Dr. Karen Rigamonti, Leadership & Executive Coach
Q-1 Culture change in any organization depends on strong leadership from the top. What advice would you give leaders on transforming their leadership culture to focus on good clinical governance, operations and patient experience excellence?
Peter Drucker famously said that “Culture eats strategy for breakfast”, meaning that while strategy is important, a powerful and empowering culture is a surer route to organizational success. Changing culture, however, is a mighty task and requires an intensely coordinated effort at all levels of the organization.
Having consistency between what is stated and what is practiced in terms of policies and rules is imperative in order to obtain cultural change. For employees and patients to buy into the new culture being encouraged it is critical that the leadership clearly communicates and walks their talk.
All areas of the organization need to adopt the new way of life, starting from the top. It is important, therefore, critical that the C-suite and the Board support the cultural shift. It is equally as important that when new policies and procedures are developed the decisions are made with the participation of frontline staff, who implement the decision, and of patients and families, who are directly affected by them. We have observed less ownership and more resistance that together lead to less likelihood there will be any lasting change, when leaders attempt to change the culture in isolation from those who implement the change or are affected by the decision.
Q-2 How we best can alleviate the caregiver burden that can aggravate when cultural health is not addressed optimally?
Caregivers’ burden becomes overwhelming when caring for a chronic condition becomes physically exhausting and there is lack of appreciation of the value of the service being provided. In our experience, clear and effective communication starting with active listening and accompanied by compassion are the best ways to alleviate the caregiver burden that both staff and families experience.
To successfully deal with caregivers’ burden, we offer to staff an experiential training aimed at improving communication and introducing more compassion in the relationship. To do this most effectively, we mix within the same experiential group clinical and nonclinical staff from all areas. This mixing forces each employee to see different perspectives and immediately produces an increased appreciation of the work of others.
This process of learning via experiential workshops regarding bettering communication and deepening compassion are equally effective when working with family caregivers who often do not fully understand what their family member is feeling and what are the constraints and perspectives of staff.
We find that this methodology enhances cultural health as well as improves relationships, safety, and medical outcomes.
Q-3 How to effectively communicate with “difficult patients and families”?
When communication is poor and compassion absent, patients and families become “difficult”. Unfortunately, employees do not always appreciate the fact that it is often their behavior (insufficient communication skills and perceived insufficient caring) that triggers this state of affairs.
We find that when offered experiential workshops on effective communication with “difficult patients and difficult families”, staff begin to have an appreciation for why patients may be seen as difficult in the healthcare setting even though if we met them in a different context, we might find them very agreeable.
Stepping into their shoes and trying to comprehend what issues they are facing, immediately makes the difficult patient or family more human and thus staff can more easily and more meaningfully engage with them.
We have found that the best communication method begins with listening effectively to the words spoken, paying attention to what is behind the words and considering what is expressed by the body language. Next, asking open ended questions is very helpful. To do this with compassion and avoiding the temptation to launch into toxic responses is the goal.
Q-4 In your opinion why is a platform like International Patient Experience Symposium important to the healthcare fraternity – what are your expectations from the upcoming gathering?
It is natural and beneficial for any group of experts to confront each other’s ideas and experiences in scientific meetings. Healthcare providers and recipients of healthcare services are no exception. In healthcare, the c-suite and the Board want data to support their strategic goals: they focus on quality (and its elements of safety, effectiveness, timeliness, efficiency, and equity) while assuring a positive bottom line.
Staff, on the other end, want to be less frustrated and feel more appreciated and valued. They want to serve as well as be served.
Patients and families want good healthcare in an environment where they can experience well-being.
In a venue such as the International Patient Experience Symposium, attendees not only speak a common language, but they open to new ideas and suggestions, setting aside their own assumptions and expectations. This is not an easy task and not infrequently, people respond to this challenge defensively.
Thus, it is expected from this gathering to exchange ideas and best practices, to learn about what works for others, to network in order to continually learn and grow, improving services so that all benefit.