Implementation of the FISH! Philosophy in Primary Care: A change in the culture of healthcare delivery

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)
Leslie Arledge (Creator)
East Carolina University (ECU )
Web Site:

Abstract: "Background: Public Health Departments often serve a disenfranchised patient population. While practitioners are committed to providing exceptional care to vulnerable populations, lack of resources and governmental bureaucracy often result in provider and staff fatigue that can translate to high attrition rates. Supporting staff may not share the institutional vision of being viewed as a leading resource for community healthcare services. Problem: The clinical atmosphere was dull and bleak. It lacked, light, color, and energy. Staff morale was generally low and patient satisfaction scores were suboptimal. The purpose of this project was to transform the culture of healthcare delivery. The clinical question was: Will a new philosophy of conducting daily work enhance staff fulfillment and improve retention? Can noticeable improvements be realized in patient satisfaction scores through enhancements in organizational culture? Methodology: The FISH! Philosophy was implemented to structure cultural improvement. Four key aspects of this philosophy are: 1.) Play – encourage creativity and enjoyment at work; 2.) Make their day – an effort to enhance the lives of patients and colleagues regularly; 3.) Be there – embrace the moment and be fully engaged; 4.) Choose your attitude – there is a choice in the way we approach our daily work and lives. Energetic employees translate to satisfied patients and organizational success. Evaluation: A comparison of pre and post employee surveys were utilized to appraise the strategic efficacy of the FISH! Philosophy. These demonstrated an overall improvement in the final evaluation of enjoyment of the work culture, feeling appreciated, and a shift in work perception to determine success of the quality improvement initiative. Staff retention further illustrated improvement. The current tool utilized to measure patient satisfaction was deployed to assess change. Enhancements were noted in the patient satisfaction survey for the quarter during this quality improvement initiative compared to the previous two reporting years for the same quarter and year-end results."

Additional Information

Language: English
Date: 2016

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