Bill B

The key would be to look at the social network as it relates to the diffusion of innovation. Who reads the newsletter? The key thing here is not just that there’s a powerful story, but that the newsletter is being read.

Jack

I would add that it’s not just who receives the narrative. What’s the content of the narrative and how is it positive versus simply negative? The tendency is to say: “Oh, well, this is going wrong. Look at all this bad stuff.” People glom onto that. But it doesn’t actually help another person reading it to know how to avoid the bad stuff because they don’t know what to do instead. And so those stories can be more applicable to folks if they think about their story from an asset-based approach. They need a narrative of what has worked so that Mark, Jeremy, Gay, Bill B and Bill G can do that helpful thing. It’s hard not to just attend to a negative. So, how do you change those narratives to provide an asset-based approach as well? Does that make sense?

Jeremy

There is that arc of the narrative. It may go to dark places, but it should end in a positive, solution-directed fashion. Jack, is that what you’re getting?

Jack

Or the narrative should have the solution to begin with. I think appreciative inquiry is a very positive approach to planning and strategic planning. It is a problem-solving approach that doesn’t focus on what’s broken. It focuses on when it worked. How do you do more of that?

Bill G

I offer an example of trying to do that in fairness to our current administration. These are the new regulations about transparency pricing at hospitals and outpatient clinics. They concern the requirement that you disclose the pricing model so people actually know and can make some kind of rational decision about whether this is worth it to them. Do you think that’s a positive move? Is that going to really help? I offer a personal example. I could have gotten an upcoming test either within or out of network. They were happy for me to see a consultant at UW. They wanted me to have my testing done at UW, but it’s out of network. So, I called them and they did disclose that a test I’d pay $60 for in the multi-care network would be $845 if I had it done at UW. And so, of course, I said, I’m going to have the test done in the network, and I’ll have them ship you the result in my chart. Do you think we really should be jumping all over that and say, yes, absolutely, transparency in pricing is essential for this narrative we’re building about the brokenness of the health care system?

Bill B

Bill G, the key thing with appreciative inquiry would be not just that you have a story about the transparency. It is important to identify the impact that it had. What you’re saying is let’s identify when things are going well. So, Bill G, you’re saying here’s something that the new administration has done well. And folks, here’s the impact it had. So, can you do more of that? Look at the impact it has had.