“Every good conversation starts with good listening.” – Tom Haak
In January, over 12,000 nurses went on strike in New York to demand changes to their wages and to bring visibility to staffing concerns.1 Nurses and many others in the healthcare industry are still concerned about work and patient load, mental health support, and fair pay.
Conversation is a powerful tool that helps us better understand one another and make stronger decisions. In the healthcare industry, conversations among decision makers and end users tend to become siloed. Especially from the end user’s perspective, if they’re not being heard when decisions that impact them are being made, morale will suffer. This disconnect—though not the only piece of the puzzle—is a contributor to recent staffing shortages, high turnover rates, and growing levels of burnout among providers everywhere. It goes without saying, then, that the industry as a whole needs better listening skills.
Enter Janae Sharp, founder of the Sharp Index. Janae started a foundation that encourages conversation and provides support around issues of burnout and fatigue amongst medical providers. On a recent episode of her Sharp Conversations podcast, Janae and co-host Subha Airan-Javia, Hospitalist at Penn Medicine and CEO of CareAlign, invited PerfectServe’s Chief Clinical Officer Kelly Conklin to discuss how good communication, well-designed technology, and input from clinicians impact well-being and burnout.
As a nurse for many years, Kelly sees crises that happen every day in hospitals across the country when they struggle to incorporate helpful technology into their workflows. We’ve highlighted some of the key points about how healthcare technology can begin to alleviate some of the root causes of burnout.
Technology as an Asset
Janae led with a simple question: “At what point will we know technology is actually adding value?”
Kelly touched on bringing technology into care workflows. She said technology shouldn’t be something a provider needs to go seek. No matter your role in delivering care, your focus is on the patient, not on the technology you’re using. Providers don’t practice medicine to check alerts and responses on an app or a computer.
“I think you have to include the teams that are going to use the technology,” Kelly said. “So many times, technology is purchased by a system based on price.”
“I’ve been talking to organizations who are investigating getting new EHRs, and they don’t have a single physician or nurse on the team,” Subha responded. In her example, there are administrators and analysts looking into solutions on the market, but no clinicians or nurses. This means that, by the time a physician actually uses the technology, their feedback is less likely to be considered. The solution has already been bought and implemented.
And therein lies the problem. When you want technology to be an asset instead of a burden, you must have people in the conversation who actually use the technology. Otherwise, you waste dollars and hours and continue to ignore the real, underlying causes of burnout and care team inefficiencies.
Building Trust Through Dialogue
Kelly believes that healthcare systems have generally made decisions with limited input for a good reason. Leadership must make decisions by accounting for finances, time savings, and operational needs. In that vein, leadership has good intentions by inviting fewer cooks into the kitchen.
“They’re making decisions and not involving people because they think it’s another person pulled away from the bedside, or ‘we can make the decision faster and quicker and more efficiently if we don’t involve people,’” Kelly said.
Unfortunately, this viewpoint causes a disconnect between leadership and providers, as providers do not get a seat at the table before, during, or after implementation. This can sometimes lead to distrust and even feelings of disvalue among care team members.
“I think about the reports of physicians who don’t believe their leadership is going to go in the right direction,” Janae added. Janae’s work with a non-profit helped her realize that the power of choice impacts clinicians, patients, and everyone in a positive manner. To Janae, the correct program or solution for your health system isn’t the one with the bells and whistles. It’s the solution that your people (your care team and administrators) choose.
“The power people have when they are involved with the decision, and when you give the power back to the clinicians, that’s the difference between leadership that people have trust in and want to work for and leadership that will end up losing more people,” Janae said.
“It’s an opportunity to help people feel heard,” Subha added. “A lot of people feel ignored, but when you take their feedback and implement it … It goes a long way with people who already feel like they’re being trampled on.”
Streamlining Implementation and Saving Resources
Subha posed a question that juxtaposed healthcare with other industries. Healthcare seems to be one of the only industries where the people using a solution (mostly doctors and nurses) have little to no influence over the decision to implement it in the first place. Once providers bring up shortfalls or glitches, leadership has already invested so much time and money on implementation that the door for any post-implementation conversations about areas for improvement is closed.
The trouble is, an organization is actually wasting time, money, and effort by not bringing in nurses, providers, and other end users before and during implementation of a solution. Kelly said that health systems have invested so much time and energy into implementing the technology that they don’t want to waste more by making significant changes or starting the process over. They may even waste more resources by adding additional solutions just to fill gaps in the first solution’s capabilities.
“Now, it’s so cumbersome to unravel all of that work that [the health system is] stuck with it,” Kelly said. “Or, I’ve then seen systems go and spend additional dollars and resources bringing in a second technology that does the same thing as what the complaints are about.”
Long-Term Planning Versus Crises Planning
Funding is critical to a health system’s operation, especially when considering new technology solutions. Janae remarked on the differences between short-term and long-term financial planning, saying there are different priorities between the two. The long-term view tends to produce the best results.
“The most successful organizations are those who do just that,” Kelly said. “They keep their head up. There’s that high-level vision of where we should be heading that doesn’t get bogged down with the day-to-day. There is a crisis every day in every hospital in our country, and you can get stuck in a quagmire of the churn of it.” Kelly went on to say that other organizations that work with multiple vendors desire consolidation. They want to have one partner with a solution that meets broad needs instead of various solutions that fix smaller chunks of problems.
The Bigger Picture
None of this is to put blame on the shoulders of those who make these important decisions. Kelly, Janae, and Subha all acknowledged the burden and stress of a decision-making role, which requires thinking through many difficult choices and taking countless variables into consideration.
“Oftentimes, [decision-makers’] jobs get burdened, and their plates get full with ‘implement this,’ ‘implement that,’ and ‘it has to be by this time,’” Subha said. She thinks they should instead look at the bigger picture and strategy of all the solutions on the table. With the help of providers and clinicians who would be using the tools, they can then analyze how their organization’s needs can be met with each solution. The best way? Have more chairs at the proverbial table to start a deeper conversation.
Seeing Results in Real Time
In her capacity as PerfectServe’s Chief Clinical Officer, Kelly shared her experience working with a multi-state health system to implement communication software tailored to the needs of nurses, a project the organization has dubbed “Care Mobility.” This technology gives nurses one inbox to check for all messages, calls, alerts, and alarms that come their way.
As part of the planning process, nurses were asked to join in on conversations with the implementation teams. Nurses tested the technology and suggested tweaks and design changes, and after implementation, they were able to make further adjustments to optimize the technology for their day-to-day work.
“It’s all about the governance, leadership, and buy-in,” Kelly said.
Subha agreed, saying, “I think a lot of administrators undervalue the impact that technology plays in how a clinician, a nurse, anyone feels, and how likely they are to get frustrated and walk out. Decision-makers in organizations don’t realize how impactful technology can be in helping their workforce’s well-being.”
The Many Aspects of Communication
When Janae thinks of “communication” in healthcare, she thinks of things like scheduling and billing. But that’s not all that goes into communication, especially considering the pace at which healthcare evolves. This also means gaps open up as more and more elements of care get added to the mix.
“As healthcare has begun to transition outside the four walls of the hospital, one of the biggest gaps we’re seeing and feeling right now is, how do we connect people outside the four walls into what’s going on inside the hospital?” Kelly said. “Then, layer in the virtual aspect of it as well. There are people getting care through virtual nursing—how do we connect those virtual pieces back into what’s happening day to day?”
Subha explained that it’s easy to see healthcare communication as different groups. From patients and their caregivers—including their friends and family—to operations managers and providers, there are interconnected parties who require communication between them. She says this necessitates both communication and collaboration.
Kelly mentioned that proper communication and collaboration relies on a “push”—the need to get information from one provider to another. This is where technology solutions can step in and advance the communication process.
The Keys to Job Satisfaction
During their discussion on the many aspects of communication, Janae also brought up scheduling. As a staff nurse, Kelly often felt pressured to come in on her days off when she was asked to step in and help.
“Schedule is so important in all of this,” Kelly said. She explained that solutions can be used to put rules and preferences into place that yield better schedules and increase provider satisfaction. For example, if a provider has a recurring family obligation every Tuesday afternoon, physician scheduling software like Lightning Bolt can account can account for that preference when building out a provider’s schedule. When implemented, these rules protect providers’ valuable personal time, in turn giving them a better work-life balance and improving their overall well-being. But this starts with looking for a solution that prioritizes provider wellness.
Subha highlighted how healthcare is still an industry that doesn’t always take job satisfaction into consideration. “In my hundreds and hundreds of conversations over the last few years, the words ‘job satisfaction’ have never been said,” Subha shared. “It feels like there’s a huge indifference or gap in thinking about job satisfaction and whether that’s important for nurses and doctors.”
Through having conversations like these, this theme of “pushing down” discomfort in the workplace is finally starting to change. “It’s finally to the stage where it can’t be ignored,” Janae said. She wants there to be more assessment tools to look at, understand, and value people’s preferences and personality types. Though they may be prevalent in other industries, the adoption of these insightful tools among healthcare professionals has been relatively slow.
“There’s so much opportunity out there to make healthcare better for everyone,” Kelly said.
At the end of the day, the conversations we share can and do dictate where we’re going next. Whether the dialogue focuses on the next technology solution your system will be implementing or just opens a door to understanding the pros and cons of existing clinical workflows, these conversations won’t be in vain. The more we can learn to listen to the people who use this technology—the people who are actually providing direct patient care—the more we can begin to make a true difference in both provider and patient satisfaction. The first step is easy: start listening.
If you’d like to learn more about PerfectServe and how our communication and scheduling technology drives positive outcomes for thousands of healthcare organizations, contact us today.
1 Nurse Strikes In 2023: Where And Why Are They Happening? BetterNurse.org: https://betternurse.org/nurse-strikes/#:~:text=About%2012%2C000%20nurses%20across%20seven,currently%20no%20set%20end%20date.