshall Burke, an economist at Stanford, it is estimated that the gap in per capita income in the richest and poorest countries is 25 percentage points larger than it would have been without climate change. That is because poor countries are disproportionately concentrated around the equator where even a slight increase in temperature can be devastating to crop production, human health and labour productivity.

    India, the world’s second most populous country, would have been 30% richer without climate change, the study concluded. (Based on data from 1961-2000). (Marshall Burke and Noah Diffenbaugh.).

    As for the countries away from the equator, we have yet other threatening reasons to worry about courtesy of climate change.

    Of all air pollution measures, PM2.5 is believed to pose the greatest health threat.

    Insights into PM2.5

    • PM pollutant group affects the most people globally.
    • Particulate Matter (PM), is a term used for particles found in the air, including dust, soot, dirt, smoke, and liquid droplets.
    • 2.5 annotation designates the size 2.5 micrometres (µm) or less.
    • Often described as fine particles, they are up to 30 times smaller than the width of a human hair.
    • PM2.5 is reported as a mass per volume of air – µg/m3.
    • PM2.5 is too small to be filtered by our nose and lungs.
    • Sources: PM derives from a wide range of both anthropogenic and natural sources.
    • Common direct (primary) sources include combustion of fuels
      (such as petrol, wood, diesel, coal), materials such as rubber and plastic.
    • Motor vehicle engines, power plant emissions, industrial processes, dust from construction and demolition sites,
      bushfires agriculture, and firecrackers
      all cumulatively result in ambient or outdoor air pollution.
    • Sources of household or indoor pollution – burning of solid fuels in open fire cooking stoves. PM2.5 also develops through other pollutants reacting in the atmosphere (secondary).
    • Black carbon (soot) is a component of PM2.5.

    A study published in 2019 proves that there is a statistically significant negative relationship between PM2.5 concentration and people’s happiness and productivity levels.

    Other Considerations

    • Research suggests the most damaging along with PM is carbon monoxide (CO), mainly associated with petrol vehicles. It leads to worsening of heart disease, drowsiness, also linked with learning difficulties.
    • In some air monitoring stations, pollutants are also measured in terms of visibility reduction.
    • In large parts of Europe and the U.S., the main air pollutants of concern are nitrogen dioxide (NO2) and ozone, so looking at PM2.5 only does not give a representative picture of air quality and health risks in some regions.

    Lack of visible smog is no indication that the air is healthy.


    As a much-needed reality check, we need to know (more than ever) that the World Health Organisation estimates that 91% of the world’s population lives in places where air quality exceeds WHO guideline limits.


    WHO: In 2016, household air pollution from cooking with solid fuels was responsible for 3.8 million deaths, and 7.7% of global mortality


    It can easily be argued that air pollution is no more a local issue, but a global public health concern – WHO Interactive global ambient air pollution map.

    To see whether the air is safe in your region or country there are a number of websites that display data from air quality monitoring stations such as IQAir’s real-time AirVisual Earth view,

    World’s Air Pollution: Real-time Air Quality Index and

    Plume Labs Worldwide Air Pollution Maps

    Figure 1. United States Air Quality Index

    WHO recommends an annual mean exposure threshold of PM2.5
    at 10 ?g/m³ to minimize the health risk whilst advising that no level of exposure has been shown to be free of health impact.

    (Fig 1, Fig 2, Fig 3, Fig 4 – Images taken from +IQ Air AirVisual 2018 World Air Quality Report – Region & City PM2.5 Ranking)

    Figure 2. Global map of estimated PM2.5 exposure by country/region in 2018

    This global map provides an overview of the average, estimated PM2.5 exposure by country/region in 2018. The estimation is calculated from available city data as a regional sample and then weighted by population. Countries and regions that remain grey had no or limited PM2.5 data available for 2018.

    Let’s see how some of the capital cities in the world rank.


    Figure 3. World’s top 10 most polluted capital cities.

    (Vertical line indicates World Health Organisation PM2.5 Target at 10 ?g/m³).


    Figure 4. World’s top 10 cleanest capital cities

    Countries from Asia and the Middle East occupy most of the top of this regional capital city ranking, with Delhi and Dhaka’s values both 50% higher than the 3rd ranking capital, Kabul. Only 9 out of 62 regional capitals included here have an annual mean PM2.5 level within the WHO air quality guideline of 10µg/m³.

    PM2.5 Heath Adversities

    PM’s relatively microscopic size enables it to both remain suspended in the air for long periods, and be absorbed deep into the bloodstream upon inhalation, causing a wide range of short-and long-term health effects like:


    • Irritation of the eye, nose and throat
    • Irregular heartbeats
    • Asthma attacks
    • Coughing, chest tightness
    • Shortness of breath
    • Respiratory illnesses such bronchitis, and emphysema (type of chronic obstructive pulmonary disease)
    • Impact of the exposure is exacerbated in people with heart or lung diseases
    • Children (since their immune systems are underdeveloped) and older adults are more vulnerable to the pollutants
    • Vehicle pollution results in 4 million child asthma cases annually, i.e. it results in about 11,000 cases of asthma in children every day. A report from The Guardian states that these results are found from nations having pollution levels well below the established WHO levels, suggesting the enormity of the harm caused by the toxic air.
    • Regular hospital visits
    • Cellular and genetic damage
    • Premature death
    • According to researchers, teenagers exposed to PM2.5
      are 45% more likely to have symptoms of psychotic experiences like hearing voices and paranoia. Nitrogen dioxide emitted from diesel vehicles are one of the major reasons for the same. Besides, the obvious respiratory illnesses, air pollution also reaches the brain and is linked to causing depression, dementia, etc.


    Ammonia in Air and Respiratory Concerns

    (Source: TIMES NEWS NETWORK, TOI, April 2019).

    A study conducted by Mumbai-based researchers at the Indian Institute of Technology – Bombay (IIT-B), National Environmental Engineering Research Institute (NEERI), and the Sustainable Approach for Green Environment
    (SAGE) found that it isn’t just particulate matter in the city’s air that is a cause of concern. Concentration of ammonia (NH3) in the air is a cause of some of the respiratory illnesses.

    The sources of ammonia were the fertilizer units in certain areas, and solid waste, according to the founder of SAGE. The study found that 45% of population inhabiting in the area around the fertilizer plant was exposed to illnesses. In a particular location, the fertilizer plant was 10km away, yet the concentration was high due to high population density.

    Sewage drains and solid waste lead to high levels of ammonia in isolated places. Ammonia disperses faster, and has short-term impacts, according to the director, NEERI.

    Climate Change: The Clock is Ticking!

    Read an IPCC special report on the impact of global warming of 1.5 °C above pre-industrial levels, 2018. Global warming of 1.5% could be reached by 2030 if we stay on the same trajectory with devasting consequences to wildlife & many communities.  To prevent irreversible damage from Climate Change we need to ACT NOW!


    “I used to think the top environmental problems were biodiversity loss, ecosystem collapse and climate change. I thought that with 30 years of good science we could address those problems. But I was wrong. The top environmental problems are selfishness, greed and apathy … and to deal with those we need a spiritual and cultural transformation … and we scientists don’t know how to do that” – James Gus Speth, American environmental lawyer and advocate.

    Greta Thunberg, the 16-year-old Swedish climate activist and now a global hero speaks at the UN Climate Change COP24 Conference and at a follow-up interview speaking far more sense than the various Governments and policy makers that have led us to this mess.


    The green warrior, Greta Thunberg, at the European Parliament, 16 April, 2019.

    More than 9,000 Londoners are estimated to die prematurely each year from long-term exposure to pollution. Recently, in April 2019, environmental protesters in central London highlighted demands for the British government to declare a climate emergency. The Parliament declared a climate emergency, following in the steps of Scotland and Wales and major British cities.

    Air Pollution and Human Intelligence. Could There Be a Connection?

    In 2017, Xi Chen, a public health researcher at Yale University conducted a study on over 25,000 people in China. People who had been exposed to air pollution the longest were seeing the steepest drop in their cognitive test scores (maths and language skills), roughly equivalent to a loss of one year of schooling.

    The study found that the cognitive impact may be more pronounced in cities where dense traffic, narrow streets and high-rise buildings often trap pollutants at street level. For instance, in London, 95 per cent of the population live in areas that exceed the WHO guidelines for PM2.5.
    The mayor of London made air pollution a priority, carrying out audits on air quality around primary schools, introducing Ultra Low Emission Zones, and re-fitting diesel buses.

    Fecht, a medical researcher at Imperial College London explains that polluted air leads to oxygen deficiency, impacting brain functions.

    Researchers from Imperial College London and King’s College London
    found a probable association between air pollution and dementia. That study published in September 2018, followed 131,000 patients over an average of seven years.

    Severe Air Pollution Affects the Productivity of Workers

    Economists from the National University of Singapore (NUS) completed an extensive study, published in January 2019, and it reveals that exposure to air pollution over several weeks is not just unhealthy, it can also reduce employee productivity. An increase in PM2.5, by 10 micrograms per cubic metre sustained over 25 days, reduces daily output by 1 per cent, harming firms and workers.

    Polluted Air May Pollute Our Morality

    Exposure to air pollution, even imagining exposure to air pollution, may lead to unethical behavior, crime and cheating, according to new findings.

    THE SOLUTION TRIAD – Governments, Communities, and Individuals

    For the highly toxic PM, most governments have created regulations – both for their emissions and for the ambient concentration of particles. Technology is being used for reducing air pollution in smart and sustainable future cities.

    Top leadership level:

    1. Governments, international bodies and industrial regulatory authorities need to converge holistically.
    2. Public and private forces need to construct collaborative policies (according to the who, health benefits far outweigh the costs of meeting climate change goals).
    3. A centrally monitored network of clean air zones for near or beyond dangerous limits,
    4. Rigorous enforcement, and regulatory compliance audits will help both – the policy makers and breakers.
    5. Urban and agricultural waste management systems need to be within safety borders.
    6. Think tanks need to execute urban planning policies at a benchmarking level.
    7. Motivating citizens to be pro-active towards a truly civil society by encouraging connected and clean mobility solutions:
    • Prioritizing shared and public modes of travel as the preferred mode.
    • Marketing of electric cars at a large scale with easy payment options and credit points, a relaxed tax system, ban on highly polluting vehicles,
    1. Replacing wood fired cooking with low-emissions sources such as solar cookers, petroleum-based stoves or other modern technology would would save millions of lives.
      (Courtesy of Guardian News & Media Ltd).
    2. Air quality forecasts and actionable health recommendations that allow individuals and organizations to reduce their exposure to air pollutants will help.
    3. Some European countries promote cycling for everyone as daily transport mode (PRESTO), reducing air pollution and encouraging healthy lifestyle.

    United Nations Secretary-General António Guterres is calling on all leaders to New York on 23 September 2019 with concrete, realistic plans to enhance their nationally determined contributions by 2020, in line with reducing greenhouse gas emissions by 45 per cent over the next decade, and to net zero emissions by 2050.

    Community level
    best practices
    include resilient measures that can bring solidarity, like:

    1. installation of plants for composting of waste,
    2. deploying an air quality monitor in the neighbourhood to accelerate access to real-time information and align it with national air and fuel quality standards,
    3. public education campaigns and health awareness initiatives

    At an individual level, we are the beneficent and beneficiary, both.

    Climate action is not a one model solution, but do commit to altering your personal choices that can have a significant impact:

    1. Indoor air purifiers, outdoor masks and scarves.
    2. Choosing clean modes of transport (walking to work, cycling, driving an electric vehicle
    3. Use public transport, where available
    4. If you have a young child with you, try and lift them up above the level of vehicle exhausts
    5. Limit car use on highly polluted days.
    6. Supporting local air quality initiatives

    There is hope if governments commit to strategic planning to deal with the air pollution exigency and utilize technology for its intended use – to make our lives healthier.

    Political commitment and cross-sector partnerships are the unequivocal key factors to reduce pollution.


    Let’s start with NEW ZEALAND, nurturing the cleanest capital city, Wellington, in the world (2018).

    1. Ministry of Transport, New Zealand has announced its Electric Vehicles Programme, which aims to increase the uptake of electric vehicles in New Zealand.
    2. The New Zealand Emissions Trading Scheme (NZ ETS) by the Ministry for the Environment, New Zealand is the Government’s main tool for reducing greenhouse gas emissions. It puts a price on greenhouse gas emissions. This price on emissions is intended to create a financial incentive for businesses who emit greenhouse gases to invest in technologies and practices that reduce emissions. It also encourages forest planting by allowing eligible foresters to earn New Zealand emission units (NZUs) as their trees grow and absorb carbon dioxide.
    3. The government is investigating the potential of second-generation transport fuels derived from diverse non-food based renewable sources such as biomass, woody biomass and landfill gas.
    4. The government introduced a requirement for the fuel economy of vehicles to be displayed at their time of sale and has created a FuelSaver website where the public can compare fuel efficiency of vehicles


    CHINA

    Of the 50 most polluted cities in the world China has 22 cities represented. China is tackling this issue by:

    1. Reducing the production of steel and of coal-fired electricity, replacing coal wind and solar power.
    2. Nationwide network of monitors tracking levels of PM2.5, making the data from those monitors publicly available, with measurements taken outside thousands of factories. People with smartphones in China can check local air quality in real time, see whether a particular facility is breaching emissions limits, and report violators to local enforcement agencies via social media. (National Geographic, 2017).
    3. The Smog-Free Tower cleans 30,000 cubic meters of air every hour, the smog particles are then compressed and used to make cufflinks and rings.
    4. Electric buses for Beijing are underway.

    5. China conducts a monthly air quality ranking of 169 cities to pressurise local authorities to clean up dirty skies.


    INDIA

    Of the 10 most polluted cities in the world in 2018, India had 7 cities represented. Delhi is the most polluted capital city in the world. Some of the changes being implemented include:

    1. Odd-Even road rationing scheme – Cars with license plates ending in an odd number and even number were allowed to be used on alternate days.
    2. During the Diwali festival, air pollution surged to unhealthy levels as a result of the burning of firecrackers. As damage control measures, the government banned the entry of heavy and medium goods vehicles into the national capital for three days. Vehicles carrying perishable food items, tankers carrying petroleum tankers were exempted.
    3. Authorities halted operations of industries using coal and biomass as fuel for 10 days.
    4. Civil construction was suspended and all stone crushers and hot mix plants were shut down. Workers of Public Works Department (PWD) sprinkled water in areas to settle the dust. (Money Control, 2018).
    5. India will soon adopt the Bharat Stage VI (BS-VI), for regulating emission standards. Under BS-VI, cars, especially diesel cars will have to undergo significant changes to the engine to conform to the norms. Delhi already has BS-VI fuel on sale, in which the sulphur content of diesel is < 10mg/Kg, which directly reduces the PM10 and PM2.5 emissions of diesel vehicles.
    6. Recently, the Union government approved the second phase of the Faster Adoption and Manufacturing of Electric Vehicles scheme (FAME-II) and the National Mission on Transformative Mobility and Battery Storage. With these two movements, and a focus on transportation metamorphosis through electrification, India is exploring to enter into a sustainable future with viable opportunities to rely on.
    7. Forecasts indicate that EVs (Electric Vehicle) can reach price parity with ICE (Internal Combustion Engine) vehicles by 2024.


    FRANCE

    France is addressing pollution in a multitude of ways.

    1. Coloured stickers displaying car emissions are mandatory, helping the authorities to classify cars and issue targeted bans to the most polluting vehicles
    2. Environmentally healthier transport mode options promoted.
    3. Cars manufactured before 1997, and diesels registered before 2001 restricted from entering the city centre on weekdays between 8am-8pm, facing heavy fines for not abiding.
    4. By 2024 diesels, and petrol cars by 2030 will be completely removed off the streets.
    5. Cycle tracks and bus lanes are given more preference by provision of more space, than for cars.
    6. Attractive subsidies by city council to motivate citizens to choose alternate transport.
    7. Alluring, but conditional benefits offered to buy a bike, a public transport pass or a car sharing scheme, the condition – abandoning their motor vehicles and motorbikes.
    8. Taxi drivers are given grants to buy environmentally-friendly vehicles, and the installation of electric charging points is funded.

      (Source: BBC).


    SOUTH KOREA

    South Korea is battling pollution through the following approaches:

    1. Use of artificial rain in order to reduce air pollution in Seoul.
    2. During emergency levels, limiting the number of diesel cars and reducing the dust from construction sites and power stations are put in place.
    3. Retirement of old coal-burning power plants.
    4. Installation of high-capacity air purifiers in more daycare centres. And schools.
    5. In collaboration with China, warning dissemination technology is being established. (Al-Jazeera, 2019).
      Sirens go off and people are sent a text by the government warning people not to go outside.

    o

    UNITED ARAB EMIRATES

    Abu Dhabi was at No. 9 in 2018’s World’s top 10 most polluted capital cities. It devised a system that can be an epitome of what strategic planning during air environmental crisis should be like.

    Air pollution was identified as a primary environmental threat to public health in the Abu Dhabi State of the Environment Report 2017. Developed in partnership with key public and private stakeholders, an Air Emissions Inventory has helped produce over 50 high-definition sector and pollutant specific Air Emission Maps that identify the location and intensity of each emission source in Abu Dhabi.

    The emission inventory shows that oil and gas production and road transport are the main contributors to emissions of regulated pollutants in Abu Dhabi. By identifying the main contributors to emissions, it is now possible to work systematically to reduce these emissions through working closely with the public and private sector and wider community.

    In Dubai, a similar approach is being developed but it still has a long way to go to bring pollution down to healthy levels with pollution levels for PM2.5 at 55.3 in 2018 (meaning on most days of the year people are breathing in unhealthy air). This average is higher than Abu Dhabi’s rating of 48.8. A positive step forward has been publicly sharing the live data from 13 air pollution monitoring stations but so far the results for the most dangerous type of pollution of PM10 and PM2.5 are not shown.


    UNITED KINGDOM

    The UK is the first nation to have officially declared a state of climate emergency on 1 May 2019. MPs are calling on the government to make changes that include setting a new target of reaching net zero emissions before 2050.

    1. The U.K. government plans on banning all new diesel and gas cars from roadways by 2040, with half of the vehicles being hybrid or electric by 2030.
    2. The Road to Zero initiative is a move to encourage people on the adoption of electric and hybrid vehicles. (Interesting Engineering, 2018).
    3. In April 2019, London introduced Ultra Low Emission Zone to combat air pollution.
      Motorists of older cars need to pay a new charge of approximately 15 euros to enter the city centre –at the same times as paying a pre-existing congestion pricing, which was implemented in 2003.
    4. Since the afternoon of 1 May, 2019, Britain had gone a week without burning coal for electricity for the first time since the 19th century. The government says Britain will eliminate coal from its power supply by 2025, generating more power from wind, solar and other renewable sources.
    5. Councils in the city are threatening to clamp down on the good old ice cream trucks, as the vendor’s eco-credentials have been unable to escape scrutiny because of the fears that pollutants from the truck’s diesel engines may be endangering lives. ‘The local authorities are cracking down on diesel vehicles running their engines for hours’ – Caroline Russell, a Green Party member of the London Assembly.
    6. Threat of flooding: According to The Environment Agency (EA), communities near the coast or rivers could be forced to move as England prepares to counter average global temperature of up to 4°C. The EA’s new climate strategy estimates an average annual investment of £1 billion over the next 50 years in England, for the traditional defenses.

    WORLD HEALTH ORGANISATION – EUROPE: TRANSPORT AND HEALTH

    Evidence shows that air pollution at current levels in European cities is responsible for a significant burden of deaths, hospital admissions and exacerbation of symptoms. WHO – Europe:

    • promotes sustainable transport for health and the environment through an integrated approach, which prevents and reduces the health effects associated with current transport patterns;
    • assists its Member States in fully considering transport policies’ implications for health, the environment and sustainable development, and supports them in defining and managing mobility policies that benefit health.

    Conclusion

    Civilized. Responsible. Intelligent. It is high time we justify these virtues by collectively outsmarting the air pollution menace to enhance our life-span on this earth. We need to wash away the dark gray trails for us to perform at our optimum capacities, accelerate our nation’s growth, and rescue our battered planet.

    It will need the relentless efforts of international bodies, national governments and local communities. And our individual conscience.

    The reason is evident. Look up – our skies aren’t blue, look within – our health isn’t pink, and look around – our economies aren’t green either.

    The time has come for this poetic justice. Afterall, we cannot be forever running anxiously in search of greener-cleaner pastures. We need to take action, here, and now.

    As a final recommendation, find time to watch the following documentary:

    Pic source: Department of Foreign Affairs and Trade [CC BY 3.0 au]

    Sir David Attenborough, an English broadcaster and natural historian, presents the compelling and poignant

    Climate Change The Facts (2019) Documentary
    (Rights owned by BBC).

    _________________________________________________________________________________

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  2. Leadership Practices of Memorial Hospital and Health Care Center

    May 15, 2019 by BPIR.com Limited

    Article originally posted on Blogrige by Dawn Bailey

    mhhcc01

    Five-Part Leadership Blog Series
    In this five-part blog series on the 2018 Baldrige Award recipients’ leadership presentations at the 31st Annual Quest for Excellence® Conference (April 7–10, 2019), senior leaders of the five newest national role models share best practices and stories of how they achieved excellence.

    Addressing the Critical Care Shortage

    To relieve the critical shortage of beds in its rural Indiana area, Memorial Hospital opened its doors in 1951 for patients across eight counties. The Little Company of Mary Sisters set the direction in how the hospital cares for patients and each other, following the mission: “Christ’s healing mission of compassion empowers us to be for others through quality and excellence.”
     
    Now recognized nationally as a top regional hospital, Memorial Hospital and Health Care Center offers 137 patient beds and employs more than 1,700 staff members, with 100 physicians as active medical staff. Memorial also has 32 medical offices strategically located in its service area, annually providing care to 6,500 inpatients; 260,000 outpatients; 3,000 emergency patients; and 1,000 newborns.

    Developing Relationships
    According to Kyle Bennett, president and CEO, two constants have helped the hospital reach role-model status: the commitment and support of the Little Company of Mary Sisters and community support.

    “In order to bring care closer to where we are, we develop relationships,” said Bennett, speaking proudly of Memorial’s many collaborations, including opening a clinic in an Amish community, developing a tele-stroke inpatient program in collaboration with the University of Louisville, and partnering with the Indiana University School of Medicine to develop a family medicine residency program to open in summer 2019.

    Because of this program, “the access to primary care [will change] for many years into the future for our service area,” he said.

    Adopting Baldrige to “Be the Provider that We Needed to Be”
    “Employers and the business community look to us to be a strong health care provider, and we knew seven years ago that we needed to make some improvements in order to sustain and be the care provider that we needed to be for the communities we serve,” said Bennett.

    In looking for ways to sustain and inspire improvements, he said the hospital realized that the Baldrige framework aligned with its mission.

    “The benefits that we’ve realized have helped us define what excellence is to us for the communities we serve,” he said. “[The framework has] helped us create discipline around our processes, improved our financial performance, and improved our focus on key quality metrics.”

    Bennett said adopting the framework came with some struggles. “When we began, trying to apply the Baldrige framework was for me nothing short of awkward. It felt like something else that we had to do. I could answer the ‘what’ questions [in the Baldrige Criteria], but I really couldn’t answer ‘how’ questions. We hadn’t really defined our processes.”

    “Thankfully, today the framework is how we do our work,” Bennett added.

    Modeling “Attributes of a Servant’s Heart”
    “We knew that to make any sustainable, meaningful change, there had to be deliberate change among senior leaders,” said Bennett, so the hospital developed a Servant Leadership System, with an emphasis on building its culture.

    Bennett said senior leaders knew that they needed to model the attributes of a servant’s heart (words around the circle in the graphic): selflessness, forgiveness, honesty, commitment, patience, kindness, humility, and respect.

    According to Bennett, the blue circles on the graphic are leadership goals (e.g., set organization direction/determine priorities, engage the workforce, monitor performance), and the triangle at the heart of the model, which lists the mission, vision, core values, covenants, and core competencies, represents the building blocks of culture.

    Identifying the Keys to Success
    According to Bennett, Memorial Hospital knows that the keys to its success are related to its focus on the mission, a committed workforce, and disciple around the strategic planning process.

    “Those things have been integral to us over our journey,” said Bennett. “We work to live our mission every day. It’s the foundation of all we do. And we consistently return to it as we seek discernment and perspective.”

    Similarly, workforce members are “empowered to be and to act,” said Bennett, adding that a no-pass zone at the hospital requires that all patients and their families, as well as all workforce members, are greeted at the front door.

    “Our workforce is key to building and sustaining our culture,” he said.

    Achieving Results
    Memorial Hospital’s results have helped propel it to national role-model status. Results include the following: 

    • Centers for Medicare and Medicaid Services (CMS) 5-star rating for overall quality of inpatient care since the ratings were released
    • National top-10%, net-positive, value-based-payment performance since 2017
    • Performance excellence outcomes: zero early elective deliveries before 39 weeks (since 2015), zero pressure ulcers in the Skilled Caring Center (since 2016), zero central line-associated bloodstream infections (CLABSI; since 2016), and zero hospital methicillin-resistant staphylococcus aureus (MRSA) infections (since 2015)
    • “A” Leapfrog Hospital Safety Grade since 2016
    • CMS top-10% performance in patient safety composite results since 2017
    • Registered nurse turnover rate below 2% since the first quarter of 2016

    “Thirty-seven,” added Bennett, “That’s how many [opportunities for improvement] we had in our feedback report [received with its Baldrige Award application]. . . . We realize that we’re the recipient of this wonderful award. Our patients are the recipients of the care we provide. . . . The quality that we provide can get better, and those 37 things will help us get there.”

    View more processes and results of Memorial Hospital and Health Care Center.


  3. The Kaleidoscope of employee morale and workplace wellness

    May 10, 2019 by BPIR.com Limited

    Article contributed by Dr. Almas Tazein, BPIR.com Limited

    EmployeeHappiness01

    Can we compare Einstein with Beethoven with Shakespeare? Likewise, one cannot undermine the significance of employees, irrespective of the chain of command. They are expected to create everyday miracles, survive the bullets in times of crisis with stoicism, or at least, sustain the positive status quo.

    And we wish to give back. Employee engagement / reward / recognition / appreciation – whatever we term it – it’s not about, but beyond the apathic sales incentives, official celebrations, or a fleeting ‘thank you’ over an email (for salvaging an impending operational-financial catastrophe). Maslow’s hierarchy confirms that all of us function at different levels of need at various stages of our professional lives. Our motivations are chalk and cheese – intra, and interpersonally.

    Furthermore, Texas Quick, an expert witness at trials of companies who were accused of overworking their employees, states that "when people get worked beyond their capacity, companies pay the price." Most experts feel that the chief responsibility for reducing stress should be the management. “Work-life balance ranks as the second most important workplace attribute behind compensation, according to research conducted by the Corporate Executive Board among more than 50,000 global workers”. (Dayton Daily News).

    So how do we plan to support our employees and make them feel cherished?

    How – With empirical case studies and global trends in how organisations contribute to their employees’ psychological health, physical wellness and social camaraderie at work and outside of it, here is a pragmatic guide with the 10 most relevant Best Practice Reports that BPIR.com has published in the employee morale and wellness domain.

    Who – From struggling organisations and its dispirited personnel, to eclectic leaders with their effervescent employees, this article will benefit and inspire one and all.

    Index of Best Practice Reports – Includes new and old (but still relevant ) reports
    1Employee Happiness
    2Employee Recognition
    3Workplace Wellness
    4Employee Motivation 2 & 1
    5Building a Healthy Society and Workforce: Awareness and Prevention of Diabetes
    6Employee Development
    7Emotional Intelligence
    8Work and Life Balance
    9Mental Toughness
    10Occupational Safety

    1. Employee Happiness

    Happiness at work is a mindset, which enables employees to maximize their performance and achieve their potential. An important part of this happiness is the emotional commitment or engagement that employees develop towards a company, its values, and its mission.

    Case Study: How the Head of an organisation implemented a Martini Culture, resulting in a reduction in voluntary turnover from 17% in 2013 to 6% in 2014, and a significant reduction in stress levels, and greater control over their work-life balance.

    2. Employee Recognition

    Despite the unquestioned benefits of employee recognition, organisations frequently execute their policies or programmes quite badly. In this light, many professional companies have now jumped on the bandwagon and offer employee recognition programmes and services. Employee recognition award.

    US $46 billion! That’s how much the employee recognition industry is worth annually. That is about two per cent of the total payroll for individual companies. Does recognition mean money? Read here for the Value and ROI in Employee Recognition.

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    3. Workplace Wellness

    Workplace wellness programmes are designed to help employees pursue a healthy lifestyle and reduce health risks, enabling to improve their physical, mental and social well-being. Because, ultimately, good health is the best investment plan for doing great business.

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    Measure and Evaluate – N.B.: this is a representative portion of the full self-assessment, which may be found in the member’s area at www.bpir.com

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    4. Employee Motivation 2

    Low employee morale leads to lower productivity, substandard work, and high staff turnover, all of which contribute to revenue losses. Writing in Aftermarket Business magazine, Tim Sramcik outlines the five misconceptions associated with improving low employee morale.

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    Example Cases – Philips Electronics, Deloitte LLP, Southwest Airlines, USA.

    Employee Motivation 1

    According to a research conducted by Greg Smith (2002), President of Chart Your Course International,

    Main causes of employee dissatisfaction at work / Factors that de-motivated staff were:

    Lack of appreciation33%
    Too much paperwork27%
    Problems with supervisors23%
    Poor pay and benefits22%
    Lack of training20%
    Lack of opportunity20%
    Fairness18%
    Problems with coworkers16%
    Commute15%
    Boring job9%

    The factors that workers thought were the most effective actions a firm could take to improve retention were:

    Train managers better32%
    Listen more28%
    Try something new24%
    Pay more23%
    Select managers better22%
    Set the example22%
    Hire better people18%
    Improve benefits13%

    Learn some key actions to implement strategies, and ensure and enhance motivation within your organisation. It is not an option, but a need to measure and evaluate your motivation strategies in order to establish how aligned individual objectives are to that of the organisation, and how motivated and committed employees say they are. Read how First Tennessee National Corporation initiated Work-life programmes to bring positive organisational results, and other novel case studies.

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    5. Building a Healthy Society and Workforce: Awareness and Prevention of Diabetes

    International Diabetes Federation reports that someone dies from diabetes every six seconds. Extensive research by the World Health Organisation estimates NCD mortality and morbidity of 56.9 million global deaths in 2016, 40.5 million, or 71%, were due to noncommunicable diseases (NCDs) i.e., cardiovascular diseases, cancers, diabetes and chronic lung diseases. The socioeconomic impacts of NCDs threaten progress towards the 2030 Agenda for Sustainable Development, which includes a target of reducing premature deaths from NCDs by one-third by 2030.

    This special issue focuses on some of the incredible efforts in the field of preventive health management and wellness initiatives to combat diabetes by governments, not-for-profit, private, and corporate organisations.

    The Blueprint for Change Programme by Novo Nordisk is a series of excellent case studies across more than 10 countries. Read how the World Health Organisation is effectively strategizing to salvage the threatening effect of this non-communicable disease.

    Explore novel social awareness campaigns for diabetes, and exemplary measures by health regulating bodies and government authorities in UK, USA, UAE, Canada, Australia, Belgium, India, Qatar, Europe, Saudi Arabia, Cayman Islands, Eastern Mediterranean Region, Hong Kong, along with the Global Report on diabetes.

    Hence, cost-effective strategies for dealing with diabetes and ongoing research are crucial  to the long-term effects on society and future generations.

    6. Employee Development

    Employee Development is a strategic investment typically provided through internships, job rotation, coaching, mentoring, training courses, and peer group assistance within the work place.
    Doing a fair share of the work: A UK survey concerning employee development which was carried out by "Investors in People" revealed that in all sizes of organisation half of employees reported working directly with someone who failed to do their fair share of work.

    Almost 4/10 managers – complained about colleagues not pulling their weight.
    40% of employees reported that their employer did not take any action to address this issue.
    Staff cited that working longer hours and feeling undervalued were amongst the most damaging issues they coped with, and that this in turn led to decisions to begin looking for a new job.

    7. Emotional Intelligence

    We have been led to believe that our IQ is the best measure of human potential. In the past 10 years, however, researchers have found that this isn’t necessarily the case and that a person’s emotional intelligence quotient (EQ) in actuality, is a greater predictor of success in life and work.

    EQ can have more explicit applications in the following domains: Communication between and among staff members; Conflict resolution; Customer service; Hiring; placement and staff turnover; Training and development; The development of a corporate culture or climate; Productivity; Leadership development.

    Unlike IQ, EQ can be developed and worked upon, having a significant impact on financial performance. Success stories: Recruitment costs in the US Air Force (USAF) were cut by a minimum of $3M annually due to its practice of choosing recruiters based on EQ-I criteria.

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    8. Work and Life Balance

    It is now accepted that family preoccupations can cause stress, absenteeism from work, adversely affect staff performance and productivity, and lead to resignations. It is a worldwide problem that employers can ill afford to ignore.

    Vancouver based Martha Frase-Blunt (2001) identifies that many employees, in their concern for their work, only take a ‘busman’s holiday’ – doing on their days off, or in vacation time, what they would do at work. Frase-Blunt cites studies that show workers take mobile phones, laptop computers, and beepers home over the weekends and on holidays. Calling into work to check progress, and accessing voicemail and e-mail were also shown to be common practices.

    Jill Casner-Lotto of the Work in America Institute believes that "while today’s communications devices are a boon to flexibility, freedom and enhanced sharing of information, they also undermine the work/life balance". The Society for Human Resource Management’s HR Content Expert, Nancy Lockwood (2003), also cites a recent study that "reveals that employees are often pre-occupied with work when not working, and when in the company of family and loved ones experience an inability to be meaningfully engaged in non-work spheres".

    The question is – What are businesses supposed to do about it?

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    9. Mental Toughness

    All companies want to be successful. But this would be a far-fetched idea if lackadaisical associates run the show, or associates have to communicate with their overtly sensitive colleagues. The situation may even demoralize a well-meaning team. Hence, employers aspire to hire pliable candidates, and leaders need to foster mettle in them by inspiring them to be relentless, i.e., lead by example.

    10.  Occupational Safety

    Occupational safety and health (OSH) – It is legally incumbent that employers have a common law duty to take judicious care of the health and safety of their employees. Based on the ergonomic survey and research data, safety cultures can be improved by optimizing safety-related communication throughout an organisation
    Some 2000 offices in the United States were assessed for the impact of ergonomic conditions, training, and equipment used by office workers. A sample of 299 employee evaluations reported measurable gains in productivity as a result of improved ergonomics, with an average increase of 34 minutes per day. At $30 per hour this represented $4,250 per year, per employee. Costs associated with performing the evaluations—along with the average hardware improvement costs—per employee amounted to $600. Therefore, net savings, without allowing for any injury or illness avoidance costs, was calculated at $3,650 per employee per year (i.e. $4,250 – $600), and the return on investment period was 2.3 months. Considerable savings were also recorded in illness and injury reductions, with a decrease of 28 per cent in cases.

    Successful safety programmes have to capture the hearts and minds of the people involved in them, where employees are motivated to take ownership of occupational safety, thereby plummeting the accident rates.


    To join BPIR.com and support our research, simply click here, or to find out more about membership, email membership@bpir.com. BPIR.com publishes a new best practice report every month with over 100 available to members.

  4. Best Practice Report: Think Tanks

    May 5, 2019 by BPIR.com Limited

    Think tanks are defined as organisations that engage in the business of public policy. They research, analyse, and produce opinions on every imaginable topic in order to advise and inform public policy makers and those who think about public policy. Think tanks operate all around the world, usually as independent, not-for-profit organisations; they tend to support themselves through their products and consultancy services, as well as through donors and sponsors. They can be affiliated with the government, political groups, interest groups or private corporations.
     
     
     
     
     
     
     
     
     
     

    In This Report:

    1. What is a “think tank”?
    2. Which organisations have received recognition for excellence by being or by having a think tank?
    3. How have organisations reached high levels of success by being or by having a think tank?
    4. What research has been undertaken by and into think tanks?
    5. What tools and methods are used to achieve high levels of success in developing a think tank?
    6. How can the effectiveness of a think tank be measured?
    7. What do business leaders say about think tanks?
    8. Conclusion.

    Access the report from here. At the bottom of the page is a PDF version of the report for easy reading. If you are a non-member, you will find some of the links in this report do not work. To join BPIR.com and support our research simply click here or to find out more about membership, email membership@bpir.com. BPIR.com publishes a new best practice every month with over 80 available to members.


  5. Best Practice Report: Self-Managed Teams and Holacracy®

    May 4, 2019 by BPIR.com Limited

    Self-managed teams are groups of employees who work with minimum supervision. Whereas in a hierarchical organisation employees have to report to managers, self-managed teams are responsible for handling various assignments, solving problems, and making decisions. Holacracy is one of the more recent systems of structuring self-managed teams within an organisation. When fully adopted, there is no conventional management hierarchy; instead, power is fully distributed, giving individuals and teams the freedom to self-manage while staying aligned to the organisation’s core purpose. Holacracy favours small teams, called circles, with team members holding a number of different roles depending on the assignment. These circles self-organise, make rapid consensus-based decisions, and have the flexibility to adjust roles and solutions effectively to meet organisational goals.
     
     
     
     
     
     
     

    In This Report:

    1. What are “self-managed teams” and “Holacracy”?
    2. Which organisations have received recognition for their use of self-managed teams and Holacracy?
    3. How have organisations reached high levels of success through their use of self-managed teams and Holacracy?
    4. What research has been undertaken into self-managed teams and Holacracy?
    5. What tools and methods are used to achieve high levels of success using self-managed teams and Holacracy?
    6. How can success in the use of self-managed teams and Holacracy be measured?
    7. What do business leaders say about self-managed teams and Holacracy?
    8. Conclusion.

    Access the report from here. At the bottom of the page is a PDF version of the report for easy reading. If you are a non-member, you will find some of the links in this report do not work. To join BPIR.com and support our research simply click here or to find out more about membership, email membership@bpir.com. BPIR.com publishes a new best practice every month with over 80 available to members.