By Doug Lawson, PhD
CEO, St. Luke’s Health, and Senior Vice President, CommonSpirit Health
In healthcare, we are often good at highlighting awards, achievements, and patient stories. However, we could do a much better job of explaining the business of healthcare and how it relates to delivering quality care to our communities. That’s why I suggest it's worthwhile to invest some of your time in reading two recent Houston Chronicle articles featuring St. Luke’s Health.
As healthcare leaders, we strive for excellence in the services our organizations provide to our communities and the interactions we have with every patient. Administrative policies and procedures underpin this effort to deliver high-quality care.
From helping us safeguard patients from hospital-acquired infections to preventing potentially devastating falls and the worst consequences of an unprecedented pandemic, policies and procedures are, at their heart, about the well-being of our patients and the safety of our staff. But how do we keep patients top of mind as we craft the rules and plans that will affect their care and, possibly, shape their future? Sometimes, this requires walking in their shoes.
Unexpected Change of Perspective
When I was 25 and leading the cancer program at Baylor Scott & White Medical Center in Temple, Texas, I suddenly found myself needing its services. I was diagnosed with Hodgkin lymphoma and needed chemotherapy for several months.
As a young healthcare professional, especially a nonclinical one, it was easy to view healthcare conceptually as a service to the community. As executives, we have the opportunity to work with some of the smartest and most talented people in the world. It’s also easy, however, to lose the connection between the intellectual exercise of being a healthcare executive and the care delivered as the bedside. As a young cancer patient, it was eye-opening to experience that care firsthand and was a powerful reminder of the fact that we are caring for human beings with different thoughts, opinions, and feelings.
I believe our ability to connect with patients’ thoughts, feelings, and perspectives has a direct correlation with their treatment outcomes. My experience as a cancer patient, which was intense, extensive, and long, provided a unique glimpse into our healthcare delivery systems—inpatient and outpatient care, operating room, hospital room, imaging centers, and clinics. Frankly, I consider myself fortunate to have been diagnosed with with cancer because it prepared me for my leadership role at St. Luke’s Health—and the difficult work of weighing the disparate needs that healthcare delivery requires.
Balancing Individual and Collective Needs
Healthcare administrators spend a significant amount of time developing policies and creating procedures designed to keep patients safe, prevent errors, protect our staff, and enable our healthcare systems to respond to the greater good. These policies and procedures are designed to accommodate large populations, but that doesn’t mean that we should not consider the human dimension as we create new policies and procedures.
In addition, the family is a critical part of the care process. It’s also one of the reasons we encourage our hospitals to invite former patients to serve as advisors on some of our committees to ensure they include patients’ views.
One of the most difficult things I’ve had to support was changes to our hospital visitation policy during the COVID-19 pandemic. Those changes were designed to keep our staff safe and prevent the spread of the coronavirus between healthy individuals and immunocompromised patients, but they also severely limited families’ access to patients.
Designing policies and procedures to avoid negative consequences for individuals is complicated. Ultimately, policies and procedures exist to keep patients and staff safe and protect our communities. However, we must always remember, respect, and honor the patient’s perspective and thoughts and feelings and the role of the family in the care process.
The COVID-19 pandemic was an unpredictable trial that forced us to adapt our policies and procedures to a stressful, fluid situation. We had two goals: to ensure we had the capacity to care for patients, and that we could do so safely. Consequently, we implemented masking, screening, and visitation policies.
Much was learned from the pandemic. For example, it led us to augment our previous isolation policies for patients with tuberculosis and C. diff infections. Now, we have a less complex, more unified approach to isolation for patients with those infections as well as COVID-19. In addition, the masking and testing policies we implemented will undoubtedly serve us well during future infectious disease surges or pandemics.
The pandemic also underscored the importance of communicating honest, transparent information across a broad platform. Siloed information that varies or appears inconsistent is one of the biggest challenges we’ve faced in dealing with the pandemic. Our ability to communicate effectively is a crucial skill.
The pandemic isn’t over, but as we consider our future after COVID-19, a key area of focus is educating our staff regarding current policies and procedures to bring compliance as close to 100% as possible. We also look forward to rededicating ourselves to some key quality efforts areas, such as fall prevention, that were eclipsed by pandemic-related policies and procedures in recent years.
Most of all, we recognize that the past three years have been exhausting for our physicians, nurses, technicians, and other valued team members. We will focus on caregiver well-being and burnout prevention as important pillars of our work moving forward.
I believe strongly that leadership is a relational activity. Our ability to be effective leaders in the healthcare environment is largely predicated by our ability to relate to the individuals we’re called to lead. When we do this we are better positioned to care for patients as individuals, recognize key cultural imperatives, and provide more personalized care for the communities we are called to serve.