When administrators shadow doctors and nurses, good things happen


I want to share a cool idea used at Mission Health in North Carolina. I recently interviewed Dr. Ron Paulus, CEO of the health system. Three years ago the organization launched “Immersion Day,” when board members leave their corporate meeting rooms to shadow the doctors and nurses in their hospitals.

Journalists and legislators are also invited to join. They don scrubs, go through an orientation, sign privacy forms, and spend 9 to 12 hours behind the scenes watching frontline clinicians in their everyday work. They gain insights they could never have gained otherwise.

According to Dr. Paulus, Immersion Day helps each side learn how the other thinks. For many board members, it’s the first time they’ve been on the front lines of care. For many physicians, it’s the first time they’ve met a member of the board. (The health system has a second program, appropriately named “Walk a Mile,” for senior executives.)

The experience, which has been repeated several times since its inception, has catalyzed better understanding and positive change. One board member was quoted in an article about the initiative as saying, “I learned more about hospitals and health care from my ten immersion hours than six years sitting on our board.”

Dr. Paulus told me that after seeing the stress level of doctors and nurses and the frustrations they dealt with every day, the board unanimously agreed to a multimillion-dollar program to improve the usability of the electronic health record and fix inefficient and frustrating workflow processes. They also approved funding for additional behavioral health services in the ED, for which the need was evident during their shadowing experience.

How can this idea help prevent burnout? Initiatives like Immersion Day can bridge the gap that exists in many organizations between the daily world of the care providers and the board members, executives, and legislators who make decisions that profoundly affect that world. As Dr. Paulus told me, “It’s easy to disrespect someone you don’t know and have stereotyped. A key solution is to have people spend time together and listen to each other long enough to avoid discounting and stereotyping.”

When administrators and board members can see the downstream, longer term effects of their decisions about resources, staffing, performance metrics, organizational priorities, and work policies, they can begin to appreciate what research in other industries has already shown: valuing employees, through improving their work experience and other means, makes good business sense and results in better overall performance. And it’s the right thing to do.

Diane W. Shannon is an internal medicine physician who blogs at Shannon Healthcare Communications.

Image credit: Shutterstock.com


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