Being a Caregiver to the Caregivers
Transitional Transformational Leadership Improves Staff Engagement and Patient Satisfaction
Howard Lull RN, BSN, MHA
At a songwriting conference that I attended, which was similar to an “American Idol” type production, I was asked what it was I did for a living. This particular conference panel was record execs, well known band members, and music industry execs—I told them that I am a “Caregiver to the Caregivers.” They became inquisitive and asked for more, so I obliged and said I am an RN with a master’s degree in Health Administration, and I go around the country helping Emergency Departments increase their quality and satisfaction by taking care of the caregivers. I started my profession by giving direct patient care and now I give direct care to the caregiver. I told them that I take care of those who take care of patients so that they can give their best to those patients in their greatest time of need. What happened next surprised me.
One of the panelists asked, “Then why are you trying to leave that to do this instead? What you’re already doing is important.” While I was surprised by the question, and responded with, “Thank you! Thank you for holding my profession in such high esteem! People see you all on TV and think you are the best thing that has ever happened; yet you are showing my profession the respect it deserves.”
The panelists started chiming in one by one, saying things like, “My mom is a nurse, my aunt is a nurse, my sister is a nurse,” followed by the respect and awe they had for those people. They actually held my profession in higher regard than they did their own. After I played my song to them, I finished my response with, “I am not here to get discovered or become famous, I’m simply trying to learn how to be a better songwriter.” It’s what I love doing in my creative time.
Now you are probably wondering what in the world does this have to do with being an interim leader!
It has to do with answering your call-in life and investing in others in your chosen profession and being able to see the positive outcomes you produce. I love my profession, because I get to invest in the caregivers and patients themselves.
To provide the best care possible for the patients often begins with providing care to the caregivers themselves. Putting them in a position to be successful takes leadership that has a presence within the Emergency Department itself, and having a finger on the pulse of those delivering the care. Research has shown that there has been an improvement of patient satisfaction scores when Institution Leadership has a presence engaging and empowering staff. It’s popular to call it “rounding,” but I prefer to call it being normal. I was actually shocked to hear leaders have to be told to round on their staff. I learned this concept in high school from my football coaches, as they always had our best interest in mind. “Rounding” was something normal leaders did, they didn’t have to be told to do it. They always had their peoples best interest in mind, without having to be told to do so.
As an inteirm leader, I can make this happen.
It’s certainly not news that providing healthcare today is at its most challenging time. Emergency Departments have challenging wait times, admission times, and patients holding takes up resources and beds meant for the emergent and urgent patient. Patients that are willing to wait face long wait hours and condition deterioration—dependent upon their specific illness. Inpatient units struggle with timely discharges and getting resources for patients going home.
Medicare and Medicaid Payers have higher demands for the care outcomes being delivered and have now placed patient satisfaction as a measure to how much reimbursement is being given.
The relationship between staff satisfaction and how it relates to patient satisfaction is often overlooked. Patients notice staff dissatisfaction and it has an influence on their perception of the care they receive.
Emergency Department leaders cannot be expected to operate entirely under the old status quo that requires them to be in meetings that do not give them anything substantial to run their departments. The leader needs to have a presence that enables them to listen to the frustration of the caregiver and giving the caregiver the tools to provide the best care they can in a very challenging environment. They also set a leadership standard by exhibiting their presence, which makes it easier for staff to follow as they respect the leader’s efforts. In this process, the staff gains confidence that their leader is listening to and hearing their needs, frustrations, and desires. In turn, the staff will give their all in delivering efficient quality care.
As I invested in my staff with the leadership that they needed, I have witnessed a transformation in them. There’s an old saying attributed to many that says it well: “No one cares how much you know until they know how much you care.” (author unknown)
At times the business of healthcare can be cold. Its numbers and results that often times don’t speak well to the bedside caregiver, because that isn’t in their training. It is my leadership that bridges that gap and gives them understanding on how everything they do and say is perceived by their community. I then show them the satisfaction results and say, “This is what your community is saying about you.” I often see wide eyed expressions as the data now becomes meaningful to them. Then we form a plan of action to change and enhance perceptions—together we develop a new sense of urgency and excitement in change for the better.
Through all of this, I have witnessed patient and staff satisfaction scores increase in most of my interim leadership projects. I have seen staff satisfaction scores rise as high as 20 percentage points and patient satisfaction scores rise into the 70th to 90th percentiles. It takes a leader to lead and It takes a team willing to be engaged and drive the process.
These things are a must:
- A leader who knows their calling and who loves their people, leads their staff, and manages situations
- Establish what is truly important in the leader you hire to do the job
- Presence: Culture change requires a presence in the unit by the leader
- This leadership has to be sincere—not some new flavor of the season program
- Support from the C-suite that gives the unit leader support, space, and time (even if they aren’t totally convinced to the methods)
- Good two-way communication, planning, and accountability between leaders
My experience and success has proven that If you desire true culture change and staff engagement and satisfied patients, then you will need to roll up your sleeves and become engaged with your staff—empowering them to be all that they desire to be, all while establishing focus and minimizing distractions and laying the foundation of an accountable unit.