'COVID-19 doesn't respect silos and neither should we': Nuvance Health's CXO on patient experience during the pandemic

The COVID-19 pandemic may result in lasting changes to public and private healthcare, including changes to the patient and caregiver experience arenas. Amid the crisis, healthcare organizations have had to be quick on their feet to overcome myriad clinical and operational challenges thrown at them, all while ensuring the well-being of their patients and clinicians.

Here, Stephen Meth, chief experience officer of seven-hospital Nuvance Health, based in LaGrangeville, N.Y., and Danbury, Conn., discusses how the health system has kept patients connected with their families and supported caregiver well-being. He also shares advice for other experience leaders weathering the pandemic.

Question: As CXO of Nuvance Health, what are some of the biggest challenges you have faced leading patient and caregiver experience during the COVID-19 crisis?

Stephen Meth: One of the biggest challenges has been keeping our patients connected with their families. As most health systems have done, we have limited visitors to our hospitals, with no visitors allowed for COVID-19 patients, except for extenuating circumstances, including end-of-life situations. This has been incredibly difficult for patients and staff alike. We know that families serve an invaluable role in healing, wellness and as support partners. Their absence to reduce exposure to COVID-19 in our hospitals strains the family integration we encourage and foster. We rapidly deployed technology to bridge the gap, such as providing mobile devices to patients, but we know virtual visits are no substitute for having loved ones at the bedside, especially for these critically ill patients who are scared.

Another challenge has been for caregivers working throughout our health system, who have been so dedicated, innovative and proud to serve our communities yet also worried about bringing COVID-19 home to their families.

Q: How has Nuvance Health been balancing patient and caregiver experience during this time?

SM: We implemented digital solutions to offset what would have been more manual tasks for our care teams, such as creating an alert in our EMR to determine the patients most vulnerable to having no visitors. These patients may have difficulty using a phone, have anxiety and/or long lengths of stay in the hospital, or other concerns. These alerts trigger an appropriate team-based response, including having licensed clinical social workers, patient experience and spiritual care teams wrap support around the patient and their family.

For our staff, we rapidly trained over 200 peer-to-peer supporters to provide confidential, emotional first aid and support resources to their colleagues. Accessibility, diversity and outreach were key in order to reach our staff and have the greatest impact. We wanted to make sure there were several ways to participate because staff need options to reach out or receive help when, where and how they need it. Our peer supporters are accessible 24/7 through our hospital operators, and they coordinate rounds and departmental virtual support groups to be proactive.

Q: Is there anything you have learned through this experience that you want other C-suite leaders to know? 

SM: Overcoming fear to resume elective procedures and in-person ambulatory care requires asking a lot of questions of our current, potential and former patients to manage perception and expectations, and to make sure everyone knows that meticulous planning for collective safety is guiding our every decision. Our patient-family advisory council helped with this. We also plan to consult with an anthropologist to focus on human-centered design to help us get better at this.

Q: Do you think the COVID-19 pandemic will have a lasting effect on patient and caregiver experience? How so?

SM: We've always practiced relationship-centered care and know that each patient is unique and has specific needs. This is even more pronounced now and will have a lasting effect on experience because of the new processes and protocols we implemented during the COVID-19 pandemic to ensure every patient and their family has the support they need, especially during times of extreme uncertainty and fear. We're also tracking these processes and protocols more closely. We embedded qualitative and quantitative research methods to measure the impact, refine the practice and share our learnings.

Guided by our simulation centers for advanced learning at [Nuvance Health's] Danbury [Conn.] Hospital, we practiced scenarios to ensure our outreach was of the caliber our patients and families deserve. The number of people from our care teams, board and the community who participated and supported the effort was overwhelming and reaffirming of the connectedness we feel for the communities we serve.

Q: What advice do you have for other CXOs as they navigate the pandemic?

SM: COVID-19 doesn't respect silos or reward our ingrained habits, and neither should we. So, it's a great moment to examine what we deemed essential playbook interventions prior to this pandemic and systematize more personalized approaches. This pandemic demands a team-based approach. It's an opportunity to ensure the teams that traditionally fall into experience have aligned outcomes metrics and work daily to deliver on those metrics. For example, gift shop, patient experience, spiritual care and volunteer services — if people, process and systems aren't working together daily to identify and cater to the unique needs of patients, families and caregivers, consider making that change a positive lasting impact of COVID.

More articles on patient experience:
Online triage tool reduces patient uncertainty about care needed, study shows
Michigan hospital launches book exchange initiative for patients
Hospitality trumps care quality in patient surveys, study finds

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