NewYork-Presbyterian CXO Rick Evans: The national outlook for patient experience in 2022

As we forge ahead into a new year, we find ourselves, once again, facing the unrelenting challenges of COVID-19. Here in New York City, the omicron wave appears to have crested; we are seeing cases begin to drop after another significant surge over the last few weeks. Sadly, we’ve grown accustomed to the rising cases, staffing challenges and restrictions on visitation that come with each new wave. But it still takes a toll each time. 

Healthcare leaders all over America know what I am describing. We have all been through it. And, for many other parts of the country, omicron hasn't crested yet. There are still months of this wave left before it dissipates.

What happens after this wave? What will we be left with? 

Many are saying the path back down from omicron will be faster than previous surges. Some are saying that this may be the wave that brings the transition where COVID-19 becomes a much less disruptive factor in all our lives. 

I hope this proves to be the case, and we begin to move forward from the last two grueling years. If the picture begins to stabilize as we move through 2022, what is the outlook for patient experience this year and beyond?

I’ll be frank — I see another very challenging year ahead. Many of the dynamics that have diminished our ability to provide a consistent patient experience will persist through much of the year. These include continued restrictions on visitation and family presence at the bedside, staffing challenges and shortages, supply chain challenges, burnout and exhaustion. But I also believe this year can be a year that brings not only recovery, but longer-term transformation in how we measure, assess and improve the patient experience.

When I think about the year ahead, I believe we will need to focus our energies on three things: rebuilding, recovery and transformation.

First, we must make an ongoing, robust effort to rebuild the underpinnings of our organizations. The top priority must be recovery of staffing levels. The media is replete with articles about staffing shortages, the "Great Resignation" and related factors. It’s hard to talk about connecting with patients and implementing best practices when there aren’t enough people to do the work. We need to not only recruit staff more effectively, but also find ways to orient and support new hires and newly graduated clinicians to our teams. We need to get at the root of why people are leaving healthcare and address these issues to prevent a further mass exodus from our ranks. All of this is daunting work because we are all competing for these precious human resources. 

Our individual organizational efforts will not be enough. Our government must also invest in rebuilding healthcare human infrastructure. Here in New York, Governor Kathy Hochul just announced a plan to do just this. Investment will be needed to complement the efforts we are all engaged in to recover staffing. 

On top of the basic effort to restore clinicians and other key team members to the bedside, we need to help our teams recover. We must keep programs in place that foster self-care. As staffing pressures begin to ease, our teams will begin to make space to attend to their own wellness. We also need to help our teams put the experience of the last two years into context. When I talk with colleagues who have opted out of healthcare, a common reason is a loss of connection to purpose. Some have lost sight of what healthcare is about because it has been so difficult to work to our purpose. It’s felt like a conveyor belt of patients and tasks, and some just want to get off. The most resilient among us have found a way to maintain their connection to purpose and have been able to see their role in the unique and historic time we have all lived through. They understand that this will end and that there is meaning in what we have been able to accomplish together. Our organizations need to support programs to help us all put ourselves back together, as individuals and as teams. This healing and recovery process cannot be short-changed or skipped. It’s a path back out of the woods that we all need to take.  

Finally, we need to go beyond recovery and toward transformation. There are aspects of our pandemic experience that should be reassessed and reset for the future. For example, we need to take a hard look at what we have referred to as "visitation." The pandemic has taught us how critical family presence at the bedside is. We need to think differently about this and recast it not as visitation, but as family participation in care and restructure our approach accordingly. 

We also learned how important connection is in healthcare — between our teams and patients and with each other. We learned this when we were denied connection during these surges. Connection is at the heart of patient experience, and it requires time and space. In a task- and checklist-filled environment, connection is being lost. In addition, we learned in the pandemic that connection can be in person, but it can also be virtual. Out of necessity, we used technology in new ways to work with each other. We also learned that patient autonomy and participation in care can be enhanced by thoughtful use of technology. We should use the years ahead to integrate what we have learned and create an ecosystem for connection that combines in-person and virtual elements. This work could be transformative — for the patients we serve and for each of us as team members. 

This is the journey we are on at NewYork-Presbyterian. 2022 will be a very challenging year for patient experience, but we also intend for it to be a turning point. 

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