Making It Stick – Aultman Style

Added on Oct 3, 2015

Healthcare Safety

A few weeks ago I was onsite with the team at Aultman Health Foundation. We held a refresher session on the High Reliability Leadership Expectations for about 140 leaders across the system. The session opened with Aultman Health Foundation President and CEO, Ed Roth, talking about the “journey to high reliability”. He said that as a child, his family would take long trips in the car and inevitably someone would ask quickly “are we there yet?” He shared that his father wouldn’t just say “no” but that he’d say “No, but we're in __________ town so take a look out the window and tell me what you see.” Ed explained that at Aultman we were doing just that. The journey to becoming a High Reliability Organization (HRO) is long (and really never ending) but we do need to take note of where we are and talk about what we see.

Chris Remark, CEO of the Aultman Healthcare Delivery System picked up where Ed left off and described the view out the window during their HRO journey. First he asked the leaders to imagine what life would be like without their Daily Check-In. He then celebrated the 100+ reliability coaches within the system and then explained how the good catches being shared are evidence of a culture shift. Finally, he stated that the reason they were having a refresher was because he wanted everyone to know that reliability culture at Aultman was never going to be a “flavor of the month” and we must always refresh ourselves on the tools, tones and expectations.

At the close of the session, Chris introduced a sticker of the leader commitments to the team. Items such as Rounding For Purpose, Learning Boards and commitment to the Aultman HRO Tools and Tones were on the sticker. He challenge the group to put that sticker wherever they needed as a reminder to this commitment to becoming an HRO. He then showed photos of the sticker on all sorts of interesting places: on a coffee cup, in the car, on a baby’s diaper, and even on a pillow while you sleep. He said we had to do whatever it takes to ensure these expectations become our habits. Finally, he shared his personal favorite place for the sticker (photo inset).

Questions to consider:

  • 1. How do you know that your behavior expectations are really sticking in your organization? Do you have measures in place? Is there an accountability loop?
  • 2. Are you willing to take action if you sense complacency among the expectations you set months or even years before?
  • 3. What is your organization doing to ensure safety and reliability isn’t viewed as a “flavor of the month?”


Thank you to Ed Roth, Chris Remark, Dr. Lori Mertes and the team and Aultman Health Foundation for continuing to work so diligently in your HRO efforts. You’re really working to make it stick!