Highlights from Mission Critical: Physician Engagement During COVID-19

Hospital administration faces the challenging task of organizing rapidly changing information and guidelines and then disseminating it to affected staff in a timely way.

Simply pumping out information isn’t good enough – it must be received well and acted on, which means presenting it effectively while taking into consideration the personal, emotional challenges that the recipients are dealing with.

Clinical staff, of course, are at the top of the list of people who need both information and support. Here, we offer some practical tips – focused specifically on physician communications – provided by three health system leaders and based on their real-time experiences. These tips will help hospital leadership navigate three broad areas of need: creating an information pipeline, navigating operational changes and supporting caregivers.

For more, be sure to see the replay of our recent webinar, Mission Critical: Physician Engagement and Communication During COVID-19

The webinar featured:

Be honest

It’s important to lead with truth and facts. We can’t paint this rosy picture and then when something happens, they’re going to feel like the leadership let them down. We will all be criticized at some point during this journey. The way we handle it now may not be evident until after the crisis is over, and people feel like they were not supported well enough during this time and then they start questioning the leadership.

– Dr. Forrest

Focus the information

Early on, we adopted a hospital incident command system model. We didn’t want to assume that every one of our providers would understand how that might change their regular communication channel, so we spent time clarifying how information was going to flow and how decisions would be made. We wanted to minimize the amount of effort that front line staff had to invest in identifying where they needed to go for that information, so we built a structure that centered on value of communication over volume.

– Toal

Coordinate the message

Engage department chairs and local leaders to provide information to their staff, because they will have a better relationship and communication with the people under them and it doesn’t seem like everything is being pushed down from above.

– Dr. Forrest

We focused on creating that single source of truth. Everything was parked in our Infection Prevention Hub, regardless of the audience, but then layered information in other places where physicians might choose to access it, like our provider portal, to reduce the friction of them getting to the information.

– Toal

We recognized a little way into our journey that as information was changing, it was very difficult to ensure that everybody understood what the most current version was. We added timestamps, so that our providers could be confident that they were using the most current information.

– Toal

Create consistent cadences

Have multiple touch points. That could be daily communication at the global level, but also daily huddles at lower levels of the organization within each of the business units to focus on some of the things that need to get done that day.

– Dr. Forrest

A daily update has been really important to our communication. Our daily COVID-19 update is a number of brief but really important notices to our entire physician and employee population.

– Glenn

Respond and adjust

When do you hit email overload? When we first activated the command center, we sent two updates a day. That was caused more stress than anything. So we went down to one a day. And that daily email has been the most valued tool we’ve used – we did a quick survey to ask people what channels were most appreciated and that email was number one.

– Glenn

It’s important to get real-time feedback from doctors. And it really matters. We should be asking one to three questions. You can send it out in an email survey, have the physician liaison ask those questions. You can do it in a segmented way to see where you are, for example, with employed primary care docs versus independent physicians. There’s an opportunity to look at those questions, cull the information and bring it back to the command center to hear the voice of the “customer group.” Ask them what they need so we can help them.

– Barlow

Work with, not against

We have seen our providers and staff share their perspectives via social media. Some have written opinion pieces for our local newspapers. What we’ve tried to do is reinforce our internal processes around those topics. But more importantly, we have reached out and offered support from the communications team, if that’s desired. It’s not to control the message, but to help people articulate what they’re trying to share.

– Toal

Not secluding yourself and getting out by going to the hospital, talking to people, and having that calm and reassuring voice and message is really important. If there’s a void, it will be filled by people creating stories that create uncertainty and anxiety. That means peer-to-peer conversations when we hear about physicians saying things on the floor in the clinics. It’s pulling them aside and saying, ‘Hey, look, you know people are looking to you as the leader of your unit to kind of set the tone here.’

– Dr. Forrest

When we hear people doing things that go against policy, we try to figure out why they’re doing it and speak to the leader of that area directly. It comes down to explaining why a policy is the way it is, here are the bare facts around it and here’s how we got those facts. We tell our staff, ‘Here’s the truth as we know it today. If the information changes, then we will change our policies to reflect the best ways we can protect you.’

– Dr. Forrest

The anxiety, the fear, the stress is very real. So even though we talk about the science of why we don’t want people to bring in PPE from home, it’s not just a scientific issue. It’s a strongly emotional issue. So now we’re going to schedule a meeting between the union leadership and others to talk about why we have the policy we have, where it’s endorsed, but at the same time, showing a lot of empathy because it is just really scary for those on the front lines, and we’re trying to walk that line between having really great policies based on science and being empathetic and understanding their fears.

– Rose Glenn

Remember your mission

A statement that I use a lot around here is, ‘Be a purpose maximizer not a profit maximizer.’ We always have to do what’s right for the people we’re taking care of and our own people. It’s not about how much money you can make in work. This is about everybody working together to serve the community and minimize any impact and loss of lives in this area. So we’ve reached out to the other two health systems here in town and we share everything, like what we’re doing to keep staff whole from a compensation standpoint. We wanted to make sure that all three systems were doing something in a very similar fashion so that nobody was singled out.

– Dr. Forrest

Make it personal

There are two groups. You’ve got the very anxious provider who wants to jump in and be active from the beginning. And then you have another group that is withdrawing and trying to avoid any type of contact at all. When we talk about the withdrawn side, we need to let them know that there’s security for them and we’re doing everything we can to protect them. For the other group, we have to let them know that it’s okay not to be busy right now. They’re on deck, and we’re going to need them to step in. So they don’t need to be available right from the beginning, but we are going to need them all at some point and they should take this time for some personal development to do things that will prepare them mentally and physically.

– Dr. Forrest

Although our daily emails have to summarize a lot of critical information, more and more we’re trying add messages of advocacy and support, whether that’s support from our depression center or our wellness institute, or just a thank you – showing gratitude.

– Glenn

We provide personal thank yous during our town hall meetings. “Prior to this pandemic we didn’t live stream our leadership when they were giving state-of-the-organization addresses and expressing gratitude. People now are so appreciative of this town hall and the authenticity and the empathy it provides because it’s so much easier to express it verbally. They also appreciate that two-way engagement and being able to ask questions in real time.

– Glenn

I was on hold with our information technology group – as employees we’re often waiting for support. They cycle through messages as you’re waiting. And this time it was our IT team members, expressing in a very sweet way their gratitude for the caregivers on the front line. It was peer-to-peer recognition, and it was so genuine and surprising.

– Toal

David Shifrin
dshifrin@jarrardinc.com