Speaker: Hello and welcome to the AMA STEPS Forward® podcast series. We'll hear from health care leaders nationwide about real-world solutions to the challenges that practices are confronting today. Solutions that help put the joy back into medicine. AMA STEPS Forward® program is open access and free to all at stepsforward.org.
Jill DeGroot: Hey, everyone. Jill DeGroot here, producer of the AMA STEPS Forward® podcast. Today's episode was pulled from a full-length webinar moderated by Dr Jill Jin, presented by Dr Jonathan Ripp. Highly recommend you check out the full-length webinar; it also has a question-and-answer session at the end. The link to that webinar is in the episode description. Now back to today's episode.
Jill Jin, MD, MPH: Hello, everyone. My name is Jill Jin. I am a senior physician advisor with the AMA STEPS Forward® program. I would like to introduce today's speaker, Dr Jonathan Ripp. He is well-known to many of us for his great work in burnout and well-being. Currently, a professor of medicine, medical education, geriatrics, and palliative medicine, the senior associate dean for Well-being and Resilience, and chief wellness officer at Icahn School of Medicine at Mount Sinai in New York. Welcome, Dr Ripp, thank you so much for joining us today.
Jonahan Ripp, MD, MPH: Thanks so much. Really great to be with you all. Today, we'll be talking about the role of communications in promoting a culture of well-being. No doubt many of you are experiencing and are seeing in your communities that we're still dealing with a lot of challenges and the wake of the pandemic as it relates to the well-being of the health care workforce. What is a buffer? What can be protected? And that is feeling valued by your supervisors, feeling valued by your institution, reduces the risk of wanting to reduce or leave your practice. I think it's fair to say that we may be in the reconstruction phase coming out of the pandemic, but certainly reeling in many ways and almost certainly worse off than we were. And of course, there are events that occur along the way, whether it's an adverse reaction or other stressors that creep in that might lead to a setback.
So it's not just a straight recovery that we're going through related to communications during times of extreme stress of crisis, there's this curve that follows the extent of the pandemic. So if there's a pandemic wave, for example, and as the cases are going up in the beginning—very basic need, how am I going to get to work? How am I going to protect myself? How am I going to care for my family? Driver in one's workspace, uncertainty drives anxiety, and so the ability to leverage communications to address that uncertainty can be really an important and supportive tool.
And so what is the goal or the purpose of a well-being communication strategy? It's to address informational needs. Again, remember that uncertainty can drive anxiety, and so understanding where that uncertainty is, where the need for information is can really help to alleviate anxiety. It's to deliver informative messaging that reaches the intended audience. That's the key piece. That's your marketing strategy. You can have a beautifully crafted message, but if it doesn't get to folks, then it's not useful.
Provide content related to support. You want to, want to show people that you care about them and that there are supports there for them and use a tone that engenders a sense of caring. This is where I think a lot of internal communications go wrong is around the tone, which can be hard to fix, but here's a couple of sample tactics related to each of those elements of a communication strategy. So how do you enhance reach? Well, ask people how they want to be contacted. You can do this through surveys, through focus groups.
How do you deliver the right content? Well, identify champions across your communities who can help capture what the information needs are, identify what the uncertainty is so you can deliver that information or help deliver that information. And then to modulate the tone, maybe form a group that's really good at this, that's good at understanding how messages land.
So words do matter when you're developing a communication strategy, and so it's not about the individual. It's not about the individual getting themselves. Well, really when the focus is on the system, it's important to use terminology that you define and highlights that. So that we're all speaking the same language when we're communicating. That should be the output of a well-being communication strategy that you're able to show through actions and words that you care about the workforce, thereby enhancing the culture of well-being.
Dr Jin: Thank you so much, Dr Ripp. So many key points. As we're all aware, there are so many ways to get ahold of physicians these days, so whether it's email, text, paging, cell phone, regular phone, Teams messaging, Epic Chat, these communication channels are meant to make it easier to reach physicians, but also leads to redundancy in communication, fatigue. From your leadership perspective and experience, have any best practices for addressing all these communication channels?
Dr Ripp: Yeah, it's a real challenge. I think your question relates directly to the idea of creating a well-being communication strategy from the standpoint of how do you reach a workforce that is being overreached, so to speak, that is being contacted in so many different ways. I think internally we owe it to ourselves to create some hygiene, for lack of a better word around that to decide, to come up with standards upon which we will or will not be reached. Increasingly, you're seeing this happening. For example, you'll see there's some strategies that we employ at Mount Sinai where we suggest, for example, that if it's not an urgent message, it doesn't need to be sent outside of work hours. So one strategy you can take is limiting the time during which messages are sent.
Those people who use best practices limit the times that they send emails or suggest that they don't need to be reached out of normal hours. That's all left up to the individual groups to decide how they want to do it. We need to push the culture further so that it becomes standard practice. And that means creating operational policies at the system level. This has to be a partnership with your marketing and communications colleagues who are expert in that.
All of us who are involved with the electronic health record inbox have been inundated with messages and there are models where you can get rid of the stupid stuff. I'm sure some of you are familiar with that. Ways to just eliminate small things that are getting in the way that are those daily annoyances, multiple clicks to get certain things done when you're ordering in the computer or messages that maybe never need to come to you in the first place. It's not about solving every large problem all at once but being able to listen to folks and then acting on their small requests.
Dr Jin: Thank you. We talked about the underlying message always being we care, but how do you maintain as a tone of being genuine and authentic?
Dr Ripp: What about tone? Well, here's a great example.
“Dear Staff: A recent audit has brought to your attention that there is wide variability in the time between patient visits and the completion and closure of documentation. Timely closure is an issue of quality of care and compliance with billing. We have recently instituted a new policy. All charts must be closed within 24 hours of patients being seen. The full policy can be found in a policy handbook. We thank you for your understanding of this important new requirement.”
So the point here is that well-being communications and a communication strategy, it's not just about sending messages that are messages of support. It's about infusing all messaging with a tone that is thoughtful to the way in which it's going to land. And so this may be a necessary message, this may be a requirement, but the way in which that requirement and the message is the tone of that message is crafted can really make a big difference in terms of how people feel cared or not cared for.
It's easy to get this message wrong if you're communicating with a component of the workforce that work environment is short-staffed. Maybe they're feeling like they're not being compensated the way they should be, or they see peers at other institutions being compensated differently. If you come in and say, “Hey, we care about you.” And you don't address those issues, that's going to, at best, fall flat and at worst, backfire. It's really about knowing your audience. And so if your audience has real significant efficiency, operational concerns, then the message... The best way to say we care is by saying, “Tell me about what your challenges are and I'll see what I can do to address them and fix them.” That delivers the message we care, which is very different than saying, “We care about you.” Because if you say, “We care about you” and you don't address the things that are really negatively impacting one's work experience, then it's going to fall flat. It's going to backfire. It's not going to be useful.
Many of you may be familiar with AMA STEPS Forward® module to LISTEN-SORT-EMPOWER that Steve Swenson authored, creating a system where you enable folks to not only be heard, but also a space where their needs can be acted upon. And this model, which is called LISTEN-SORT-EMPOWER, also talks about how to, when you start to listen to people and you start to hear what their needs are, there will be some that have low impact and low feasibility you just won't be able to do. You can't get those done, but there'll be some that are highly feasible and highly impactful. That's your priority 1. Those are the things you want to do right away.
And the point being is that you're not just thanking people, you are listening, you are sorting what can be done in your empowering action. Good communication strategy will also manage expectations. You have to figure out how to communicate that you're not going to be able to do everything that everyone wants, but, and then the critical, that last step, the last mile, is circling back and saying, “We heard you. Your needs were clear, and we were able to address some of them, and here's how.” And I think that extends beyond pandemic and crisis periods. That's the base of what I believe well-being communication strategy for an organization needs to deliver.
Dr Jin: Thank you again so much, Dr Ripp, for all your expertise in this new area of focus and of research. Thank you all again for joining us, and we hope to see you again soon.
Speaker: Thank you for listening to this episode from the AMA STEPS Forward® podcast series. AMA STEPS Forward® program is open access and free to all at stepsforward.org. STEPS Forward® can help put the joy back into medicine by offering real-world solutions to the challenges that your practice is confronting today. We look forward to you joining us next time on the AMA STEPS Forward® podcast series, stepsforward.org.
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