innovation

Navigating Healthcare: The Importance of a Hospital Advocate

/ Jonathan Sachs

Working for the last decade in large hospitals, I get calls. Even though I am not a doctor or nurse, family and friends call when they get sick. All are experiencing some combination of being scared, stressed, and confused by how healthcare works in the United States. They generally ask for advice about how to navigate being a patient.

I always give them the same advice:

Make sure you have someone advocate for you while you are in the hospital.

I will share in this post why I absolutely hate having to give this advice and what can be done about it.

Why it is Important for Patients to Have a Hospital Advocate

Family and friends can serve as hospital advocates

Hospitals are busy places. They are designed to care for the sickest of the sick. A good rule of thumb is if you feel like you are not getting enough attention at a hospital, it means that your doctors do not consider you among the sickest patients in the hospital.

So that’s the good news.

With that said, it can also mean long wait times for simple tests, bumps in the operating room causing your surgery or procedure to be postponed, and limited face-time with your care team. Unfortunately, these delays are all patient dissatisfiers and the uncertainty involved can be stressful to anyone receiving care.

There are many reasons why hospitals operate this way, many of which are economic and operational, so I won’t get into that for this post. (Although if you want to know, just ask, I’d be happy to hear from you).

Because of these factors, navigating care at a hospital can be difficult. Furthermore, The patient in the hospital is usually in a compromised and vulnerable state. They are sick, medicated, in pain, anxious, bored, and sleep deprived, among other things.

That is why you need an advocate in the hospital.

The Best Hospital Advocates

The best advocate for a patient is generally a family member or a close friend. For more complex cases, there are for-hire patient advocates who are usually trained medical professionals.

Sometimes, there is an employee or volunteer affiliated with the hospital called a “Patient Advocate” or “Patient Representative.” These roles range in functions from risk (Dealing with the threat of legal action) to service recovery (Trying to fix a patient’s experience reactively) to ombudsman (Listening to patients and investigating issues to correct them for future patients).

Unfortunately, many hospitals cannot provide someone to advocate for your needs as a patient like a family member or friend can. The simple act of walking over to the nurse’s station, getting to know them, and asking questions about your loved one’s care can go a long way to helping to improve a patient’s care.

To check myself on this advice, I have asked former colleagues of mine what they think about it. Almost universally, doctors, nurses, and administrations I speak with agree with this advice.

The best thing you can do as a patient is to have someone with you to advocate for giving you care and attention while you are in a hospital.

The Downside to a Friend or Family Being a Hospital Advocate

Within the last 13 years, my father, mother, and sister have all been neurosurgery patients. Without exception, during any hospital stay, none of them were alone for any period of time. When my father had emergency surgery, my mother never left the hospital and vice versa. My mother stayed with my sister during the entirety of her multiple hospital stays as well.

At first, I thought they were crazy. But, having now worked in hospitals, it is clear to me that this had major benefits to each of them as patients. Furthermore, the nurses and physicians welcomed the help. My mother and father refilled water, brought up food, and helped to make sure the room was tidy. These responsibilities almost always fall to a nurse or another member of the care team.

In fact, during the COVID-19 pandemic, we frequently heard from doctors and nurses that patient experience was worse when family members were restricted from visiting.

However, this schedule was not without cost. Both of my parents are self-employed and had to miss work and reschedule other life events. They often slept upright in an uncomfortable chair. They didn’t shower. The stress they felt was palpable. While they appreciated the people on their care team, they didn’t trust the hospital to take care of them.

It shouldn’t have to be like this.

I often say that my life’s work as a leader in healthcare is to create an environment where I wouldn’t have to give this advice.

In this reality, family and friends can stay with a patient, of course, but could feel confident that their love one is in good hands. That they can go home and shower, sleep in a bed, and work knowing that the people at the hospital care about their loved one.

What Can be Done?

Fundamentally, patients need an advocate in the hospital due to a lack of trust.

Hospitals generally don’t do a great job building trust. Hospitals are almost always running late and timelines get missed. Doctors and nurses are overworked, rushed, and often burned out. It is difficult for doctors and nurses to empathize with patients because of the mundanity effect, which happens when something extraordinary (like caring for patients and saving lives) becomes routine.

From my point of view, the solution here is three-pronged:

  1. Fix the aspects of the hospital operation that make doctors and nurses jobs unnecessarily difficult or that take them away from patient care.
  2. Create and enforce behavioral expectations for how doctors and nurses treat patients and family members.
  3. Create ways for patients to see more of their doctors and nurses.

While this list is pretty easy to type out, actually making these changes could take decades. Most hospitals are still operating under business strategies and process improvement models from the 1980s. Remember, healthcare is highly regulated and complex. Making change doesn’t take weeks, months, or years. It usually takes decades.

The issues in healthcare are systemic and ingrained. There are many large stakeholders involved in the system today including large care providers, insurance companies, health plan administrators, etc. Large players like Amazon and Walmart are even trying to disrupt this behemoth of an industry, which has been notoriously hard to do.

Trying to change or cure the underlying diseases of healthcare has too long of a time horizon to make meaningful change for struggling patients and families today.

The Role of Technology

Luckily, technology can help with #3 – Create ways for patients to see more of their doctors and nurses.

This is why I made a career change recently.

I recently joined a company called WUWTA (pronounced “What-ah”) as their CEO. I first met WUWTA co-founder and Chairman of the Board, Jock Putney, when I was Chief Experience Officer at Robert Wood Johnson University Hospital.

On the WUWTA platform, physicians can guide patients through their healthcare journey personally from referral to discharge and follow up appointment. When I led Patient Experience, I spoke to patients every day. They desperately wanted more of their physician’s time and often were so excited when the physician spoke to them, they could not retain what the physician said!

WUWTA addresses this patient experience pain point simply. At each stage of the patient’s journey, the patient gets a video from their physician, explaining their next step in simple terms. The WUWTA platform enables doctors to hold a patients hand digitally and at scale.

Platforms like WUWTA are the necessary interim step to helping patients have a better experience without having to immediately address every systemic healthcare system disfunction.

After meeting with Jock, I felt so passionate that WUWTA represented a way forward to make healthcare better for patients, that I left RWJ to join the company.

What’s Next

We are far from my dream of a hospital system where having an advocate would not be necessary. Technology offers an important interim step to achieving this goal.

My belief is that it is a good thing that technology has enabled patients have access to more information. As the healthcare system continues to shift to be more consumer centric, patients will use that information to demand a better experience. That is when real change will happen faster. I am excited to be a part of it.

Key Takeaways

A hospital advocate is essential for patients navigating complex healthcare in the US, ensuring personalized attention and care in busy hospital settings. Technology platforms like WUWTA provide interim solutions by improving patient access to doctors, empowering them with information, and enhancing their healthcare experience.

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5 Ways for New Leaders To Meet With Their Teams

/ Jonathan Sachs

Facilitating discussions and meetings is an essential skill for leaders, especially in business.

Effective facilitation enables leaders to tap into their team’s collective intelligence, generate new ideas, and make well-informed decisions. The best leaders understand this and possess an exceptional ability to create an environment that encourages open and productive communication.

Jeff Bezos advise for new leaders on facilitating meetings

Why are great leaders gifted at facilitating discussion and meeting?

Great leaders understand that their team’s collective intelligence is far greater than any one person’s smarts. To have the best results possible, leaders create an environment where team members feel encouraged to express their ideas and opinions. In addition, they possess excellent communication skills that enable them to listen actively, ask questions, and provide constructive feedback. Most of them are curious at their core. They also possess the ability to keep discussions on track, ensuring that the team remains focused on the agenda and achieves the set goals.

Elon Musk and Jeff Bezos are two examples of business leaders who excel at facilitating discussions and meetings. In a recent interview, Musk highlighted that he has a “no PowerPoint” rule in his meetings. He prefers that his team members express their ideas verbally and then encourages open and frank discussions based on the verbal presentation. This approach allows for a freer flow of ideas and prevents the suppression of any potentially great ideas that might have been lost waiting for a break in the presentation to ask questions. Musk is also known for asking people who are not contributing to leave a meeting and go work on something more productive.

Jeff Bezos, on the other hand, has a “two-pizza rule” for meetings. He limits the number of people in a meeting to those who can be fed with two pizzas. This approach encourages smaller, more focused meetings, where everyone can have their voice heard and contribute to the discussions.

Five ways leaders can be better meeting facilitators

  1. Prepare: Leaders should have a clear agenda for the meeting and ensure that all team members are aware of the agenda beforehand. This helps team members prepare and ensures that discussions are productive and focused.
  2. Encourage participation: Leaders should create an environment where team members feel safe and encouraged to share their ideas and opinions. Leaders should actively seek the participation of all team members. To create an environment where everyone on the team can participate, regardless of whether they are in the office or working from home, I use the 55″ Vibe Board and the Owl Camera. These tools help to encourage participation and inclusion.
  3. Active listening: Leaders should seek to understand their ideas and opinions by asking probing questions. This helps to build trust and encourages team members to share more openly.
  4. Keep discussions on track: Leaders should ensure that discussions remain focused on the goals of the meeting and set clear timelines. Leaders should also prevent discussions from being sidetracked or dominated by a single team member.
  5. Evaluate and improve: Leaders should seek feedback from their team members on how they can improve as a facilitator to capture more ideas.

In conclusion, great leaders possess exceptional facilitation skills that enable them to tap into their team’s collective intelligence, generate new ideas, and make well-informed decisions. Elon Musk and Jeff Bezos are excellent examples of leaders who excel in facilitating discussions and lead productive meetings. By preparing adequately, encouraging participation, active listening, keeping discussions on track, and evaluating and improving, leaders can become better meeting facilitators and drive their team’s success.

Key Takeaway

Effective facilitation skills are essential for leaders to tap into their team’s collective intelligence and make well-informed decisions. By preparing adequately, encouraging participation, active listening, keeping discussions on track, and evaluating and improving, leaders can become better meeting facilitators and drive their team’s success.

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How neurochemicals can help you lead and be innovative

/ Jonathan Sachs / 4 Comments

Welcome back to Leadership as a Practice. I wanted to first start by sharing that I have missed writing and hearing from you about the content of this blog. I intend to be writing far more consistently and am filled with optimism as we come out from under the worst of the COVID-19 pandemic.

Today, I wanted to share something I learned recently through The Innovative Healthcare Leader program at Stanford University. I found it interesting that the program was a week-long but only discussed design thinking on one day. The rest of the program was devoted to becoming an innovative leader and shifting the mindset of an organization so teams can think creatively as well.

One of my major takeaways came from Professor Baba Shiv, who spoke about a framework he developed called “The X Framework.” A version of the framework is posted online and shown here:

The idea behind the framework is that people have three neurochemicals that change their mood, behavior, and willingness to tolerate risk. Coritsol, the stress neurochemical, gives us a very low risk tolerance and low creativity. The response triggers most people to recoil, shut down, or seek familiarity/status quo. Serotonin is the neurochemical that reflects comfort. Serotonin is the chemical that gets released when you kiss a significant other, for example. Finally dopamine is the neurochemical that activates excitement or creativity.

Much of these neurochemical concepts and how they relate to leadership are covered by authors like Simon Sinek. Shiv’s contribution has to do with the conditions needed for innovation and creativity. In organizations that are high stress, creativity tends to be very low because levels of cortisol are high. When cortisol levels are high, dopamine is blocked from being released. To get to a situation where dopamine can be released, people must have a sufficient amount of serotonin release first.

That is why the concept of psychological safety is so important to both innovation and leadership, more broadly. If you believe, as I do, that the people closest to the work know the work the best and are therefore in the best place to improve it, they will not be able to do so in an environment that consistently increases their cortisol levels.

During his seminar, Shiv argued that one of the primary human motivations is “Social consequence,” which is the need to save face and maintain social standing. For example if a superior calls you out or humiliates you in a meeting with your peers, that would be a negative social consequence and produce a significant cortisol release leading to de-motivation.

According to a recent survey by McKinsey and Company, Psychological safety is, “When employees feel comfortable asking for help, sharing suggestions informally, or challenging the status quo without fear of negative social consequence.” Psychologically safe workplaces exist to keep the team’s serotonin levels high, providing abundance (think free food options at google), recognition, and gratitude. According to Shiv and the McKinsey survey, these organizations also tend to be more innovative and open to taking risks, including adapting to change.

If you are a leader looking to create change and unlock the creativity of your team, look for ways in to keep their levels of stress low and of psychological safety high. Innovation depends on a culture that can support positivity and safe-to-fail experiments.

KEY TAKEAWAY: Do you want to lead an innovative organization? Look for ways to keep your teams stress low and psychological safety high.

Frugal Innovation

/ Jonathan Sachs

The idea of innovation or an innovative company is in vogue. Whether it is the Silicon Valley startup, or the “innovative” CEO, that descriptor has much social currency in today’s world. In business school, one of my favorite classes was the class I took on with Professor Anil Gupta.

Professor Gupta introduced the class to several different constructs for innovation, but the one that spoke to me the most was a concept called Frugal Innovation. Frugal Innovation is the idea that the creation of something new is low cost, low environmental impact, and low resource utilization. Professor Gupta provided examples including Southwest Airlines, GE’s portable ECG machine, and the Aravind Eye Care System.

ideas whiteboard person working

Photo by Startup Stock Photos on Pexels.com

My previous professional experiences probably has something to do with the appeal of Frugal Innovation. As a lobbyist at the federal, state, and local levels of government, I observed several instances of waste. Historically, some government projects have begun with funding and then searched for solutions for the project/problem. Some people call this, “throwing money at the problem,” and I have observed how that strategy rarely ever works.

Additionally, Frugal Innovation solutions are often elegant in their simplicity. The concept includes design thinking as well as LEAN principles to create a solution for a specific market. Innovation happens in the simple delivery of the solution in a way that is both financially and environmentally cost effective.

I graduated from college during the depth of the recession. During both my academic career and in many of my jobs, there often were scarce resources to go around to deliver on the work. In fact, in all of them, the biggest resource I had to do the job was the expense for my time. While producing in a resource-constrained environment is not easy, it has challenged me to be creative in meeting the needs of the customer with the smallest resource investment possible.

I have found that the concepts at the root of Frugal Innovation likedesign thinking, analysis, LEAN, and general creativity, help me to refine my ideas and simplify the solution to be viable and frugal. I have found that I can apply these principles to solutions involving both people and systems. Taking the time to think through the problem and craft a frugal solution is usually “good enough”, if not the ideal solution.

I have also found, ironically, that after I have had some success as a lean department or through Frugal Innovation, other leaders are more likely to want to invest more in the product or service. Demonstrating that you can do things in a frugal way, even just to test and show proof of concept, is a powerful tool.

Innovation doesn’t have to be expensive. In fact, innovation can be most transformative through its simplicity. Additionally, being low impact can also help to broaden innovation to new markets and spread solutions to people across socioeconomic lines. Leaders should keep the principles of Frugal Innovation in their tool-belt especially in entrepreneurial and intrapreneurial projects.

KEY TAKEAWAY: Using Frugal Innovation principles can help leaders develop simple solutions that have a small environmental footprint and make a big impact.