Why storytelling is a key part of Sutter Health's safety work

William Isenberg, MD, PhD, vice president of patient safety at Sacramento, Calif.-based Sutter Health, credits some of the system's success with its safety work to what some might see as an unconventional workplace practice: storytelling.

"You need to capture people's hearts and minds," Dr. Isenberg said of gaining team buy-in for quality and safety initiatives.

During an interview with Becker's, Dr. Isenberg discussed why storytelling is so effective and shared a recent anecdote from a clinician that really resonated with him, among other topics.

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

Question: What safety or quality initiative will take up most of your time and energy in 2020?

Dr. William Isenberg: The No. 1 challenge we're looking at now is how to deal with and understand clinician burnout. A recent study revealed that almost 10.5 percent of physicians who say they're burned out have acknowledged that they've committed a serious patient safety event within the last three months. That's really worrisome for guys like me who are responsible for the safety of care rendered by a lot of clinicians. 

You and I can both report that we're feeling burned out, but there may be very different causes for it. Here's the analogy I use with my team: If a patient comes to me with a fever, I can't just assume he or she needs antibiotics. I could actually cause more damage by prescribing antibiotics if there is another cause for the fever. We're urging all of our clinical managers to be empathetic listeners and spend a lot of time talking to their team members about burnout. Because if you don't understand the cause of burnout, it's almost impossible to fix it. 

Q: What are some of the barriers you face when rolling out a new quality or safety initiative? How do you overcome those obstacles?

WI: If you don't start with the why, it's so hard to get people motivated. We are highly focused on figuring out how to capture people's hearts and minds at Sutter Health. In fact, I think that's why our safety work has caught on so well. My team and I spend an inordinate amount of time combing through real-life events that have motivational messages to share with staff. Stories, to me, are so motivational. When you can share what one person felt and how that impacted you, it almost assuredly will motivate others and resonate with people who have dedicated their lives to healthcare.

Q: What has been one of your most memorable moments as vice president of patient safety at Sutter? 

WI: My proudest moments are when a staff member or physician embraces one of the concepts we're talking about in the workplace and applies it to their personal lives. That's how I know we're changing our culture. Less than a month ago, I got a note from a clinician who recounted a recent conversation with her 3-year-old daughter. The daughter wanted to bring her stuffed animals into her parent's bedroom so they wouldn't be lonely, even though they had a strict no-toys-in-the-bedroom rule. The clinician realized that it must've taken a lot of courage for her daughter to speak up to her, the authority figure, about someone she was worried about, which mirrors some of the safety work we're doing at Sutter.

Our trigger phrase is, "I have a concern," and that clinician heard the concern in her daughter's voice. Together, they found an alternate solution to make sure her stuffed animals weren't lonely. The clinician told me that she so believes in the work we're doing at Sutter, that she's passing it on to her own next generation. That's like gold for me to hear.

Q: If you could fix one patient safety issue overnight, what would it be and why?

WI: If I could fix one thing by snapping my fingers, it would be fixing how promptly clinicians reach the right diagnosis and institute therapy. For example, I'm an OB-GYN by training. A woman could come to me saying she's interested in birth control. I may know that the last 50 women who started on a certain pill had good bleeding profiles, but I could still pick the wrong pill for this patient. But what if I had the data capabilities to look back at the last thousand women started on this specific birth control pill who have the same medical characteristics as my current patient? Then I could ensure the patient receives the right pill from the get-go and prevent her from having to come back and see me a month later. We have 3 million patient records on one EHR at Sutter Health and a whole research institute that's working on diving into the data for insights like this.

Q: Any other thoughts?

WI: One other thing that makes Sutter Health quite unique is our health equity work. This fall, the American Hospital Association recognized Sutter as a Carolyn Boone Lewis Equity of Care Award honoree. We serve more than 3 million Northern Californians in a multitude of zip codes ranging from the wealthiest to the very poorest. We could look at our overall infection rates, or any number of conditions, to get a sense of quality performance. But as a large integrated network, we have the capability of diving deeper into our patient outcomes to see whether we achieve the exact same outcomes for Asian Americans, Hispanic Americans, etc. We won't be satisfied until every patient in every subgroup leaves Sutter Health with the same positive, high-quality safe outcomes.

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