Storytelling Helps Leaders Communicate Patient-Centered Goals

Added on Jun 16, 2016

Storytelling Helps Leaders Communicate Patient-Centered Goals
By Deirdre Mylod, PhD, Senior Vice President, Press Ganey; Executive Director, Institute for Innovation
From Industry Edge ​June 2016

There are few techniques more powerful than a well-told story to communicate a point of view, a principle or a value. For this reason, health care leaders are increasingly relying on storytelling to nurture a more human-focused health care system in which the patient has a face and a story as well as a chart and a diagnosis. Connecting with directors, managers, clinicians and staff in this way engages, incentivizes and inspires employees to improve the patient experience in a way that cannot be achieved through data alone.

“Stories have the ability to connect with people physically, cognitively, emotionally and through the human spirit,” according to Lori Silverman, an expert in the value of organizational storytelling. Using stories to allow people to invest in these areas makes them more passionate and committed to the organization, she wrote in her book, Wake Me Up When the Data Is Over: How Organizations Use Stories to Drive Results.1

Recently, the Founding Executive Council of the Institute for Innovation convened to discuss the importance of storytelling as a strategic initiative and to share some examples from their own organizations.

Adventist Health System: Using Videos to Share Stories across the Organization

Adventist Health System’s intranet story portal allows care team members to record stories of exceptional patient care. These stories provide inspiring content for hospital leaders to start their internal meetings and create some friendly competition among Adventist hospitals.

According to Pam Guler, vice president of Patient Experience and chief experience officer, system hospitals enjoy vying for the top storytelling award granted at the organization’s annual summit. Previously, the award was given to the hospital with the most stories submitted through the portal. Recently, the award focused on how hospitals in the system are using stories, so the executive staff at each hospital submitted an application describing how they are leveraging patient stories.

Adventist’s president and CEO, Don Jernigan, also leverages storytelling by sharing “Mission Moments,” video-recorded patient stories that speak to how Adventist caregivers carry out the organization’s mission every day. Having a CEO who believes in the importance of patient stories cascades through all hospital leaders and to front-line staff, Guler said.

Baptist Health South Florida: Pairing Data with Stories to Pack an Emotional Punch

Baptist Health South Florida uses storytelling to add an emotional component to its patient experience data. According to Dr. Thinh Tran, chief medical and quality officer and corporate vice president, whenever the system publishes performance data for one of its entities, such as a hospital or outpatient clinic, the information is coupled with patient stories. Similarly, data presented during board meetings are accompanied by patient vignettes to make the information more personal and more human. Additionally, the organization’s annual Leadership Development Institute is always attended by a patient and his or her family to represent the patient voice.

Brigham and Women’s Hospital: “Love Story” Videos

Modeled after the movie When Harry Met Sally, the “Love Stories” project at Boston’s Brigham and Women’s Hospital consists of videos of a physician and a patient seated side by side, sharing details about their patient-provider relationship. Off camera, an interviewer asks the pair questions such as “How did you meet?” and “Did you have any doubts?”

Dr. Tom Lee, Press Ganey’s chief medical officer and a practicing physician at the hospital, says the goal of each vignette is to show that the patient-provider relationship is indeed a loving, authentic relationship and to demonstrate the importance of relationship in health care.

Carolinas Health Care System: Using Pictures to Evoke Stories

Carolinas Health Care System convenes front-line teammates to explore the concept of preventing avoidable patient suffering. Teammates work in small groups to create a story in response to images that depict individuals in various stressful circumstances (e.g., bankruptcy, homelessness, multitasking mom, etc.).

According to Connie Bonebrake, senior vice president, every story created by various groups is unique, yet they all recognize the impact that unresolved stress can have on them as teammates and on the patient experience. One image depicts a man holding his head in his hands with mounds of paper in front of him. In response to the image, a front-line nurse told the story of the overwhelming stress experienced by a health care executive trying to manage competing organizational priorities. These types of responses provide effective segues into discussions around teammate wellness and resiliency.

Northwell Health System: Helping Caregivers Reconnect to Their Career

Everyone has a story of why they got into health care, including executives, who are often so focused on running the business that they sometimes forget the reason they chose their career, according to Sven Gierlinger, chief experience officer at Northwell Health System in New York.

Northwell uses storytelling to help its executives reconnect to their original inspiration. During a four-hour retreat that centers on the themes of empathy and connectedness, executives are prompted to tell several types of stories, including the story of their career inspiration as well as a story about giving or receiving empathy.

The stories are transformative, Gierlinger said. Executives who may not have been known for expressing themselves openly are frequently among the first to share their stories. Knowing one another’s stories is a powerful way to build meaningful connections among team members.

Leadership also leverages the power of negative patient stories. For example, after a patient posted an unfavorable comment about the organization on social media, Gierlinger called the patient to hear about the experience. After listening to the story, he invited the patient to come in for an interview so that the story could be recorded. A video of the seven-minute interview was shown after lunch at a senior leader retreat as a contrast to a positive patient story that was shared before the lunch break. The contrast between the positive and negative patient care stories was so powerful that senior leaders still talk about it today with their teams.

UCLA Health System: Bringing Stories to the Caregivers

UCLA Health System brings stories of exceptional patient care directly to its caregivers. For example, when they hear from a patient about a care team that has made a difference, executives will gather a group of leaders together to go to the care team’s unit and share the patient’s story.

Tony Padilla, director of Patient Affairs, said the organization strives to make these meetings convenient for direct caregivers by holding them “in their time, in their space, with their team.” In the future, the patients themselves may be brought to the meetings.

University of Chicago Medicine: Making a Difference Every Day

“How do we change a world?”

“Making a Difference Every Day,” a program at University of Chicago Medicine, centers on that question and is designed to help employees and clinicians understand that they are surrounded by “change a world” moments with patients every day.

According to Dr. Alison Tothy, chief experience and engagement officer, the goal is for every employee and clinician in the system—not just the front-line staff—to learn to recognize these moments and to strive to make a difference in the lives of patients each day.

Through the program, stories of exceptional patient experiences surface frequently and are retold quarterly by the patients and caregivers themselves at the organization’s “Making a Difference Every Day” best practices forum.

Exceptional patient experiences are identified through discharge care calls and patient survey comments, and patients are contacted and asked whether they would like to participate. At the event, senior leadership delivers an opening address and introduces the patient and family members, who are interviewed about their experience using a talk show format. The interview then shifts focus to the care team and how they worked together to create such an exceptional experience.

In some instances, patients who participate in the forum are invited to become more active in the organization’s activities by joining advisory boards, attending a unit huddle or participating in quality improvement initiatives such as operational experience mapping.

Forum attendance has increased since the patient stories were incorporated into the agenda, according to Dr. Tothy. Challenges still exist, including getting more representation from front-line staff at the events, but the organization is working through the challenges so that patient stories can reach more caregivers. For example, the forums are recorded and made available via the organization’s intranet so that segments of the event can be shared at department meetings.

The best practices forums are an emotional experience for both patients and caregivers, said Dr. Tothy. They give patients an opportunity to express heartfelt thanks to their care team. From the caregiver perspective, patient stories connect back to the “Making a Difference Every Day” mission and help remind them of why they chose a career in health care. To reinforce that reminder, the organization has created an inspiring video compilation of caregiver quotes and photos called “Remembering Why.”

Yale-New Haven Hospital: Finding the Stories behind the Data

“Data tend to blind and stories tend to engage,” according to Dr. Michael Bennick, associate chief of medicine and medical director of the patient experience at Yale-New Haven Hospital.

To that point, when Dr. Bennick opened Yale-New Haven’s annual patient experience conference in 2015, he started with a slide showing a graphic of the organization’s patient experience performance. He then had the slide fade into a compilation of patient and caregiver photos to emphasize that there are thousands of stories behind the data.

The organization recognizes some of these stories during service-line patient experience forums. On a monthly basis, every service line at Yale-New Haven holds a patient experience forum during which they share a story of exceptional patient care. The patients and families involved in the stories attend the event to help celebrate the care team.

The health system also works to keep the patient experience front and center, even at the bedside. For example, family members are encouraged to create a communication board that can be displayed in the patient’s room depicting the patient’s life and interests. The board tells the patient’s story and helps caregivers see the patient as a person, distinct from his or her medical condition.

As a testament to its belief in the power of narrative, Yale-New Haven also began training undergraduates to interview patients about their life stories using open-ended questioning techniques. After each patient is interviewed, the student writes the patient’s story, gives it to the patient to review, and then laminates it and gives it to the patient as a gift. The patient’s story is also included in the “FYI” section of his or her electronic health record.

Building Better Care One Story at a Time

Storytelling can be a powerful motivator for change and a source of inspiration. Stories of exceptional care instill pride in the organization and illustrate what care should look like for every patient. They can also rejuvenate caregivers by “making them better for the next patient they see and helping them see themselves in a light that sustains them as they go about their work,” said Dr. Lee.

“Telling and listening to stories is the way we make sense of our lives,” according to Dr. Thomas K. Houston, a researcher at the University of Massachusetts Medical School in Worcester and the Veterans Affairs medical center in Bedford, Mass., and lead author of a study2 looking at the health benefits of storytelling. “That natural tendency may have the potential to alter behavior and improve health.”

The most valuable stories are those that deliver on three levels: sharing knowledge, communicating in a way that captures the attention of the audience and inspiring the audience to act.

When combined with performance data, the business case for storytelling is especially compelling, according to John Bingham, vice president of performance improvement and chief quality officer at the University of Texas MD Anderson Cancer Center. “It’s the best of both worlds when you can combine good data with good stories that enhance and complement the data—it seems like that’s where the sweet spot is.”