Amid COVID-19 restrictions and safety measures, healthcare leaders have become even more knowledgeable about what patients encounter at the hospital, based on firsthand experiences as patients themselves and through the experiences of their family members.
Becker's Hospital Review asked healthcare leaders to answer: "What is the most valuable insight you've gained about the patient experience during the pandemic?" Leaders framed their answers in terms of personal anecdotes.
The responses are listed below in alphabetical order.
Jane Albert. Senior Vice President of Marketing, Communications and External Relations and Chief Consumer Officer at Baystate Health (Springfield, Mass.): This past year, as we faced the wrath of all that COVID-19 brought to our health system and communities, I was acutely aware of the toll that it has taken on our front-line team members. What I was not aware of was the depth and breadth of compassionate care that endured despite the continual and ever-changing challenges faced by care teams. I witnessed incredible ways direct care providers and those who support patient care stepped forth to make a difference in the lives of two elderly patients.
Both my mother-in-law and father-in-law were hospitalized with COVID-19 in our busy, large academic medical center and placed on different units to provide for the level of care needed, as Mom's condition was not as dire as Dad's. With early onset of dementia being exacerbated by the changes in her environment, Mom was missing the presence of her husband of 70 years. With Dad's condition worsening toward the end of life, the care teams each set forth plans anchored by incredible compassion and consideration for their patients.
A nurse arranged for Mom to visit Dad, providing the opportunity for them to see each other and be close enough to hold hands from the wheelchair to the bed. With the hospice team now involved for Dad's care, they focused on adding to Dad's comfort, reaching out to nutrition services to bring his favorite chocolate ice cream — while ever so challenged to eat, the familiar sweet taste brought him comfort, as did the music that brought sweet sounds to his ears, and the chaplain who brought prayers for us all.
Dad's life ended peacefully at the hospital while Mom was discharged and now adjusting to life without him. The essence of all that is good in humankind came alive with all of the compassionate, caring team members committed to making a difference in Mom and Dad's lives.
Amy Brown, MSN, RN. CNO of Sparrow Hospital (Lansing, Mich.): My daughter was a new patient, and she was seeing a doctor for the first time, and I had to wait out in the hall until she was "roomed" because of COVID restrictions. She was very nervous to be in there by herself. I was just outside the door but would have rather been in the waiting room sitting next to her. The pandemic has caused us to modify how we used to do things, and we are much more restrictive when it comes to visitors. Not being able to be with your loved one when they are ill creates anxiety, especially during a time when the public is already stressed and anxious. It's important we, as leaders, continue to put ourselves in our patients' and visitors' shoes when we are developing rules and regulations. I am proud of the measures we have taken to keep the hospital safe but also address the need for our patients to have visitors.
Damara Gutnick, MD. Senior Director, Office of Community and Population Health, Montefiore Health System (New York City): Unfortunately, it has been a hard year, with several of my close elderly family members hospitalized, receiving acute ER care or extended rehab — none COVID related. As I helped my loved ones facilitate and navigate care, I witnessed institutions where care teams expressed empathy and delivered care with compassion, as well as care teams that seemed burned out from the past two years. As a champion of the international "What Matters to You?" movement, where care teams are encouraged to "ask" patients about what matters most to them, "listen" to what the patient says and incorporate what they learn into the care plan in order to "do" what matters, I wished that the question of "what matters most to you" would have been asked to my family.
Understanding what matters would have given the care team insight into why my aunt was so concerned about my uncle's sugar control (she witnessed a frightening hypoglycemic episode when he skipped a meal after taking insulin) and why proactive communication (e.g., letting her know her husband ate dinner before getting his insulin) could have eased her anxiety. This would have positively impacted experiences for the patient, family and care team, as well as avoided multiple calls to the nursing station each evening.
So much of how we can identify opportunities to establish trust and enhance patient experiences is predicated on not assuming what the patients want and need, but asking. As we begin 2022, we hope to see this important gesture of "asking" what matters most more — not just in healthcare, but beyond.
Terry Hudson-Jinks, MSN, RN. CNO and Chief Patient Experience Officer at Tufts Medical Center (Boston): Since March 2020, members of the healthcare team have had experiences to be both on the caregiving and care receiving end of the healthcare delivery system. This past year I have been a family member waiting for the call back from a surgeon following emergency surgery and by the bedside of another loved one post-trauma in a level one trauma center. I found myself grateful there was room in the OR schedule and emergency department for each, never taking access to healthcare for granted.
What resonates with me most is how frightening it is to feel vulnerable with the unknown and how patients and families hang on to every word of the care team. What did matter most was the incredible impact of clear communication, frequent updates, and words of support from doctors and nurses when talking to myself or my loved one. One nurse practitioner informed my brother before his emergent surgery: "I will be in the room the entire time supporting you." My brother mentioned that one statement gave him so much peace in the minutes before induction. Another trauma resident informed my sister and me, "I am not leaving today until you get your MRI and we know the extent of the injury." As a healthcare system, we strive to build reliable systems for those we serve, and there is work to do. At the moment of service, perhaps even more so during a pandemic, systems best serve care teams and patients when the patient and family are informed, included and empowered, regardless of the degree of uncertainty, delay or the unknown.
Brad Kruger. System Vice President of Patient Experience at Advocate Aurora Health (Downers Grove, Ill., and Milwaukee): My own healthcare experiences during the pandemic have given me insight into the deep anxiety and uncertainty that so many patients and families have experienced over the past 22 months, while also reinforcing just how much compassion and good technology can help relieve these issues.
When my 8-month-old daughter recently contracted COVID-19 during the omicron surge, I scheduled an appointment at one of our urgent care centers through our LiveWell app. The process was simple and allowed me to minimize wait time and contact with others. Unfortunately, this usability continues to be the exception rather than the rule in healthcare — when I began my search for an appointment, I realized another provider claimed to have app scheduling, but the feature wasn't turned on! This resulted in a line at a different urgent care center that was over 50 people deep and out the door.
Beyond demonstrating the need for seamless technology, COVID-19 has also underscored the problem of burnout and compassion fatigue. As the pandemic has worn on and misinformation persists, some patients disagree with visitor policies, vaccination recommendations and clinical treatment protocols. This adversarial undercurrent drains healthcare workers' energy and empathy as they respond to unrelenting waves of the virus. The truth is that healthcare workers, no matter how dedicated, can't pour from an empty cup. Peer support, mental health resources and resilience training can provide the support they need to continue delivering compassionate care every day.
Denny R. Martin, DO. Chief Medical Officer of Sparrow Hospital (Lansing, Mich.): I actually was a patient myself over the holidays and don't think the staff knew who I was. The physician did, but otherwise I was a regular guy who wasn't feeling well and needed someone to help me figure out why. My primary care doctor separated our professional relationship and frankly told me that I needed to start caring for myself better. I trained her as a resident but that didn't stop her from telling me what I needed to hear. The pandemic and everything associated with it will still be there tomorrow. I needed to make sure I would be as well! Eating better and exercise are musts. Good sleep is mandatory. Caregivers need care as well. No one knows better what I/we have been through than one of our colleagues here who has been in the trenches with us.
Dawn Robbins. System Associate Vice President, Patient Experience at Baptist Health (Louisville, Ky.): Now more than ever, it's very evident how intertwined employee experience is with patient experience. Our employees are carrying heavy burdens as a result of the pandemic, both at home and in the workplace. Their emotional reserves are depleted. As a patient, I've received care from staff who seem overwhelmed by the most simple tasks, while others manage to thrive despite staffing shortages or other challenges. In the departments and offices where staff are thriving, I have observed a higher level of leader recognition, communication and camaraderie. When staff feel valued and supported by their leaders, both personally and professionally, they are more resilient and have more to give to our patients and families. As a result of these observations, we have refocused on employee rounding and caring for individual team members as a foundational element of our patient experience strategic plan.
Joseph Tito, MD. Chief of Staff at Healdsburg (Calif.) Hospital: In April 2020, I had a spine surgery scheduled that would address the numbness and lack of strength I was experiencing in my right hand. As a surgeon, I understood that receiving treatment — and quickly — could be the difference between getting back to work or sustaining permanent damage that would end my career. It was early in the pandemic, and COVID-19 was rampant in our community, and many hospitals, including my own, had halted elective surgeries while they focused on sick patients. Hospitals were filling with symptomatic patients, and it was still unclear how the virus was spreading, and there were no treatments that we could use against it.
My surgeon understood the critical nature of this surgery, and after two weeks of isolation, testing, prepping and worrying, I went into Providence Santa Rosa Memorial Hospital for my procedure. From the moment I was checked in, I was made to feel at ease even though I knew that they were just as afraid as I was to be in a medical setting with so many positive patients in the building. With layers upon layers of PPE, they did their best to keep me, and themselves, safe. And because they were hidden behind numerous layers of PPE, they took extra time to communicate with me and made that critical human connection necessary in these situations through the only visible part of their face that could connect: their eyes.
The procedure went extremely well, and what I recall most is how professional and kind they were to me and that they did everything to ensure my care was their priority. They even discharged me through the loading dock, a departure from the standard process, but the best option to minimize exposure of others. It was a scary time but one that speaks to the very heart of our work as physicians, to do no harm.
Alan R. Vierling, DNP, MSN, RN. President of Sparrow Hospital (Lansing, Mich.): As a healthcare leader who has been a patient during the pandemic:
- Healthcare occurs one moment at time. Immediate connections are made with providers. It takes no time to create and have an exceptional and unique moment with a patient.
- Creating these "moments" for a patient is more important than ever. Connecting and making a patient feel comfortable is something that all caregivers should do, but now with extreme fatigue from the long and challenging pandemic, it's even more important for caregivers to still try to make positive experiences for patients.
- Having gone through a few procedures, I remember when a caregiver looked past my healthcare leader title and treated me as their patient. They treated me with care that they would have given their family or friends. Also, a provider went the extra mile by helping record recovery instructions on my phone. My wife and I were able to reference it many times.
- These moments matter and need to continue for all patients whether in a pandemic or not. These moments can stay with a patient long after the specific experience.