Focusing on what matters most in healthcare: People

RE: The CXO is a strategy leader. It is a true senior role and a peer of other senior leaders like the chief nursing officer, chief IT officer and chief financial officer. I sit at the table with them, and we drive the strategy together. I think the role requires operations chops and knowledge of what it’s like to run a department. Patient experience lives or dies in the workflow of our people. It’s a people taking care of people business so to do it well, you have to understand the operations. If I have a strategic idea, I need to make sure it will work for the nurse, the doctor or the housekeeper who has 20 beds to clean.

Patient experience used to be a nice thing to do. Now, it’s publicly reported and reimbursement is tied to it. You need the right strategy to make it work. We look at how our customers view us and the ratings they give us. We make changes to improve experiences, but at the same time, support our team’s success. Our people are under constant production pressure while they are taking care of people. We need to ease that burden and free them to do what they do best.

RE: We are still figuring it out. When the pandemic began, New York City was hit first and worst. It’s been lifechanging and devasting. We didn’t know what we were dealing with. I had never been physically scared at work before then, aside from 9/11. We weren’t certain we would have enough resources. It was a day-by-day race with the virus. We worried about our own safety as well as the safety of others. This deeply affected all of us and we are still recovering.

We had to learn to be authentic and transparent about how we were feeling. We had to normalize people feeling vulnerable or at times, not having the patience they needed. Although we didn’t have all the answers, we built ICUs just like that, stood up telemedicine just like that. We learned we can change faster than we thought we could.

We also learned that human presence at the bedside is critical. There was real harm done to patients, loved ones and our teams without it. People being with their loved ones means so much in healthcare. We may have undervalued that before and we have to maintain that in the future.

RE: People want compassion and connection, but they also want convenience. In New York City, if I can’t get it quickly, I’ll go somewhere else. We have to be convenient. When we talk about being patient-centered, that includes convenience. It means requesting paperwork only when necessary. It means a person should be able to get information at 11:00 at night when they’re thinking about their condition.

We have been a lagging industry. Just look at telemedicine. We have to get on top of it or we won’t succeed. It is critical for us to meet customer needs in a much more nuanced way; a responsible, moral way.

RE: We are using technology to keep humanity in healthcare through our “Front Door to Care” and patient experience initiatives. There are many things technology can do, but the risk is that healthcare could become too transactional. So, how do you use technology in a way that bolsters support and humanity? We must make room for clinicians to sit with patients, talk with them and connect with them in person. It should be a mix of technology and people that still feels human.

RE: The pandemic laid bare equity issues. George Floyd and the awakening that followed happened. The city was filled with protests outside of our doors. We were inspired to make change.

We founded the Dalio Center for Health Justice, made possible by a donation from the Dalio family. We chose the name health justice because it’s something to be fought for; it’s not just about equity. Today, we’re connecting better with our community, and we are learning more about who are patients are—their background, the communities they come from, whether they are of color or LGBTQ+. Hospitals have done a poor job of collecting that data and explaining to patients why the data is being collected. We want to know because then we can understand. We are looking for trends and outcomes in a deliberate way to see if there are differences across gender, race, sexual orientation or immigrant status. We’re also looking at protocols in our care to root out bias.

RE: So many things. We need to change the culture to allow people to say, “I’m in trouble.” The “suck it up” culture is pervasive. As an organization, we are filled with A+ students who see an A- as an F. So how do we put structures in place to support mental health, resilience and recovery? We talk about resilience, but that means different things for different people. Some need childcare or help with older parents. Some people need food assistance. It’s an array of support that we need to offer and also make it culturally OK. No penalizing or stigmatizing.

The same things that frustrate patients frustrate physicians and healthcare workers, too. Anything we can do to help patients, helps the overall system and makes conditions on the ground better.

RE: I have been so lucky to have amazing mentors. One mentor coached me through the sometimes ridiculousness of the healthcare system. He taught me, “It’s only an event.” That doesn’t mean you’re passive about what needs to be fixed. It’s about steering through a bizarre system that in the end, has to work for people.

My current boss has taught me so much about navigating through complicated agendas and the importance of emotional intelligence. It’s important to self-regulate and be aware of your reactions as you keep an eye on the ball. I think my theological training has helped me to read and understand people and use empathy. It’s like having a secret weapon in my work every day.