Patient experience in the age of COVID-19: Northwell Health's CXO on lessons learned & what lies ahead

After facing an onslaught of coronavirus cases in the early months of the COVID-19 pandemic, hospitals in New York are now focused on what comes next. With flu season right around the corner and the pandemic raging on, hospitals in the state are trying to take what they learned from the first spike to prepare.

New Hyde Park, N.Y.-based Northwell Health is especially focused on taking lessons learned and applying them to improve patient and caregiver experience. Sven Gierlinger, Northwell's chief experience officer, spoke with Becker's about how his organization plans to navigate the challenges ahead, while keeping the patient and caregiver at the center of every decision.

Editor's note: Responses were lightly edited for length and clarity.

Question: What are the key lessons learned from the initial surge of the COVID-19 pandemic?

Sven Gierlinger: As the largest health system in New York, Northwell cared for over 50,000 COVID-positive patients — more than any U.S. healthcare organization during peak of the pandemic. This health crisis has truly unified us in ways few would have imagined, and we continue to see the very best of humanity, from our heroic team members, to our brave patients and families, as well as an unwavering commitment from the communities we serve.

From a patient experience perspective, we look at three key components that have helped us along the way. First, our commitment to maintaining the patient and family connection by any means necessary, as we know that preserving human connection and support is one of the most crucial components to the healing process and the overall provision of care. Second, it's supporting our people — our team members who humbly took on the valiant role of hero — many times placing themselves in the 'war zone,' to help others. Providing consistent emotional support, transparent communication and an optimistic and positive view was and still is the way we help to carry our teams through this journey.

Finally, while many talk about innovation, we define it. We knew the rapid implementation of novel, technology-based solutions would play a critical role in our response to the pandemic. It became clear that it's not just about access to the technology when you are trying to deploy end-to-end solutions within a matter of days. It's about empowering the right mix of interdisciplinary team members to be creative and understand the impact of any solution on the surrounding ecosystem of processes and workflows. Technology, in certain contexts, has earned a reputation for having a dehumanizing effect on social interactions. However, the social isolation factor brought on by the pandemic showed that technology can profoundly improve levels of connection between patients, families and providers through the establishment of digital communication pathways.

Q: What new patient experience strategies is Northwell planning to implement based on those lessons?

SG: We have prioritized the ways in which we facilitate communication between providers and patients/families via extensive telehealth networks, virtual visitation platforms and innovative technology solutions.

Given lessons learned, all patient journey maps now take into consideration infection control and social distancing, so touchless transaction and digital communication may be deployed where possible. We are also looking to expand digital communication tools, with escalations [to] live agents [when needed], as a means of more broadly setting expectations, managing concerns and taking care of tasks that previously required a phone call or in-person interaction.

Given the likelihood of restrictive visitation policies for the foreseeable future, we are looking to expand digital communication tools at all hospitals. Playback Health, for example, is a HIPAA-secure mobile platform application that provides a wide menu of communication tools as a means of promoting virtual clinician-to-clinician, patient-to-family and family-to-clinician interactions.

That being said, we also recognize that technology is only one component of communication strategy. Simultaneously, robust education is being implemented to prepare providers and front-line teams with evidence-based empathetic communication skills training.

Q: What strategies does Northwell have in place to manage patient experience in the fall, when the pandemic will collide with flu season?

SG: COVID reinforced how important it is to remain flexible and optimistic, communicate often and to keep patients at the center of everything we do. The reality of our systems and resources being stretched due to flu season and potential COVID surge is something we are actively planning for each and every day.

From a digital patient experience perspective, we're strengthening our ability to communicate not only with patients, but also with loved ones who may be caring for them. We've expanded our telehealth offerings and are working to make it easy for people to book and launch virtual care for themselves and their family. We are also looking at how text messaging can help manage the flow of people coming into our clinics and doctors' offices to help maintain safe distancing.

There is also a lot of energy being placed into the thoughtful integration of the digital communication, telehealth, engagement, self-service and artificial intelligence solutions mentioned above. It is vitally important that these solutions be complementary, not redundant, and deliver a frictionless and seamless experience to patients, families, providers and care teams. [We are] stockpiling essential supplies, leadership teams are performing mock command center drills, technology devices are being prepared for bedside utilization and staff are undergoing cross-training so they can be quickly redeployed, if needed. [We] have been focusing on further refining and improving upon patient experience-based programs and processes we initially adopted at the height of the pandemic.

Q: How is Northwell planning to ensure caregiver well-being over the next year? What did you glean from the initial surge?

SG: Caring for our over 70,000 healthcare professional caregivers must remain top of mind. They are the heartbeat of the organization. As leaders, it is our profound responsibility that we prioritize their wellness and well-being considering the high levels of stress, acuity and mortality they experienced firsthand.

At Northwell, an interdisciplinary collaborative established during COVID will remain active, including representation from human resources, the employee assistance program, patient experience, employee wellness, behavioral health service line, the center for wellness and integrative medicine, site and service line leadership and team members.

[Northwell employees have access to] Team Lavender, an interdisciplinary group of professionals dedicated to supporting their colleagues during times of stress and/or hardship. Leaders also receive ongoing education, guidance and toolkits to best equip them to build and support a resilient team. Team members are informed at executive town halls, stay connected through internal social media platforms, utilize child/day care offerings and are invited to partake in programs such as teaching kitchens, tranquility spaces, financial counseling, etc.

Team members can also access the emotional support call center, an internal online resource center, an on-site employee assistance program and chaplaincy support, mental health and psychiatric counseling through the behavioral service line and app-based programs. With caregiver support, there is no 'one shoe fits all,' different people need different things.

Q: What is your biggest worry for the coming year and what steps are you taking to address it?

SG: One of the biggest concerns that emerged during the pandemic was that many people delayed care (in some cases emergent care) because they feared being exposed to COVID-19. Although we are confident in our ability to maintain the safety of any patient that comes to us seeking care, and have communicated such to our communities, we understand that alternative access points to care may need to be developed and offered.

One example is our emergency medicine service line exploring an after-hours telehealth program that would run after urgent care center and medical practice hours. It allows patients to get guidance on urgent care matters, and if emergency care is required, the patient may be transferred to our Center for Emergency Medical Services or advised to go to the nearest emergency department for care coordination.

Overall, we are committed to reaffirming confidence in our communities and ensuring consistent quality and safe, world-class care. We are also working to maintain family presence and participation, as we know this is an essential component to the patient experience and the overall healing process. We continue to rely on our patient and family partnership councils for feedback, recommendations and to effectively lead our efforts through their voice and influence. Finally, we have an unwavering focus on the emotional health and well-being of all staff and team members, so they have the strength and resilience to provide the level of care that exceeds all expectations.

More articles on health IT:
How CXOs chart progress amid a pandemic: 4 leaders weigh in
NewYork-Presbyterian CXO Rick Evans: How will we rebuild trust with patients now and after COVID-19?
CMS updates patient experience star ratings: 4 things to know 


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