I'm a chief experience officer: Here's what keeps me up at night

Optimism is important to a chief experience officer. While this ideally should be true for all healthcare leaders, it's especially a core competency for CXOs.

Optimism helps CXOs connect with the hearts and minds of our caregivers and keep us connected to purpose. But, it's also true that many CXOs worry. Like our colleagues in leadership, sometimes things keep us up at night.

Lately, when I wake up worried, two things have been occupying my thoughts.

First, I worry about the increase of verbal and physical assaults on our staff, which cause real physical and emotional harm. There are many causes behind this, one being the rising number of patients who come to us with psychiatric comorbidities. But I believe it's also connected to the fraying of our social fabric, by which people seem to feel freer to express discriminatory impulses and opinions. 

We certainly have an obligation to care for all who come to us — even the prejudiced and bigoted. But, what are the boundaries that must be reinforced to keep all of us safe?

We believe a "zero-harm culture" should exist for our patients, but also our staff. At NewYork-Presbyterian, we are engaged in efforts to counter acts of physical and verbal violence and bring support to the bedside as soon as these issues are identified.

We are instituting Behavioral Emergency Response Teams to respond when either potential conflict has been identified by the team or immediate assistance is needed. We have created new policies and related communication tools to define expectations around mutual respect and establish clearer boundaries for patients, visitors and staff. Our policies include procedures for proper identification and escalation of issues, and they lay out support resources for staff in the aftermath of incidents. Like many other hospitals, we are also providing extensive training on de-escalation skills and conflict management.

We are doing a lot. But even with these actions taken, I worry. When I talk to colleagues around the country, it is clear that the verbal and physical threats staff face are not limited to one market or geographic area, and they make for a pressing problem. Although I'm aware of numerous efforts underway, it's still a work in progress and no one seems to have found the right combination of solutions yet. Our field needs to come together with solutions to ensure our people can work without intimidation, threat, humiliation or harm. Our staff need to know we have their backs.

The second concern that keeps me up at night is our progress in integrating technology within workflows at our 4,000-bed system. CXOs spend most of their days thinking about communication, which either makes or breaks the patient experience. Patients tell us that the single biggest experience determinant for them is the quality of our communication — as individuals and teams. It may seem like a simple issue, but it's actually very complicated. 

We have lots of IT and communication systems, but they are too often disconnected and fragmented. Gaps persist between disciplines, shifts and care settings. On top of that, there is constant pressure for throughput. This makes it hard to communicate consistently as a team to our patients and families. We often see parts of the picture, but too rarely can we truly see the bigger picture. This is frustrating for staff and patients, and closely linked to industrywide challenges with engagement and burnout. 

We need to do better. That's why we are working very hard at my hospital to transform the patient journey and connect technology and communication from beginning to end. For the first time in a long time, with the advent of AI and other integrating technologies, I am starting to feel hopeful that we may be on the cusp of meaningful technological integration. But, like the harassment and violence our staffs face, our work is unfinished. So I still worry.

"Never worry alone." One of my healthcare mentors once shared this with me, and I recall this piece of wisdom often. I know many of my fellow CXOs share my concerns. And, although I remain optimistic about our ability to solve them, we must channel our anxiety into action. Our patients and teams are waiting.

If you'd like to share with me how your organization is responding to these two challenges, or share your reactions to my concerns expressed here, please find me on Twitter at @CXORick.


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