Communicating during uncertain times in real-time

At Tampa General Hospital, we're focused on facilitating honest and transparent two-way communication with our team. In fact, an integral part of our organizational culture is providing platforms for an ongoing exchange of ideas. 

This spring, when we found ourselves on the frontlines of a global pandemic, we realized the need to lean in and focus more than ever on ensuring that our team members heard from us regularly and that we were able to capture and respond to their ideas and concerns in real-time. 

While we had protocols in place and performed significant drills and exercises to prepare for health emergencies and natural disasters — we are located in Florida, and hurricane preparation is a way of life here — the COVID-19 pandemic brought unique, once-in-a-lifetime challenges. 

Under the most stressful conditions, our team members heroically served as both caregivers and stand-in family members. At the same time, they had to deal with the anxiety of maintaining their health and that of their own families. As members of the senior leadership team, our primary focus — in addition to the care of our patients — was the support and safety of our team members. 

We began by disseminating communications directly from our office across multiple platforms—direct emails, our internal portal, social media channels and virtual meetings inside the organization—and several times a week. We even developed a communication app that team members could access from their phones. This strategy allowed us to ensure the consistency of the communications and also reassure our team members that they could count on regular emails directly from us. The content of the transparent communications from our office was designed to not only provide valuable information on protocols, challenges that we were facing, and proposed solutions, but to offer words of encouragement and acknowledgment as to how hard our team was working in the most challenging of circumstances. 

In April and amid our pandemic caregiving, we were approached by Press Ganey, the company with whom we partner on our annual team member engagement survey, to participate in their newly designed COVID-19 Pulse Survey. Unlike our highly detailed annual team member assessment through Press Ganey, the Pulse Survey would allow us to leverage a listening platform designed to capture in real-time team member feedback and input on how we were responding, as both an organization and as a senior leadership team, to the COVID-19 pandemic. We saw the survey as an incredibly useful tool to bolster our ongoing two-way communication efforts and allow us to establish an immediate feedback loop on our organizational and leadership response. We are proud that we became the first organization in the country to implement the tool.

We then set about designing, standing up, and distributing the survey. The survey consisted of several demographic questions, ten rated items, and two open-ended questions for comments and was designed to take only 3-5 minutes to complete. It was administered in an open-format, where team members, physicians, and providers were all invited to participate using the same link over four weeks. We wanted to make the survey easy to disseminate, access, and respond to so that folks would see the value in participating without viewing it as an arduous task or an additional burden. Our goal was to use the feedback to inform our continued response to the current crisis and to design ongoing strategies for potential situations that might arise in the future. 

Throughout the survey period, over 5,000 team members (or 60 percent) responded to the survey—exceeding the national average for pulse surveys. The survey consisted of ten statements focused on crisis management, communication, team member resiliency, and safety, and two open-ended questions. This format allowed us to quickly gauge how the team was feeling while identifying themes and trends about what was most important to the team during this time so that we could either make adjustments as needed or continue with changes that were well received. 

All 10 survey items received a score of above "4," and our team members shared over 4,000 written comments. On the five-point rating scale, a score of "4" means that the responder "agrees" with the statement, and a "5" means that they "strongly agree." 

The immediate benefit of the survey was that we had real-time access to feedback from our team. A vital component of the survey process became a daily schedule of reviewing feedback during the four-week open survey period. This work allowed us to immediately address concerns, identify and find solutions to challenges raised by team members, and provide additional information as requested.  

For example, we received several comments, and right away, asking for additional specificity related to the number of COVID-19 patients and the number of team members testing positive for the virus. In response, we began posting a highlight of the statistics on the TGH portal. Had we not had the survey in place, it might have taken much longer for senior leadership to be made aware of this gap in communication, and given the solution was fairly straightforward to implement, the survey made all the difference.

In addition to providing easy access to COVID stats on an ongoing basis, we were able to analyze team member responses and offer additional opportunities for positive change that made a real difference to our team. These included providing additional information on PPE inventory, extending our limited visitor policy and screening protocols, creating processes and guidelines for travel requests, and continuing with our remote work environment for those team members who do not need to be onsite. 

When we first launched the survey, we were confident that it would help us facilitate direct communication and respond to new and unanticipated challenges. We could not have imagined the heightened level of organizational communication, camaraderie and goodwill it engendered and the transformative effect that it has begun to have across the entire organization. 

During the challenging times we have faced during the pandemic, we have witnessed the attitudes of our team members remain incredibly positive. They have responded that seeing their concerns addressed honestly and quickly have directly contributed to their feelings and have contributed to their desire to not only maintain their high standards but continue to seek ways to improve. 

While we have always been incredibly focused on direct communication with our team, our level of consistency and frequency, facilitated in part by the survey, has grown. Our team perceives our communication to be even more robust, transparent, and frequent and have expressed sincere gratitude for our efforts. We continue to receive cards and emails and are stopped during our walks throughout the hospital to acknowledge the level of feedback that we have continued to provide.

COVID-19 has tested our organization in ways that we could have never imagined six months ago, and at the same time, it has facilitated some incredibly positive change within the organization. Our teamwork was incredibly strong before COVID-19, but it is exceptional now. And, our team members recognize that fact. We continue to receive a great deal of feedback on the heightened level of teamwork across the organization. Rallying together and knowing that both the organization and fellow team members are looking out for each other, 24/7 has brought everyone closer together and elevated the organization.

The support that we were able to deliver and the care that we were able to provide to our team, thanks in part to the survey and our work to maintain constant communication, has resulted in a greater organizational cohesion, a heightened sense of empathy, and a renewed dedication to making a difference at all levels of the organization.

John Couris is the president and CEO of Tampa General Hospital, Holly Graziadio is the organization's Chief of Staff, and Stacey Brandt is an Executive Vice President and Chief Strategy & Marketing Officer.


Data used with permission from Press Ganey Associate LLC.

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