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In Change Management, High Stakes, Kaleidoscope

Vaccine Case Study: Understanding and Encouraging the Reluctant

Aerial view of a city

The pandemic has rocked California. And Cedars-Sinai provides care for over a million people annually across 40 locations in the incredibly diverse Los Angeles area.

Today, as vaccine distribution is underway, Cedars-Sinai is faced with a common challenge: how to encourage vaccination among Black and Latino communities.

We asked Dorian Harriston, associate director of brand strategy, to explain how Cedars-Sinai is tackling this challenge. The answer lies in the organization’s longstanding commitment to community partnerships.

photo courtesy of Cedars-Sinai

Jarrard Inc: The issue of vaccine hesitancy among the Black community is well-documented and something many providers are struggling with right now. What does it look like in Los Angeles?

Dorian Harriston: Vaccine hesitancy appears to be as prevalent here as anywhere else – especially in Black and brown communities.

From my experience, the level of education, income or job doesn’t factor into whether an individual is hesitant to get the vaccine. It’s a deeply rooted effect of historical medical mistreatment that has caused distrust. I hear the same things from family and friends as I do on social media and even colleagues in healthcare: People are afraid, and the conspiracy theories and misconstrued testimonies posted online are not helping. This is a serious issue.

How is Cedars-Sinai addressing the hesitancy?

We’ve prepared an overall strategy to strengthen our relationship with these communities. It starts by partnering with organizations that cater to the needs of Black and brown communities. We hope to be a true partner, amplifying their messages and providing support – and not just monetary support – to increase and sustain resources while conducting outreach to show commitment to our community.

What does that strategy look like in practice?

Initially, we’re doing a series of virtual talks and engaging faith, community and healthcare partners to discuss the issue in various formats. We’re enabling our clinicians and researchers to answer FAQs and attempt to ease fears by responding with facts.

We have to be honest about barriers that cause hesitancy to address them and help determine culturally relevant and satisfactory solutions. Transparency, honesty and commitment are paramount to changing longstanding thoughts and behaviors. We need to regain the Black community’s trust, and we must prepare for a long-term commitment.

Talk more about the role of your team members.

It’s essential that we take as much care internally as we do externally. We’re creating internal conversations around vaccine hesitancy and trust, taking the time to tackle this initiative collectively because it affects all aspects of the programs and services we provide as an institution. Employees must be ambassadors that carry factual and positive messages to their circles of influence. It will take a village to make headway.

How is it going?

We’re just getting started. The first step is to find out what Black and brown communities want and need. We’re doing this through our partners and stakeholders. Partnership is the key to expanding outreach and ensuring the message is reaching every audience within these communities. We need to communicate with influencers – whether that’s the internal family circle (caretakers responsible for multi-generational households, children that bring new information and technology, etc.) or external relationships (faith leaders, clinicians, community and civic leaders and friends). Organizations have provided what they believe this demographic needs for far too long without doing the research to back it up. We want to be sure we are addressing needs in a way that helps build trust and establish a consistent path to preventive care.

Healthcare is local. How do you, as a large system with a significant geographic footprint and diverse patient population, present messages that will resonate with each community while remaining consistent across the system?

The pandemic has forced our team to review our current practices for efficiency and align messages across channels. I see us working together more as a team due to COVID-19 than before the pandemic. Although we have a lot more meetings, being able to divide and conquer and form special project teams has allowed us to refine our messaging and reach a larger audience while promoting significant but often overlooked areas – in particular, research, education, and community engagement. These areas create a trifecta with clinical care vital to defining needs, breaking down barriers to vaccine acceptance, and promoting health equity. We also want to ensure that Black faculty and staff are included and visible so that these communities know there are people who look like them working on their behalf.

What advice do you have for other providers? Are there best practices that that apply across the board?

  1. It’s important to align strategy around your organization’s health equity and diversity and inclusion goals. Creating tactics is easy, but it’s essential to have a definitive strategy that speaks to who the organization is and provides a roadmap to inclusively provide for your community’s health.
  2. Ensure that your communication is honest and transparent. There’s no shame in admitting you don’t have a piece of information or don’t know something. Also, remember that one message may not be sufficient. There are varied audiences within each targeted demographic, and having a single message isn’t enough. Having multiple messages and communications vehicles could be the difference between being heard or ignored.
  3. Before beginning any outreach, know that there are no quick fixes. If your organization isn’t willing to invest budget, time and resources, don’t proceed. To battle the distrust and inequity that Black and brown communities have experienced, you must consistently engage and work to understand unique needs, health disparities and cultural norms. Have BIPOC (Black, Indigenous and people of color) on your team or as advisors to vet advertising and messaging and provide communication vehicles such as unique media outlets and preferred ways in which the target demographic seeks and digests information. One wrong message or misstep could injure an already fragile relationship with communities of color.
  4. When crafting a call to action, ensure you have the capacity and resources to engage and execute in a manner that will make it easier on your audience. Right now, individuals are afraid, anxious, angry and burned out. Anything that appears to be unclear or complicated will cause frustration, dismissal and possibly a negative perception of your organization. Ensure that your strategy allows for flexibility and resources that will help everyone within the community – even if you cannot provide those services.
In Change Management, High Stakes, Kaleidoscope

First in Line? No, Thank You

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Why Your Vaccination Communications Must Attune to Justified Reluctance of Black Populations

Nine months into the pandemic, it’s clear that Black people are suffering disproportionately from COVID-19. Now, on the verge of emergency use authorization for Pfizer’s vaccine, providers and government agencies are working urgently to determine who will receive it first. As plans are laid to prioritize and execute vaccine distribution, healthcare providers are well-served to step back and consider how they will address the reluctance of their own staff and their patients of color to get the vaccine.

Assuming Black healthcare workers and patients will want to be first in line for the vaccine is a flawed approach, according to Rick Smith, president and CEO of United Way of Ross County in Ohio, vice president of Advancement and Engagement at the Northern Pennsylvania Regional College, Warren, PA, and a seasoned communications strategist who’s served in senior roles at several prominent health systems.

Smith maintains that when it comes to being first in line for a vaccine, some African-Americans hear this: “You’re going to be the first because, once again, we want to experiment and see how it works. Once we’ve seen the results and tweaked it, then the rest of the population will get their vaccine.”

To that, their reaction is “No, thank you,” Smith said.

“That’s what society has engrained in that segment: We’re your guinea pig,” he added.

As healthcare provider organizations begin to develop their vaccination communication strategies, they need targeted and particular outreach – internally and externally – to reach and better serve Black populations who have been harmed by health researchers and providers in the past.

Jarrard Inc.’s national consumer survey revealed striking disparities in who is likely to get a COVID-19 vaccine, once available.  The results showed that 36 percent of Black respondents reported being extremely or very likely to get a vaccine compared to 57 percent of white respondents. Black respondents also reported lower levels of trust in hospitals, nurses and doctors.

Those results didn’t surprise Smith or Dr. Pam Oliver, Novant Health’s executive vice president and physician network president in Winston-Salem, N.C. and a practicing OB-GYN.

“Our African-American and Latinx communities are extremely vulnerable to disinformation campaigns because they don’t trust who we would say they should go to,” Oliver said. “They may not trust physicians. They may not even trust us, as African-American physicians, because now we’re part of ‘the system.’”

Smith said these disparities are driven by “a history of mistrust,” – alluding to decades of appalling mistreatment and atrocities the medical community has inflicted upon Black people in the U.S., particularly with experimental treatments.

Henrietta Lacks. The Tuskegee Syphilis Study. Cincinnati radiation experiments. These outrages are contemporary, modern tragedies, Smith said.

“A lot of people want to put their heads in the sand, saying that was so long ago and it doesn’t mean anything now. But these are real issues, and we’ve got to start to combat them head-on,” he said.

Further, these infamous examples don’t even account for everyday experiences Black men and women encounter within our health care system. For example, studies have demonstrated that Black women are often not listened to when reporting signs of complications and one-quarter of Black women reported disrespect and abuse from medical professionals in the hospital.

As healthcare provider organizations enjoy overwhelming trust among the public and a politicized battle over the COVID-19 vaccine looms, there’s work to do to overcome barriers to trust among minority groups. To do so, healthcare organizations should bear in mind:

Educate yourselves first to repair trust

Smith and Oliver agree that deeply educating leaders and internal teams is a crucial first step. “A public, open acknowledgement of where the opportunities are and the history is important,” Oliver said. Smith agreed: “There has to be a coming together to first be educated on the history of mistrust and abuse that one body of people have had most often at the hands of others. There is a mistrust, and here’s why.”

Communicate internally first

Doctors aren’t the only ones who interact with patients. Front desk staff, nurse aides and lab techs also need to be consistently prepared with your organization’s message on COVID-19 safety and vaccines – as they also interact with patients. To gain the trust of all patients related to vaccines, “a thought-out, thorough internal communications process needs to happen with these folks first,” Smith said. Oliver added that people should feel empowered to openly ask questions.

Don’t go it alone

While doctors do enjoy the highest level of trust among the general population (53 percent) and among the Black population (45 percent), provider organizations need to push beyond their own spokespeople – meeting people where they are through partnerships with community organizations and groups like historically black fraternities and sororities, Smith said. For instance, one of Jarrard Inc.’s large health system clients works with a network of 80 churches to reach underserved populations. People who are already trusted in the community should be visible and vocal, Smith said. As we say at our firm, “The messenger is just as important as the message.”

Start communicating early and transparently

While it’s true that no one knows when a vaccine will be safely and widely available, health systems need to start building trust and credibility on this issue now. For Oliver, that means being open and candid with internal teams about how vaccines were evaluated and identified and about any potential risks. Even if you don’t have all the answers – no one does! –transparency and openness are key. “If we wait to start communicating when we have a vaccine, it’s too late,” Smith said, adding that systems must proactively devote extra effort to reaching underrepresented communities.

Make a real commitment to meaningful action

To foster trust, Smith said, “People need to see themselves reflected in the organization.” “When African-American patients come into the room and see no one who looks like them telling them the benefits of the vaccine – there’s going to be a hesitancy,” Smith said. All organizations will benefit from a concentrated effort to diversify their workforces at all levels of the system. When it comes to regaining the trust of marginalized communities, “We can’t just tell people they should trust us because we have their best interests at heart,” Oliver said. “We have to find ways to show it.

About the national consumer survey

In partnership with Public Opinion Strategies, we conducted a national consumer online poll of 1,101 adults between July 31 through August 3. The demographics of the respondents included a representative sample of our nation in terms of gender, region, urban/suburban/rural. This was the second survey conducted in response to COVID-19 with the first occurring in April of this year. Both surveys were designed to assess the lay of the land for providers by measuring public sentiment on topics including telemedicine, federal funding, mask wearing, vaccines and provider trust.

About Kaleidoscope

At Jarrard Phillips, Cate & Hancock, we recognize the power of diversity in shaping perspective, generating awareness and leading to long-term sustainable change. This pertains to our own culture, as well as the work we do on behalf of our clients, most of whom serve diverse communities. Through Kaleidoscope, we hope to use our gifts to do good to drive toward action, broaden perspectives and be more inclusive. We acknowledge that as communicators we are better and our work is stronger when we consider all backgrounds and perspectives. We deeply value diverse viewpoints reflective of our communities and believe that only by seeking out and learning from these diverse voices are we able to perceive the world through the eyes of others. We will use our words, wisdom and resources to help our clients build a better healthcare community for the populations they serve and the teams delivering care, all while striving to eliminate racial disparities and being inclusive of all.

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In Change Management, High Stakes, Strategic Positioning

Part 2 – The New Healthcare Marketing: Precision-Based Execution

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In an earlier post, nationally recognized healthcare marketer Reed Smith teased the need for healthcare marketers to drive engagement through precise targeting. Smith is a 20-year veteran of healthcare marketing and digital innovation who serves as Jarrard Inc.’s vice president of digital strategy. We asked him to get deeper into what precision-based execution means and some specific tactics for giving it a go.

Jarrard Inc.: Explain what you mean by precision-based execution

Reed Smith: It’s about avoiding broad digital marketing campaigns. Of course, sometimes you do need to go broad with, say a general brand awareness campaign. But for the most part, when you’re thinking about service line marketing, service line growth or patient acquisition, you need to be going after very specific people. And some of the typical approaches – like running radio ads – may not make sense.

JI: Has the need for or anything about this rifle approach changed over the past few months?

RS: The last eight months have created some interesting nuances. Think about the flu shot. We’re focusing on everyone getting a flu shot going into the winter, so that’s tens, hundreds of millions of people who need it. But providers can still be very specific about the messaging they’re using. It’s not, “Hey, everyone needs to get the flu shot.” It’s differentiating between and speaking directly to moms with kids at homes or empty-nesters or teens.

All of that is going to weigh into where you get the shot, the message that you hear convincing you to get it, the medium used to deliver that message – is it a video or a photo an ad on the local public radio station?

JI: We also know the messenger is critical. How do you combine the right precision-based message with the right messenger?

RS: With digital tools, we have a true opportunity to bring that message to the right people via the right messenger in fairly straightforward ways.

People want to hear from physicians, nurses, therapists, APPs and other caregivers. Once provider organizations have identified those people, digital channels lend themselves to expertise and thought leadership. Think about all the live content we see on Instagram or Facebook or YouTube. People are already accustomed to these types of environments because they’re already doing webinars and taking to other leaders through Zoom.

JI: But are people going to see that content?

RS: Historically, we’ve seen mediocre organic performance on social channels. Healthcare marketing has had to push pay-for-performance if we wanted anyone to see our content. But a side effect of COVID-19 is that we’ve gotten a lot more traffic to our sites because people are looking for medical information they can trust, and providers have been sharing it. We’re seeing a wave of organic traffic. Now we need to leverage that opportunity.

JI: Whether a provider feels behind or keeping pace with digital, how do they grab the opportunity you just mentioned? For example, do they just start doing Facebook live or take a more measured approach?

RS: Historically I’ve been a heavy proponent of “proceed until apprehended.” But it’s important to put some nuance on that. When it comes to digital marketing there’s value in trying things out, beta testing new approaches to figure out how useful they’ll be. You mentioned Facebook live. It’s hard to understand the ins and outs and how useful it’ll be without just using it.

But ultimately, you need to think through a strategy and a plan before you get too far down the road. Healthcare marketers need to answer the question about what a new tactic means for the organization – both strategically and tactically. The other issue to keep in mind is the politics. “If I do something with one physician, does that affect another physician?” Overall, though, if you have an understand of what’s going on across the organization and have built enough credibility to get permission to test and tinker, it’s great to get into the lab and figure out what works.

JI: What else have providers learned over the past few months?

RS: What I’ve found interesting is the expectations around virtual care and other alternative delivery methods. We’ve talked a lot about telehealth and how people have experienced it and loved it. But think, too, about drive-through testing for COVID-19. That’s all in place so drive-through flu shots wouldn’t be a stretch, right? So, organizations have an opportunity because the baseline has been reset.

If you want figure out how your organization stacks up when it comes to digital maturity, check out our 28-question, 15-minute Digital Maturity Survey. You’ll get a complimentary scorecard and benchmark against industry averages.

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In Change Management, High Stakes, Strategic Positioning

The New Healthcare Marketing: Measure Twice. Improve Once.

Measuring tape displaying 7 inches on a granite countertop

We’ve long said that measurement is one of the consistent deficiencies we observe when it comes to healthcare marketing. We’re typically referring to marketing analytics – reach, engagement, reputation, etc. when we say that. But what really needs to happen is that we measure, well, everything.

Providers today must have a baseline understanding of where they are today so they can either consolidate recent gains or make adjustments based on existing deficiencies (or both). A recent McKinsey study suggests that adoption of digital tools by consumers and businesses has vaulted forward five years in just a few months. It’s happened in healthcare, largely with telehealth. But we have to go deeper. It’s not just spooling up new platforms. It’s ingraining digital thinking into the organization’s psyche, getting buy-in from leadership, making targeted investments in tools and people, and yes, measuring the crap out of everything.

It’s also about setting expectations for what digital thinking can do for healthcare providers. This is where providers are lagging. In our conversations with clients and friends from a variety of healthcare provider organizations, we’re repeatedly hearing that people simply don’t have a great understanding of what the expectations for digital are or should be.

To set those expectations, you have to be able to show what digital can do for your organization. But it’s hard to show what digital can do without having the infrastructure in place to do it.

The fix? Instead of going for the homer, swing for singles and doubles with things like:

  • Listing management
  • Scheduling tools
  • Patient portals
  • Chatbots for frequently asked questions

These are all easy to identify. Not always simple to execute, but manageable. For example, since you want people to find the right information when they search for you online, start with that foundational piece. And if you want people to schedule care at their (and your) convenience, look at online tools.

Let’s be clear: This isn’t optional anymore. Since March, the pandemic has forced providers to get those foundational pieces in place. So much care moved online during the pandemic, and we’re still waiting to see what the new equilibrium looks like. As patient expectations have shifted even more towards digital options, providers desperately need to invest in getting the basics right – even though doing so will take some work.

Aside from being the right thing for patients, it’s important for marketers to think big but act small. You need to know what marketing can do for your organization and what digital tools can do for your marketing. That’s the big thinking. But none of that can happen without the day-to-day execution. Ultimately, it’s about people. It’s too easy to get lost in some of the bigger ideas, which just leads to frustrated consumers, distracted marketing teams and dead ends for everyone. Realistically, we have to focus on connecting with narrow groups of people, driving engagement and helping them find solutions to specific needs.

That’s where precision-based execution comes in. More on that soon.

In the meantime, if you want figure out how your organization stacks up when it comes to digital maturity, check out our new 28-question, 15-minute Digital Maturity Survey. You’ll get a complimentary scorecard and benchmark against industry averages.

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In Change Management, High Stakes

You Are What You Eat!

A paper towel with measuring cups and spoons sitting on top

Four Ways to Feed the Health of Your Employees and Your Health System

I love whole foods and can eat veggies nonstop. My body returns the favor with loads of energy and the endurance I need to focus and get through the day. But like so many people, when I’m busy and overwhelmed, the first thing I neglect is my health. Whether it’s eating junk food, ignoring the treadmill, or feeding my soul useless thoughts and doubting self-talk, I begin to suffer from a lack of self-care and concern. I get sluggish. I become lazy, unproductive and feel empty and uptight.

Oh, the irony.

The same is true for the health of your health system. Regardless of today’s stressors – the immense pace of change, technology, your race to improve HCAHPS scores and reduce hospital-acquired infections – at the end of the day, healthcare is still a people business. What you feed your employees is reflected in your patient experience scores, reputation, revenue and even the state of your bricks and mortar.

These four ingredients provide the immediate nourishment your employees and organization need to stay healthy and productive:

  1. A cup of curiosity – Research shows that curiosity is vital to performance. Fostering an environment of curiosity in the workplace, while showing genuine interest in your people, is essential. As humans, we crave attention and long to know that someone cares. The simple act of asking questions to learn more about your employees meets this basic need and leads to better engagement and higher levels of productivity.

But take it one step further. Look for opportunities to create time and space for curiosity each day. A great way to begin is by asking leading questions before interjecting your ideas or the outcome. Be willing to pause, listen and acknowledge when you don’t know the answer. This vulnerability establishes trust and connection.

The bottom line: Curiosity helps us think more deeply and sensibly about decisions. It also improves collaboration, fuels innovation and creative solutions to complex challenges, while strengthening our ability to adapt to change and pressure more quickly.

  1. A tablespoon of collaboration – Employees need to have a voice; it’s critical to their health. When you create an environment that honors and supports two-way dialogue and communication, employees are happier, more collaborative and productive.

Fostering collaboration lines up closely with fostering creativity. Do a pulse check during your next meeting. Ask questions and call on people to share their thoughts and ideas. Consider calling on people by name, or saying, ‘We’ve covered our agenda, what else is on your mind?’ to draw input from those who may not have spoken. Rotate who leads your daily meetings. Ask everyone to share a win from the week. Also, from time to time provide an outlet for anonymous opinions through a dedicated phone line or online pulse poll.

The bottom line: Outlets for expression foster an environment of innovative thinking, improve teamwork and promote a healthy balance between new ideas and the tried-and-true.

  1. A dash of recognition – The majority of employees aren’t solely motivated by their paycheck. A study in Harvard Business Review revealed that 87 percent of employed Americans don’t feel they’re recognized enough, and 40 percent admit they’d work harder if they were recognized more.

Do you recognize your people? Not the “great job” recognition, but the “I see you and know who you are” recognition. Do you know their names, where they work, what they do and how they like to spend free time? I worked for a CEO who insisted on access to photos, names and job titles of everyone working in the hospital. He cared so much that he could call every person in the building by name when walking the halls. He even studied the surgical services’ roster before walking into the unit. This paid huge dividends when nurses on the unit were recognized and called on by name by the CEO.

How are you recognizing your people?  Healthcare workers were some of the most celebrated heroes in the early months of the COVID-19 pandemic. As time has passed, the fanfare has quieted, and for many, it’s now business as usual (or as much as it can be at this moment). With burnout and PTSD at all-time highs for healthcare workers and leaders, it’s more important than ever to keep recognizing your people. The best appreciation is honest and authentic. Take time to write a thank-you note and mail it to an employee’s home. Strategically place sticky notes on employee’s cars. Give public thanks in a group setting when it makes sense, or buy coffee for the nurse in line needing it to get through his shift. And don’t forget your leaders. They carry a heavy burden to ensure employees are engaged. They need to know they’re doing a great job as well. Consider delivering a meal to their home or create a leader award to recognize leaders at all levels of the organization.

The bottom line: Only one-third of U.S. workers strongly agrees they’ve received recognition for doing good work in the past week, and employees who don’t feel adequately recognized are twice as likely to say they’ll quit in the next year, according to Gallup. That’s a high price for something that doesn’t cost much.

  1. A pinch of possibility – Employee development and growth opportunities are critical to the health and viability of your health system. We know it’s less expensive to retain quality employees than to find new ones. Demonstrating there’s a future with your organization keeps employees engaged. Tuition reimbursement, leadership development training, online classes and access to webinars goes a long way in developing your team. It helps you remain competitive, reduces turnover, increases productivity and equips your people for the future.

The bottom line: There’s a correlation between engaged employees and development opportunities. A Quantum Workplace study found that 72 percent of hostile employees feel they receive too little training, compared to 43 percent of engaged employees. Competition for healthcare talent is only going to become more fierce, a pinch of possibility sweetens the pot.

It sounds so simple: “Feed your insides well and you’ll shine on the outside.” The reality is, it takes time, energy, effort and intense focus to deliver a five-star experience that will set you apart from those who are starving for great health.

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In Change Management, COVID-19, High Stakes

Hope Is Not a Strategy

A group of masked surgeons huddling and hugging in their medical uniform

While times of challenge and change are not new, none of us can confidently or reliably predict when the hurricane we’ve been living through for more than six months will end or the exact toll it will take on our personal and professional lives. Without that crystal ball, we plan as well as we can and then hope for the best.

A few years back, I had to laugh when a colleague declared that “Hope is not a strategy” after a thoughtful, proactive crisis plan we put together was killed by a “Let’s just hope, wait and see” leader.

As healthcare providers, we understand the power of hope even as we practice the science of medicine. When hope takes root, our strategies take flight as they are no longer just words on a page, but deep-seated ideas that are lived out in the minds, hearts and actions of our people and organizations. It’s that emotional connection that makes strategies and tactics effective. Facing today’s uncertainty, hope should be a catalyzing element of the strategies we create to keep people positive, resilient and moving forward together.

Consider these seven ways you may be inadvertently signaling that your organization’s strategy and future are hopeless—plus some smart countermeasures to combat the perception.

  1. You stop listening and start assuming. Your patients and employees desire for you to genuinely listen to them. Open the door to dialogue through pulse surveys, virtual town halls and focus groups. Reinvigorate your Patient and Family Advisory Council virtually and encourage managers to conduct one-on-ones with employees using a defined set of questions. Ensure the plans you’ve made align with the needs of your stakeholders.
  2. You lay aside your mission and undermine your values. While hope is necessary, it alone is not a strategy. Before announcing change, ensure your leadership team can articulate how the change will help fulfill your mission long-term. If a decision seems to conflict with your values, lean into the tension and discuss why it’s the right course. Proactively addressing tension helps people respect your reasoning and willingness to make tough decisions, even if they disagree with it.
  3. You underestimate the impact of change. This is a common mistake that can have severe consequences as people in our organizations concurrently face unprecedented (yes, I said it) challenges at home and at work. It’s more important than ever that leaders emphasize partnership over power and demonstrate they genuinely care about employee well-being. By listening, collaborating, making change more manageable and tying it to your mission, you will strengthen resilience and ensure your team has the bandwidth to make change happen. Be upfront about challenges you are facing, ask departments to come up with solutions and remain supportive by following up with a check in on how things are going.
  4. You create a steady drip of negative news. We all know the only thing worse than ripping off a bandage is removing it slowly. Organizations often get too clever in an effort to minimize negative perception and mitigate the impact of tough news. “We’ll announce layoffs next week, benefits changes in two weeks, service-line closures in October, cancellation of our expansion by Halloween…” Drip, drip, drip… Before long, employees come to believe that every communication from leadership will contain negative news. They’ll dread coming to work. When possible, consolidate tough changes into one announcement tied to a compelling strategy and vision – despite the unpleasant process. You don’t have to have all the details to do this. In fact, this type of announcement is the perfect moment to say, “We will partner with our employees, providers and leaders over the coming weeks to implement these changes in a thoughtful way.”
  5. You fuel speculation. Vague or infrequent communication leaves room for anxiety and rumor to grow. If employees or the community sense a scurry of activity among top leadership, chances are they will invent a reason that is likely worse than reality. Instead of pretending that all is well or avoiding communication, be responsibly transparent. It’s usually better to say what you do and don’t know than to let rumors and fear take over. If you can’t answer or don’t know, share what you can answer and do know, as well as what won’t change.
  6. You emphasize money and ignore the recognition gap. Money is usually not the primary reason people want to work in healthcare. The majority want to make a difference and also care for their families. Change challenges morale, so one of the best ways to protect it and foster resilience, trust and pride is by focusing on the recognition gap. Research shows that leaders believe they give recognition far more than employees perceive receiving it. Recognition has to start at the top, and it has to be a priority. Focusing on wins and encouraging those you lead won’t eliminate the sting of no bonus or annual pay raise, but it will help.
  7. You take the community’s support and trust for granted. Beyond your employees, your community is your best asset in solving challenges. And trust is the key to your relationship with the community. If you blindside people with tough news, make decisions that seem in conflict with your values or have a workforce that is actively speaking out in a negative tone, you very well may lose trust and find yourself worse off. Maintain community support by sharing regular updates, talking openly about the implications of external factors like COVID-19 and change in the industry. And, ensure your employees have the information they need to be ambassadors in the community.

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In Change Management, COVID-19, High Stakes, Strategic Positioning

Lights, Action and the Theater of Safety

The inside of an empty vintage theater

Now is not the time to be subtle.

Fear of the novel coronavirus is as intense as it was this spring. Almost 80 percent of people are afraid they or someone they love will get COVID-19, according to a national consumer survey Jarrard Inc. recently fielded in August.

To be blunt, Americans just don’t feel safe. When we asked how safe they’d feel seeking medical care, the answer was, basically, “Not very.” Whether a doctor’s office, hospital, outpatient surgery center, ER or urgent care center, people rated their feelings of safety no higher than 5.8 on a 10-point scale. (If you’re wondering, urgent care rated the lowest at a 5.0). One in four people rated their feelings of safety at a three or below in our August survey. Not good.

And not much better than the results we received in our first consumer survey back in April.

It seems we have lost some momentum.

Think about it. When providers started reopening services this summer, the entire industry was talking about what people needed to hear from provider organizations. Everyone knew about safety concerns. But what seems to have happened is that too many providers created the safety messages, checked the box, reopened their facilities and said, “We’re good to go.” And with volumes coming back, it seems like it was successful.

Digging deeper, though, that strategy doesn’t appear to have worked. Our August survey asked how long people would wait until seeking various types of medical care. Short answer: Unless they really need it, they’re probably not going to come back for around six months, maybe longer. That’s also no better than in April.

What we need, right now, is a bit of theater.

Theater, not because it’s fake. But because it’s visible, clear, obvious. And it makes you feel something. Because people want to see, hear, smell and feel what you’re doing to keep them safe. We asked people what they need to help them feel safer interacting with healthcare, outside of a major decline in COVID-19 cases or a vaccine. Their top answers were:

  • Screening everyone as they enter a medical facility.
  • Masks on everyone.
  • Enhanced cleaning procedures.
  • Isolating COVID-19 cases somewhere else.

In a vacuum, it would be easy to lean back and think it’s okay to stop your entry checkpoints. The CDC says it doesn’t make much of a difference, so why do it? Two reasons.

First, when it comes to healthcare, we know that people don’t seek out information until they need it. People aren’t thinking about the safety messages you put out two months ago. You have to keep those safety messages top of mind. You have to make sure your website and social channels still have information about what you’re doing to keep people safe.

Second, people want to see activity. They want to be a real-time witness to your extensive precautions.

The key point is that there’s a difference between actual safety and how people feel about safety.

Yes, you have to provide safety – this is theater, not a Potemkin village. That means going above and beyond, not stopping at “just enough.” Whether the CDC says temperature checks are effective or not, seeing those checks provides a feeling of safety. So does seeing environmental services wiping down public areas and front desk staff saying, “Here’s a pen that I’ve just sanitized for you.”

Now take a step back. The theater of safety should start even before someone gets to that temperature checkpoint. Providers need to be showing how they’re keeping people safe, so that they feel safer about making an appointment in the first place. That means resisting the urge to demote safety information on your website. Keep it front and center. And the same goes for social media. Proactively share safety measures when people call to schedule an appointment. Even though it’s added work for your scheduling and nursing teams, there’s a lot to be said for continuing those pre-appointment safety calls. In our observation, those brief calls have helped patients realize, “Hey, they’re thinking about me. They’re working to keep me safe.”

All of those things create the theater of safety.

It’s a little cliché in the “consumerism of healthcare” and “patient experience” worlds to point to other customer-facing industries for examples of what healthcare could/should/would be doing. But other industries are creating the theater of safety better than we are. Consider these examples:

  • Southwest Airlines is doing a fantastic job. They’ve just informed customers that they’re keeping the middle seat open through at least October 31. When you board a Southwest plane today, you can literally smell the cleanliness.
  • Savvy grocery chains like Trader Joe’s have stationed an employee at the store entrance who hands you a cart and says, “This has been sanitized for you.”
  • Even actual theaters – movie theaters – are reopening and publishing extensive plans and guidelines. So far, it looks good on paper. The proof will be when we walk in and can enjoy the full two-and-a-half hours of Chris Nolan’s latest masterpiece. (I’ll be there this weekend.)

Know that this can be done – and really must be done. In the end, it’s a great opportunity for healthcare providers to reframe their thinking and keep a good thing going. After all, the show must go on.

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In Change Management, COVID-19, High Stakes, Strategic Plan Pivoting

Of tightropes and treading water: Winning strategies of today’s successful healthcare leaders

Man balancing on a tightrope, displaying only below his knees

You’re still performing a high wire act of balancing the needs of your patients, doctors, nurses and staff.

You’re likely feeling deep fatigue and yet, because of your sense of purpose and mission, wanting to do more. That’s a challenging spot to be in. Yet the reality is, you and your teams have done so much.

You’ve saved lives. Many of them.

We know focusing on that daily tightrope of operational demands can make it hard to look forward to tomorrow’s strategies just paces ahead. Or to acknowledge and celebrate the victorious small steps along the way. Or to provide the physical and emotional support your team craves.

It’s no secret that fatigue and stress can lead to tension, even in the best relationships. That’s something we’ve observed at Jarrard Inc. through our client work and our recent national survey. Fact is, healthcare workers and those living with healthcare workers are a bit less trusting of hospitals than the general public, and even feel slightly less safe in healthcare settings. Surprisingly, a notable number (40 percent) is reluctant to get vaccinated when one becomes available.

Sounds concerning. And it is, especially knowing that the fall likely brings a flu/Covid-19 combo. But what this information really points to is a clear, compelling opportunity to strengthen your relationship with your incredible doctors and nurses. Because they need the attention.

Here are four suggestions – two tactical and two philosophical – for doing just that.

Double down on listening.

Ensuring your team feels supported means talking with them about the things they care about most. If you’re trying to decide exactly what’s on folks minds, ask. Bring together your C-suite to lead listening sessions with groups of 10 to 15 people. Ask, “What’s really on your mind? What could help you feel safer at work? What could we do to better support you?”

Those questions move the needle, and systems asking them are seeing a return. You’ll feel better, too. Knowing what people think and having the ability to respond is so much better than speculating.

But you can’t stop with listening. You have to then slow down and tell people what you heard. Once you’ve collected the feedback, process it and come back to people with, “Here’s what we heard you say, and we’re making this change because of it.” Or, if it’s simply not feasible, explain why.

Reconsider your messengers.

One of the most revealing pieces of data from our survey was the continued trust people place in doctors and nurses for healthcare information. The public expects and desires for clinicians to be involved in conversations around healthcare.

But the conversation must be authentic and start internally. Though trust in doctors and nurses is a bit lower for healthcare workers, they still hold clinicians in high esteem. Therefore, you’d be wise to use them for internal communications. Make sure you have respected, well-spoken clinicians as messengers. If you’re not a physician-led system with a physician in the CEO role, there’s real opportunity in featuring your chief medical and nursing officers as you deliver messages about safety or protocols employees need to follow.

With the right messengers offering the right – authentic – messaging, you can convey that you have your team’s back.

Consider what could have been.

Consider that data around the feelings of healthcare workers as a bright spot. The survey’s “scores” on trust and safety for providers have held steady through the roller coaster ride of the past several months – even while there has been so much working against healthcare providers. But you, your team and your organization have hung on. That goes to show you that temporarily treading water is sometimes enough. Even if it’s not the most satisfying activity.

Remember also that in so many critical areas, you’re making a difference. So many lives have been saved. How many people have you discharged from your COVID ICU? Celebrate the caregivers and the administrative teams that made those discharges possible. Some clients are celebrating milestone discharge numbers – 100, 200, 500 patients back home and recovering.  Could your team name with pride how many are recovering? Help them do so.

Imagine what could be.

There’s a lot of work yet to be done—but it’s work that matters. Imagine what it would look like to strengthen the financial position of your organization through additional federal funding and more favorable payer contracts? Imagine what it would look like to allay fear and move the needle on people feeling safer, to provide them an even better experience both in the midst of and after the pandemic. Imagine what it would look like to gain traction on vaccination rates for the first time in decades. Any of those things would be a big achievement…and you can do this. Take that message to your teams, remind them of your shared purpose. Check in and listen to their fears.

And celebrate the work they’ve done and will continue doing.

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In Change Management, COVID-19, High Stakes, Strategic Positioning

How will Health Systems Deal with a COVID-19 Vaccine?

Woman lifting her shirt sleeve while a man inserts a medical shot into her arm

As opponents build their case, providers risk reputational damage if they don’t take a point of view.

Early in the COVID-19 era, sometime after Bargaining and Depression, Acceptance began to set in.

With it came the grim realization that we wouldn’t fully leave this era until there was a widely available and reliable COVID-19 vaccine. And we were told that cavalry wouldn’t be rolling in until early 2021 at the absolute soonest. Now here we are, months later, still in suspended animation and confronting another major question:

What if there’s a reliable vaccine, and people refuse to get it?

Our recent national consumer survey shows that just 53 percent of Americans are extremely or very likely to get a COVID-19 vaccine. Now, there’s a lot we don’t know about an eventual vaccine. But we do know two things:

  1. The public overwhelmingly expects and trusts healthcare providers to actively talk about healthcare issues, which includes educating about the coronavirus and encouraging people to take specific actions to protect public health.
  2. The looming war on vaccines will make the masking battles look like tickle fights.

Six months ago, no one cared about the idea of wearing a mask. The idea that it could become a major political signifier would have seemed absurd, even for these absurd times. But as we saw, the issue quickly took on major cultural importance for months before we settled into our current détente. Some of the political air has left the balloon. Most people have accepted their masked fate, while the holdouts remain largely unpersuadable.

There are several significant differences between masking and vaccines, with the most obvious being that one is gently draped in front of your body and the other goes directly into it (via needle, no less…shout out to my fellow trypanophobiacs!). There’s also the fact that suspicion about vaccines has steadily risen over the last several years, long before COVID-19 swept the land. Some groups, particularly marginalized groups with unpleasant histories of medical trials in this country, have every right to be wary. Then there are the Jenny McCarthys of the world, whose rationales are less reasonable but even more, uh, viral.

So, are we telling you that you have to mandate vaccines for all your employees and aggressively promote the vaccine’s efficacy to the public? We are not.

However, as the trusted voice on healthcare in your community, healthcare leaders have an opportunity and a responsibility to educate the public, starting with the people who work within your organization.

Of the 47 percent of the public (and 40% of healthcare employees) who are hesitant about taking the hypothetical vaccine, the overwhelming majority are either worried about the potential side effects or worried about getting infected from the vaccine. These are very reasonable concerns about what is likely to be the most quickly developed vaccine in history. They are also an opportunity for health systems to leverage the trust the public has invested in them in a way that answers the public health concerns they seek.

Broad education on vaccines must start now, while clarifying that specific instruction on what to expect from a COVID-19 vaccine will come later, when we have the appropriate information. Don’t take for granted that everyone understands how vaccines work. Hypothetically, there could be a communications consultant who’s worked in healthcare for years but is just learning today how they actually work. Hypothetically.

Both now and later, explain how your organization will evaluate any vaccine. Make it clear that you won’t just be pulling syringes off an unmarked van and administering them to patients. (You’re not going to be doing that, right?) By explaining the process, we can begin to socialize the idea that any vaccine that comes our way will be thoroughly reviewed for safety and efficacy – “Operation Warp Speed” notwithstanding.

This is a major challenge, and it’s one that many health systems would prefer to avoid. It is an instantly political issue which will be further politicized and weaponized in our dismal national discourse. While it may not feel like it, the far greater reputational risk lies in health systems not doing everything they can to get responsible, timely and accurate information out to the public. As we continue to confront the greatest public health crisis this generation has seen, shrinking from the moment is a guaranteed way to lose the trust you’ve built.

What is your plan? You don’t have an option to sit this out, so you best start preparing one now.

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