Improving Patient Experience Through Employee Empowerment

<p>welcome to the CX matters podcast a production of the American Journal of healthc care strategy with your host Cole Lions hello everyone this is Cole from the CX matters podcast joined by a very special guest today please introduce yourself Nick hey friends my name is Nick D Stefano I often go by awesome Nick D because most people can't me can't say the last name and I just want to make the world a little more awesome I didn't want to attempt it without asking I appreciate you D Stefano I tell people it's the Smith of Italy if you met one D Stefano you're probably not related to another oh that is great that is really funny I like that I like that so you have such a great experience in that that ex world that employee experience where you use that to empower the patient experience I want to talk about where you started many years ago back in undergrad and grad school I believe you got a degree in organizational kind of leadership right correct yes so I actually went to a small school in Dallas Pennsylvania the pause is intentional and uh I went to school initially for physical therapy I'm clearly not doing physical therapy on anyone today but I get to work with lots of physical therapists and I I got really involved in all these different things related to leadership and organizational learning which I didn't know was really a thing at the time it was more just like I enjoy being these organizations and doing all this extra work and so I went and got my Master's Degree after I finished my undergrad I went and got it in organizational management and part of the reason I did that was because I knew I wanted to work on improving teams I always enjoyed working on team building and I liked facilitating activities and I liked liked being in front of the room I did a lot of work in orientation when I was in undergrad where I got to lead groups of new students and that was always something that I really enjoyed and I knew I wanted to to try and do something with that but in undergrad there is no org management degree so I was actually an undergrad major of interdisciplinary studies which I jokingly say is people who just couldn't make up their mind so uh I I went back to school for org management and then actually got involved initially in some of my first roles outside of my Master's Degree I got involved working in higher education specifically and part of that is just because I did my assistantship my G graduate assistantship and did some work while I was in my master's program specifically working in higher education in Residence Life and housing and um yeah and that's so that's that's what kind of got me started um and then it's and where where are we now how does how does that compare to where you are now yeah so um I was in higher education for close to 10 years um and I did a lot I used my degree so I worked in in training students and then got into um Talent Development related to faculty and staff and specifically at the University I was at which is unique to higher education there was a big focus on service excellence and the experience of our students and how can we set our faculty and staff and our our employees how can we set them up for Success so that they can provide the best service for our students or you know as we'd say now our patients and right so um that was my background before Co hit and then obviously you know you know the fit hit the Shen with all of that and it was like okay now what am I going to do things changed at the University where I was and higher education in general is changing um and I I shifted my career and went from one industry and higher education where I was working with 18 to 22 year olds and they were my primary people that I served as well as the employees to now I'm setting up professionals who a lot of times in our world are people who recently graduated right so still that kind of young professional but how do I set them up for Success so that they can provide the best experience for for our people and so um definitely different worlds for sure I I still haven't learned all of the acronyms in healthcare there's more than I can count and uh every day there's a there's a new one but I have realized that you know it's that passion that people have and ultimately the experience we provide for our employees that impacts the experience we provide for our patients so let's talk about that cpxp that you got right so you are certified impatient experience but yet you focus on that employee experience and so you know so long we've kind of neglected employee experience in business plans or we've deprioritized uh employee experience in a lot of the business plans now going through business school we're being taught we need to make sure that your employee experience is just as high on the canvas as your customer experience but that wasn't always the case and so can you tell me a bit about how you came to be someone who you know cultivates amazing patient experiences through employee experience yeah so I couldn't agree more I think so first the first thing that has to happen is we need to just change the perspective and change the lens that we're looking at the overall experiences in our businesses um and remember that whether it's the employee or the that it's ultimately The Human Experience and I saw that coming in as someone fresh into healthare that you know postco world really still partially in the in covid in the middle of me joining Health Care there's just this need for us to better set up people for Success so what I really mean by that Cole is I'm thinking about you know how many managers how many leaders how many people in a role where they're now responsible for other humans right you're responsible for this team of people who are also ultimately the people providing the service whether that's in higher education or or in in health care we often see people in those roles who do not have the appropriate training the appropriate education level and it's not you know not whether you have a bachelor's degree or a master's degree but I'm talking about the education surrounding how do I provide care for my employees how do I coach my employees how do I Mentor my employees how do I lead my employees and even just understanding the difference between leadership and management and which one am I supposed to do you know people get training all the time on the performance employee you know process right we call it a pep process at the organization where I work full-time but you know regardless of your organization people get those logistical things but they often don't get the leadership training the you know people skills the ability to actually have the tough conversations and I saw that when I was in higher education and then when I got into Healthcare I realized this is just as relevant if not more necessary you know we promote the high performing nurse to the manager role and now they have to learn something like Microsoft Office they didn't know need to know that before so we focus on that and yet we missed the whole boat in terms of leadership development and I I'll tell you co so one thing that I I say whether it's in my full-time job at the organization where I work or as a leadership speaker is that I firmly believe we need to redefine what leadership looks like and we've done this thing in America and in the world where we place leadership on a pedestal we say one day I'm going to be the leader I'm going to be responsible and I'll get there when I do this thing and the next thing and I'm able to you know have tough convers it's all these different things right you could list off characteristics of the person in charge should be able to do and just make this massive list of what it is and the reality is that when we do that we're limiting our own potential so I think we need to as organizations figure out how do we knock over the pedestal of leadership and say let's make leadership less of a one day my employees will be in this role and more of a today what can my employees do to provide that experience and when they see themselves as a leader I think that's when they provide the best experience for our patients and they can only do that if we also see them as a leader and create an experience where they feel empowered and valued and mattered and that that's what needs to change I have some questions on this and you presented some interesting ideas and it's talking about that pedestal of leadership right so most people's leaders in uh their organizations especially large National organizations probably earn about five or six times as much as them and that does not just in terms of salary that's also total comp right so we're talking two to four weeks extra vacation time you know there's also a lot of benefits that leaders get so when we're talking about knocking over the pedestal how does that actually work when it comes to things like compensation benefits right how can you have a leader who's equal to everyone uh in you know thought I guess or in spirit when in reality they're making you know six times more with all these benefits yeah so I I think it starts with our own individual teams in like our own nucleus so if I the leader of a team of 15 employees I can't change the overall structure or organization in terms of what that culture is because a lot of that is systemic issues that have been in place at many organizations and across the you know the country that make it very difficult for people to you know climb and advance and and ultimately like hold down the people who you know are the ones providing that service at at the front line and I think if we start within that own nucleus and we look at how can I as the leader in this role right and I'll I'll say even for myself as a millennial right and I think that's a piece of a large piece of this is what where are we at in terms of the generations and how those those gaps in the workforce are closing and how there's so many more Millennials in Generation Z in the workforce than than ever before I think if we start looking at how can I be more human myself as the leader before we ever get to the top so to speak right the CEO um maybe someone who is in a in a different generation more likely than not is in a totally different generation than me and has benefited from these structures for so long but if we start changing what leadership looks like within our own nucleuses and I build a team where I'm vulnerable and I'm human and I own my flaws and I'm not perfect as the leader right I'm not the person who's at again on that pedestal I'm with you working with you a part of the the the the reality of what we do every day if I do that then what I ultimately hope will happen is that you as someone on my team is going to see this is what it means to be a leader I've felt empowered and then when I get when you then get to the next thing you're going to take those skills that culture and you're going to spread that and that's going to slowly spread across organizations um I'm not saying we should sit around and wait until all the Baby Boomers are out out of out of organizations and like that's going to change things um but I think a lot of it is about how do we focus on like our internal locus of control and what I have you know really to say true control over is the team around me and even then you don't have true control you only have control over your own thoughts feelings and emotions at the end of the day and we could just role model what we hope to experience and at the same time still challenge status quo that's part of leadership as well is being able to say hey I'm going to speak some truth to the power here and say this doesn't driive with me because this impacts our employees and then this is ultimately impacting The Experience so you consider sit here and look at HC caps all you want but the HC caps aren't going to change if we don't change how our employees show up to work every day and how they feel I really appreciate that in in a lot of ways because right now there's so many systemic problems whether we're talking about inequity along racial uh you know or gender lines but then we also have just inequity in terms of age in the workplace an experience in the workplace clearly somebody who's 50 or 60 years old has that experience and it should be rewarded to a certain extent but sometimes you're saying it's this kind of weird situations that go on and how do we combat that and it makes sense that we do this by setting an example over time so that when you know we are in the positions of Authority or others are in the positions of authority they can make those meaningful changes so I really do appreciate that a lot I want to talk about one of the ideas that some people will think of when it come you know what you said at the end there improving H cap scores improving our patient you know satisfaction and how it's about how our employees show up to work every day some people might hear that and say we got to get on these nurses and tell them that they need to yeah right good luck with that so how does what you practice differ from that traditional method of the manager coming down and saying you guys need to do better at your job our scores are low how does what you teach differ from that yeah so I would challenge anyone who is responsible for a team of of individuals to think about how am I creating a culture where my employees feel psychologically safe so what does that mean what does that look like it it creates a space where there's open dialogue right where it goes both ways so even just some thinking about something as simple as like how are your team meetings structured what does that look like so when we're working with a um you know whether it's an organization or whether it's in my job and I'm working with a um a specific team it's it's looking at the day-to-day because oftentimes we set these you know these big values we value all these things but then we don't operationalize it and figure out like how do I do this so it's nice to talk about knocking over the leadership pedestal and making leadership something where people feel empowered but okay how do I do that Nick so let's look at something as simple as a team meeting one how often are you holding them two what what's the structure of them is there an opportunity for open dialogue um is there a space where you as a leader go first that's a a massive pieace in leadership is is being willing to be the person to go first so when we're talking about whatever the issue might be or if we're just talking about what our expectations are or what it means to be a part of this team or our organization I need to be as the leader the one to go first and say hey this is how I feel I'm uncomfortable saying this and this makes me feel Fillin the blank whatever it might be and express that vulnerability and humanness and and when we do that I think that's what challenges people or creates spaces where people might feel challenged but also where they're going to feel that support because that's what often happens is in traditionally we want to challenge our teams we we can do better let's create competition let's let's make this um all about who can have the best scores and that's great and you know that works to some degree but you also need to individually connect with them so I would ask managers when's the last time you had lunch with each one of your individual employees sit down and say hey what's important to you you know I I have a resource in my business that I give to every single manager when when I get to work with them that's the top 25 questions that all young professionals wish their wish their managers would ask them and 24 out of the 25 are not about what you're getting done at work and um you know what tasks you accomplished it's about me as a person it's about what's important to me what do I value what do I need to be successful um where do I want my career to go and when we look at the relationship you have as a manager it's less manager and more Mentor coach right person who connects with them on a human level that ultimately then makes the difference why does managing performance not actually help performance it's a great question um I think it's because we should manage it's because you manage things and you lead people right um but when we lead people that will lead to Greater performance but we focus on right we like to say organizations are you know data driven I I don't I don't think data drives anything like we're driven by people like there's no you know like data robot I mean AI is becoming much more prevalent but there no data driving robot that like changes your hcap scores there might be technology you use to improve your experience and you know and manage their performance absolutely yes like let's make things faster friendlier easier Embrace technology 100% but also let's look at how do we stop letting Data Drive the per the the organization and maybe start focusing on how do my people show up and how are they able to be the best version of themselves so that they can then drive the performance of the organization um data is a part of that right we don't make changes for shiggles right we make changes for a reason we're not like hey let's just let's start telling our nurses that they need to be nicer no there's data that shows like our patients are telling us this is the issue like we're not meeting the average or this is a gap whatever it is there's data that informs that but that's only part of the story like let's look at what else is going on some of this might be hard for Financial leadership I know you know when when I look at my organization's you know numbers there's so many people who are proposing so many things but inboxes full right with all these different proposals on how to increase you know employee retention increase engagement increase customer leads all this stuff and so we have to be very fiscally conservative we can't just spend money on everybody's you know ideas and so what exactly do you offer or suggest these organizations what are some of the different formats these organizations can take to gain this knowledge from individuals like yourself because I know you do multiple different things you do the Consulting you do the speaking there are different you know so what are the options for organizations yes so I think it's important that organizations do a strong needs assessment and obviously need to have some type of a strategic plan I don't I don't ever want to work with an organization when they're just come to me and say hey we need you know training on resilience well okay well let's talk about that help me understand it's why there's know like if you were to go to my website like you know spend this amount of money and Nick will just show up it doesn't work like that it's how do we it's not a solution of you know this is the answer it is how do we look at what are our true problems right kind of doing those Gap analyses and looking at where where are we actually going and what are some things we can do to get where we you know where we want to be it's that you know there's this Gap that we have of what we're trying to fill in whether it's scores related related Finance Rel there's a lot of things and it's different for every organization but um the one that I see that's across the board and in healthcare and and in just many different Industries specifically as the generations change in the workforce is just a misunderstanding of what leadership looks like and how we set leaders up for Success like I I was talking about prior and it's there's lots of ways you can change that it's not just a onetime training though and that's what I find a lot of will do is they say Hey you know we'd love to work with you and schedule um you know one three-hour training or you know a one and a half hour keynote for all of our leaders that's wonderful but I don't want to just do a one hour keynote and I'm not saying that because I'd make more money if I did something else but what often happens is places will say we're going to do this and then it's an hour of I left feeling empowered and you know I have these skills but then there's nothing to follow it up there's no is this is the next level so you know a big thing that I like offering is is coaching programs and working with individuals who who are struggling or who are specifically um you know doing well and can then take that and do something else with it so um I would just say like what whatever it is you're looking at in your organization I think you've got to do a good job of figuring out what is the true root cause and not just applying a Band-Aid to it we do a really bad job of putting Band-Aids on bullet holes often times and then expecting that you know it's going to be better and then rather than stepping back we just apply another bandaid on top of it another one and we just keep sticking it on there it's like this isn't actually going to fix it you know for healthcare organizations we don't always do a very good job of triaging what's actually happening in our organizations well and so I have a question about that and if you can speak to any outcomes we I'd love to hear just maybe one outcome is maybe kind of the final question for you you know one of the things that I see a lot when I read these surveys that are done by you know big organ big consulting firms you know the two that I read a lot of press gandes and McKenzie some of the companies publish them publicly and it's great to see uh it seems like often there's this excuse that people just rank the scores badly because they want to make more money and I think everybody wants to make more money right even the richest people always you know we want to make more money but I don't necessarily really believe that that's the case because I've experienced it myself like yes I'd like to make more money but overall I'm pretty content in my job so I feel fairly compensated but yet if I was at a worse job I don't know if I could ever be fairly compensated and so are there any outcomes where you've been able to increase employee satisfaction where you've seen the salary kind of uh you know frustration go down after increasing the satisfaction so you know there's you're absolutely right and there's actually lots of studies that show that even when we increase an employee salary then you know the satisfaction from that only lasts about three months before they're looking for for something else so where I see the most success in terms of like employee retention in organizations is when we start specifically with the manager um and like I was saying when you asked about you know how do we fix these these bigger issues if we start with individually what what is my team doing to keep my people right what am I doing um and then what are we doing with it outside of that within the organization right you know so you look at things like what does the reward and recognition look like at your organization I me that's a massive piece piece of it and it's again it's it's about that connection of the human piece so do we do we create a reward and recognition program that is easy to implement do we create something that is inclusive of everybody um I've seen the implementation of recog Mission programs make a massive difference in how our employees feel but only when it is done in a way where it is truly inclusive Equitable where it is you know representative of all employees right across you know different races and genders and people get a choice in what they want um that makes a massive difference in terms of the retention of employees but only so when that specifically when that is coupled with managers who actually care so if your managers are just in a role without and caring is a skill right so like when we teach an a manager how to care um and then also with that give them the resources to do a true reward and recognition program that isn't just a you know slap something on the wall like simple you know you did a great job or look at your scores okay but like what does that mean to me here's a pizza what's important yeah exactly here's some pizza cool okay what if like you know and if we're trying to change habits and looking at that you have to be able to look at what do those look like for each person it's different it's not the same for every I really love that uh Nick and it makes me think about some of the leaders that I've had in the past that have done really good jobs at this and then also areas uh thankfully outside of my organizations where I've seen some other people have struggles in that area so excellent excellent advice we're going to tag your LinkedIn your website to this video so that people can go and learn more uh but I really do appreciate you volunteering your time during your lunch hour to to explain these really interesting Concepts to us yeah AB absolutely Cole it's been a pleasure I'm I'm grateful that you all are you're doing this um and that more organizations are going to have an opportunity to learn about the importance of leadership and the way we you know the like you said the employee experience impacts the patient experience um so thanks for having me of course of course</p>