When reviewing survey answers from employees, Ann Lewis, CEO of CareSouth Carolina, was surprised to see "purple gets ugly" and multiple other responses saying they were "bored" of their uniforms.
A few years back, CareSouth Carolina, a Hartsville-based ASC group with more than 600 workers, rebranded with teal, a light purple and platinum, and different departments began representing the organization's colors with their scrubs.
"Well, that came back to us," Ms. Lewis said, laughing. "They said that they were kind of bored with this."
The company — which has 13 ASCs, nine pharmacies, multiple mobile units and nine other care locations — quickly responded to the common disgruntlement. There is now "Blue Jean Friday," and during the holidays, staff can wear different colored scrubs.
This "win-win," as Chief Quality Officer Randy Carlyle put it, is part of a larger initiative from the Institute for Healthcare Improvement called "Breaking the Rules for Better Care."
For a few weeks in 2023, more than 100 CareSouth Carolina employees answered the question, "If you could break or change a rule in our service lines to better care for the patients, what would it be?" Fifty-five rules were named.
A few of the policies can't be changed because they're from The Joint Commission or CMS, but others are up for review. CareSouth Carolina leaders organized the results into a color-coded spreadsheet, with pink labeling mask policy-related answers, orange for workday and pay responses, and blue for multiple comments about facilities being too cold.
"The heater thing shows up a lot. Unfortunately, because of Joint Commission rules and also just the electrical outlet load requirements or lack thereof, some of our circuits won't take the load," Mr. Carlyle told Becker's. "We've heard this complaint long before we did this survey."
He added that the system's head of maintenance is evaluating each location and working to "remedy some of those cold spots."
In the Excel spreadsheet, some rows are highlighted green because the respondent said there were no rules they wanted changed. One person concisely answered, "I'm a rule follower."
Each employee received updates on whether the rule can be altered, and if so, how CareSouth Carolina is working toward change. The ASC group later rolled out the same question to 18,000 patients, and department leaders are currently working their way through the 348 answers.
For other leaders who are interested in the rule-breaking initiative, Ms. Lewis recommends they avoid being defensive.
"Don't scoff at what their issues are," Ms. Lewis said. "A uniform might not be what we may think would be a big thing, because those of us that are in management, we're not wearing uniforms, but for the front-line and those front direct staff, it was a big deal. … These are their day-to-day needs, and they're important."
Mr. Carlyle said CareSouth Carolina plans to resurrect this project each year to account for staff changes and the natural turnover of rules.
"We think it's real problematic if we get stuck into rules or processes," said Ms. Lewis, who has been at the organization for 43 years. "As we grew, there were a lot of things that got inculcated into becoming a rule. We joke about it, because we call that rule 'Ann said,'" she recounted, laughing. "It's maybe 'Ann said' something 20 years ago that got ruled. Now, we need to take a hard look at it."