Thoughtful insights for patient experience leaders in 2022
These reflections by a former Cleveland Clinic Chief Experience Officer and self proclaimed forever Chief Empathy Enthusiast may help others chart a path through patient experience challenges.
The pandemic has left a mark on everyone in many ways, not the least of which has been the extra pressure placed upon a beautifully intentioned yet woefully exhausted workforce.
Since the emergence of COVID-19, the National Academy of Medicine reports that about 20 percent of healthcare workers have left the industry. Of those who remain, four out of five say that staff shortages have negatively impacted their ability to work safely and care for patients.
Many expect 2022 to be another year full of challenges and transitions. I recently underwent a transition in my own professional life that, quite honestly, generated a potpourri of emotions. I've been in healthcare for 20 years, formerly as the CXO of Cleveland Clinic, and now as the Chief Medical Officer at Qualtrics. As hard as that has all been, it also presents an opportunity to transform old ways of thinking and find (and design) a purposeful life – a life led consistent with my values that drives joy, and I wanted to share some reflections with my fellow empathy enthusiasts.
I used to tell my children that being brave was about doing things that you are afraid of, only to discover that being brave is about being who you are. And that is much, much harder. Experience leaders don’t exist in all organizations, and if they do, they might be at THE table or they may be at the table down the hall, around the block, and down the stairs.
Just remember no matter where you sit, people are counting on you – people who are tired, suffering, isolated and marginalized. We are advocates for people. And, every organization should worry when the patient experience leaders go quiet.
But these days it's hard to speak up – there are a lot of voices, fewer resources, more incivility and higher expectations. Some phrases that might be helpful: “I’m hearing that we want higher HCAHPS scores, and I have no ability to make decisions about resources. Am I reading that right? If so, can we talk through how to resolve?” Or, “We have the value of inclusion and have hired 10 new leaders that look just like us. How can we better close that gap?” You’ll notice I didn’t use a single emotional word there because, in my experience, emotion in leadership doesn't always work the way you might intend.
For patient experience professionals, bravery looks a lot like reflective listening and compassion.
- Listen deeply and with intention not only to what people say, but for what it reveals about what they value.
- Reflect your understanding of the content and context of the situation. Choose your use of emotion carefully. Check that understanding.
- Express desire to act. Then act.
Chase your joy
At some point, I was thinking about a career shift and was asking myself what role or job title would fit. And I found myself going in circles. I was asking the wrong question. One day I sat down, drew a circle, and divided it into pie slices based on what a life filled with joy could look like. It looked like this:
Caring for myself, being more present with my family, giving gratitude in my community, being a better friend, and reducing suffering in healthcare all made the cut. Then I started designing a life based on my joy pie.
What’s in your joy pie? Is HCAHPS on there? How about benchmarks and reporting? Probably not, yet these are the things we tend to focus on most. Whether a brand, a company or an individual, living a life consistent with our values can create joy. It's when we find ourselves in environments that ask us to compromise our values – like choosing scores over people – that moral distress gets created and, over time, burnout. We have to find the joy or move on. No one is going to do this for you, so make your joy pie and chase it down.
Lift. Lift and Lift some more
Our colleagues in healthcare need lifting. That's an understatement. Chocolates and pizza are nice, and yet most people don't want to stay at work for wellness – they want to go home. Restoration of the soul doesn't follow a single path.
And yet at least some are lined with gratitude. Patients can help write letters of gratitude for the ER, and you can write personal notes to your fellow leaders telling them to keep going. Bon Secours made a beautiful gratitude video of unexpecting caregivers reading letters from their patients that will have you grabbing for the tissue box. And similarly, Northwell partnered with Yoko Sen to create an auditory masterpiece of COVID reflections from healthcare workers.
We have to assault the senses with lifting. Visually, we can create nature-infused, healing environments for healthcare workers to retreat and breathe (not cry in stairwells) and commit to private rooms. From an auditory perspective, music in the halls and local pianists in lobbies and music therapy help combat the 70 decibel unit noise level seen in hospital floors during the day – equivalent to city traffic. Tempt the taste buds with food you would eat …that has color…and the right temperature. As for skin sensations, no soft pillow ever touched my face as a resident. We can aspire to gowns that cover the backside. Rooms with temperature patients can control. If patients or families complain, send them a handwritten Thank You note they can open with their hands.
You get the idea. Our collective responsibility is to not only NOT cause harm - patients already expect you won’t hurt them - but to also create joy and ease.
Draft your own job description, including what you are not responsible for. All too often, we assume the Chief Experience Officer is the one responsible for making all PE improvements and owning CAHPS scores, but the truth is that everyone needs to be a Chief Experience Officer. The nurses certainly are.
At the same time, being clear that the Chief of Staff is responsible for doctor communication and Environmental Services is responsible for cleanliness and quiet ensures everyone owns their part. One of the coolest things I used was the RACI diagram. It's critical in patient experience. I had some good ideas, and yet (sadly) many of the best ideas didn’t come from me. Putting up posters in rooms that ask who patients are as a person so healthcare employees can see it and engage. Giving patients a token of their port the day it came out for good. Calling people after they go home to tell them we care. These key innovations came from the owners of the work.
I've done the research on patient pain points over the years – I've called for novel experience metrics that matter to employees and patients alike. Holistic metrics that matter to actual humans. I defined experience metrics as inclusive of teamwork, empathy, communication AKA safety and ease (of access, billing, telehealth). Define your own. And above all else, keep going. If you’re ready to innovate, run down that path…If you aren’t, keep one foot in the old way and one foot in the new. But keep running.
Here is my weird. Well, some of it. I tripped the first day of high school in my cool new outfit despite training in ballet for most of my life. I worked hard in high school to be a rapper and goth at the same time. Obviously, that worked. My family was dysfunctional, and I wrote about my formative experiences in a medical school application essay. Only one person read it. I kept the first name of my first patient that died in a frame so I would never forget them. As a neurologist, I ask my patients what they do for a living and what they are afraid of.
You may say – none of that is weird, but I feel weird, out of place. Because even though we show up in the worst moment of people’s lives and hold their hand as they take their last breath, we are often expected to move through healthcare as though we didn’t just also have an emotional experience. As though our heart doesn’t ache. As though we weren’t impacted.
And if we as empathy amplifiers don’t lead the way by modeling compassion to our colleagues and selves, we contribute to the sharp pain of suffering that is invisible, unknown, and carried alone. So, harness your weird. Your creativity. People need us oddballs in these equally weird times.
Some things to try:
- Design gifts for parents who have lost a child.
- Let the artists in.
- Reach out to someone if you feel alone.
- Let the patients make and pick the art.
- Take a class in design thinking.
- Serve your hospital food to the executive team.
- Operationalize The Pause.
- Read the names of patients who have died. Of colleagues. Everyday.
- Show up on the floors when a colleague dies.
- Use the word love in a meeting and mean it - at least once a week.
Adrienne Boissy, MD, is chief medical officer of Qualtrics, Provo, Utah. Her column was originally published as a blog here.