In this rare episode, we are honored to have the opportunity to hear from pioneer healthcare leader Quint Studer. His feelings on the current state of healthcare and what we can do to improve. Sponsored by iRIS Healthcare Simulation.

Quint Studer is a lifelong student of leadership. He worked for multiple health systems throughout his career, the last stop being president of Baptist Hospital in Pensacola, Fla. In 2000, he founded Studer Group, a healthcare and education coaching company that received the 2010 Malcolm Baldridge National Quality Award. The company was sold in 2015, and Mr. Studer left in 2016. He went on to found the Studer Community Institute, a not-for-profit whose mission is to improve the quality of life for all people. 

In 2022, Quint founded Healthcare Plus Solutions Group (HPSG) with longtime colleague, Dan Collard, to bring enhanced solutions to the healthcare industry. The mission of the organization is to have a positive impact on those that receive care and those that provide care. HPSG specializes in helping healthcare organizations to diagnose and treat their most urgent pain points in order to achieve and sustain results. 

He has authored many books, with several listed on bestseller lists. His newest book, The Calling: Why Healthcare Is So Special, is aimed at helping healthcare professionals keep their sense of passion and purpose high. He serves on various healthcare boards and is a frequent speaker, workshop facilitator, and mentor to individuals and organizations. The tools and techniques Mr. Studer has created over the years are now staples in healthcare systems throughout the world. 

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Transcript

Disclaimer: 0:00

The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of anyone at innovative Sim solutions or our sponsors.

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Thanks to iRIS Health Solutions Limited for sponsoring this week's podcast. iRIS is a scenario design platform, which makes it really easy to design, set up and run great scenarios in line with recognized best practice. Iris makes co-design and sharing of scenarios simple and the library and review. Ensure one high quality version is always maintained. You can also join the iRIS Fair Share community and access , reuse, or repurpose over 700 scenarios from colleagues around the world. With IP always recognized, the new Iris mini sim wizard allows quick and easy scenario creation for simpler sims, such as in situ two , primary care and paramedic.

Intro: 1:00

Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, edited by Shelly Houser. Join our host, Deb Tauber and co-host Jerrod Jeffries as they sit down with subject matter experts from across the globe to reimagine clinical education and the use of simulation. So pour yourself a cup of relaxation, sit back, tune in, and learn something new from The Sim Cafe.

Deb: 1:39

Welcome to another episode of The Sim Cafe, and today we are truly blessed to have Mr. Quint Studer join us, the Quint Studer . So thank you so much. We have Jerrod Jeffries, the co-host, myself, Deb and Quint Why don't you go ahead and for those of our listeners that don't know about you, why don't you share a little about yourself?

Quint: 2:03

Sure. In fact, yesterday I was in a meeting and we all went around and talked about how many years of experience everyone had and we came up with the fact that you can have a new company or new department, but an awful lot of experience. And so I had other people do the math for me. And so I've had about 37 years in healthcare. I got in it at there later. Um, I was a special education teacher for the first 10 years of my life and then I ended up getting into behavioral medicine than acute care. And then healthcare systems. I started out like many people as a hourly employee. And then one day I think the manager quit and they said, will you be the manager? And I probably didn't know what to say and they said, can you just try it on the interim? Which is how most of us took our first healthcare job. I didn't know what we were doing interim. And then I became a Director and I went up the normal routes, a Vce President, a COO, and then a CO of a hospital. And along the way I was very fortunate to be given assignments , um, that I didn't have skillset in. But I think my background in special ed is you really diagnose and assess the situation first and then you come up with a treatment plan. And when I was at Holy Cross in Chicago, we, we took and did some really neat things that raised our employee engagement and our patient experience really to the top. And that got a lot of attention. Then I became the president of Baptist Hospital and we did it again. And then no longer can somebody just say, well, that's the right location and the right, blah, blah blah. So then the question was could this learning be transferred? And this sounds too self-oriented, but the , the feedback was, well that's cuz Quin's there, can it work when Quint's not there? So that became a real challenge to me to show that it wasn't me, that some of the methods, the tools and the techniques is what it was. And so we started helping other organizations. I started my own company, which then we won the Malcolm Baldridge Award, I think we're the first healthcare consulting company that ever won the Malcolm Baldridge Award. I , I wrote some books that did really, really well cause I, I write books for the middle manager. I write books for the supervisor. And my whole thing is the magic of anything is, is it doable? Cuz it can sound great in a book but if I can't make it doable, it doesn't work. And then I , my company got sold, I had a non-compete so I had a sabbatical, you called it sabbatical or non-compete for five years. And but dur during that time I really got involved in early brain development and children and got very involved in getting hospitals to do tutorials for moms before they leave the hospital. Cuz 80 to 85% of the brain is fell by age three. And then during that pandemic was sort of cute . I got a call from a CO and said, Hey, I'm looking for somebody to do this stu stuff. Do you know who ? Do you know who I can call? And I said, why don't you call me? And he said, oh you can do it. I said, yeah, it just sort of happened. That timing was right. But you know what I learned quickly, you just can't dust off an old playbook in a new world, in a new environment. So you've got to once signal , go back to the roots, which is diagnose the current situation and then collaboratively design what's gonna work to relieve the pain points that are currently going on. And you're gonna hear me use this word again. It doesn't matter how good it looks on an overhead or how good it looks on paper, but is it doable and can the supervisor implement what we're asking them to implement? So that's a long intro but that's sort of it .

Deb: 5:28

You know what, thank you for the long intro. I actually learned some things just listening to your intro. Like I said, I'm, I'm really big fan. I still have my copy of one of your books that says thank you Deb, you make a difference. And it meant a lot. Thank you . So we'll get into some of the questions now and how have your coaching methods shifted post pandemic and and why?

Quint: 5:51

Um, I think they've shifted considerably to different methodology which really ties into simulation, skill building, role playing and so on. And it's based on on diagnosis. So if you look at coaching methods or methodology, methodology or anything, who are you trying to coach? So the first thing you do is you assess like the person. And what we found is for middle managers today, since the pandemic, normally we've never met an organization yet that doesn't have at least 25% of their people in a leadership role being brand new in leadership in the last three years. So there's no going back to basics cuz they weren't here during basics. So let's forget this whole concept of going backwards when they weren't even here at the backwards moment. Then there's probably another 20% that are, so it's usually between 40 and 45% of the people that might have been a leader before because of resignations. We call it one up . They're one step up than where they were. So yeah, I was nurse manager now was supervising hourly nursing and staff, but now I'm a director of nursing and I'm supervising nurse managers or leading nurse managers. So I think the biggest aha was the newness and the lack of experience. And I again know other professions and in other professions when somebody is new they change , they narrow the game , they narrow, they change the game plan or they narrow the scope. So I don't think we did that in healthcare. We just plugged in these new people and expected them to pick up where the last person left and they've never done it. They don't have any experience. And you talk about skills lab type things. This might, I think your listeners are gonna like this cuz it's usually a haha when we survey nurse managers and we ask them, you know, first of all we always start with what's your biggest concern or worry? It's always failure. I'm gonna fail on this job. It's like a new nurse says I'm gonna kill somebody, you know , uh, in the ed, oh my gosh, what do I do? Well with the manager it's I'm gonna fail. And then when you start digging into their concern or worry it's I don't know how to do these things and I don't know who to tell. So let me give you a role play in which I think ties into a lot of what you guys do so well, I'm a new nurse manager, I've been promoted during the pandemic and my one thing is staff this place, I don't care what you do, we gotta get staff in here cuz we got patients. So, Hmm , over time Deb, you are ne owner over time goes through the roof cuz you need people. My daughter-in-law's a nurse. She could have probably worked as many hours as she wanted during the pandemic at Beloit Health System in Beloit, Wisconsin. Bring people in here, don't worry about overtime. Oh and let's get some agency nursing in here cuz we've gotta fill these gaps cuz we got nursing ratios we wanna fill for all the good reasons. And so all of a sudden then in the last six months you're getting an email or a conversation that says, oh , oh look at our labor expense. It's through the roof, we're losing money, we can't catch up, you've gotta reduce overtime. And by this month we want agency nurse down 25% and we want it down 50% and by this to month we want it down 75%. We did a survey in nurses and their number one request they had teach us how to schedule well that's a for simulation, you give them different patients, different acuity, different mixes and they've gotta figure out how to schedule. So we call it an OSAR. What's the outcome we want? What's the skill that person needs? What action is that person gonna can take and what resources are we gonna provide? And when you do that, you see a manager, particularly in nurse managers, anxiety go down cuz we've made something doable. We show empathy and understanding. So it's really measuring the experience starts with it . The second part is taking what we do in precision medicine. Cuz you know precision medicine in the last 15 years is completely changing how we treat patients. It's based on pathology, it's based on mutations, it's based on all sorts of things. Um , being somebody , uh, cancer situation myself, I understand precision medicine, I understand mutations, I understand pathology. So when you look at precision medicine, you really create a treatment plan based on the individual. We need to do that for training and development. Now I still like group training. I like big group training. I like small group. I , it's not saying you don't quit, you don't stop those things. But Jerrod is gonna learn differently than Deb . Jerrod has different experience than Deb . Jerrod might have a different comfort level with people than Deb . So I need to look at Jerrod and Deb. We actually assess leaders like you do a patient now and come up with what we call a personalized leadership plan that helps them get the skills they need. So it could be skills labs, could be various simulation with scheduling, but it's also goes a little bit deeper cuz it also says are they a good critical thinker? So we have an assessment tool that tells you where are they in the critical thinking skills. That's an important part of leadership. Are they comfortable with people? Are they more comfortable with structure? Both can be valuable. So I , I think when we look at our coaching methods have shifted, they are much looking at the individual would take experience and they're also realizing we've got to give people time to develop the skill. I use the story, how come a doctor's in residency three years, but we put a manager in residency, 10 minutes. I either like sports analogies, if if you look at the N F L , they'll tell you the quarterback, you really know whether you have a quarterback or not. But in their third year and these aren't highly paid first round draft picks that come out. So it's really having helping CEOs and executives be more patient with their managers and realizing there's just a maturation point of a manager and you've gotta be patient. And we call it n equals one. Everybody's different. So that's a long answer. But basically what we've done is made our old , our old methods obsolete. Not that you don't do some of 'em , but we don't need to teach anybody how to do group training. But the assessing of the individual and coming up with the individual's outlook. So one of our first OSR Jerrod is this, it's a Cooperman Barnabas hospital in New Jersey. Manager wants to hit their outcome is hit our labor, target, our budget, the skill is scheduling, then the actions are meet with these mentors who are already good in scheduling and learn from them. Meet with your manager and practice or simulate different scheduling models based on what's going on. And resources could be these mentors, your supervisor. Oh and by the way, in our learning management system we have some micro-learning videos and so on and articles on scheduling. So that's really, we've just completely revolutionized how we look at skill building and managers.

Jerrod: 13:11

I absolutely love that. Quint I have never seen it put so succinctly and concise with the outcome skill, action resources. And then it goes into, and maybe this will touch upon the nurse managers and directors and such that you've, you've worked with as well . But what gaps have you identified in professional and skill development for these nurses and managers and other leaders today?

Quint: 13:32

I think it's usually the one up . The one up has not seen their role as a development person. And again, I gotta be real careful, I don't want people too upset with me. But you have eight human resource departments you have at nursing and education departments and you have organizational development departments all have a good role. But somehow we've backed away and think they're in charge of developing talent and they're not in charge of developing talent. They're in charge of needing , introducing talent to certain techniques. Hr, the rules, the policy , the values od tips for new managers, education, how to start an iv. All important people. So who's in charge of developing the person skillset ? Well of course it's the person we can't act like you're not involved. So Jerrod, you have to own your own skillset development but then your one out has to own it. So I believe if you went to most organizations and you sat with the executives and said, let's go around all your direct reports and tell me with all your direct reports what current skill building you're doing with them right now and what outcome are you pursuing? Most would not know because they think it's somebody else's job. So I , I think the biggest learning we've had, Jerrod, and it's really interesting cuz cos the light will go off on a CO and you almost have to explain to people you are a chief development officer. Now it doesn't mean you have to be the one that does all the training and teaching, but you're the facilitator. I gotta say Jerrod, I know schedulings an area we're working on. Did you meet with your mentor? Tell me about the resources you're utilizing. How can I help? So I think it's, it's truly getting the one ups and we call that whoever you're reporting to, to understand you're a chief development officer and you're developing the talent that you have. You can't outsource it. And Deb , you're a nurse, you know how a nurse manager can wanna outsource training to another department. But when you come back from training, that leader still has to say, how'd it go Deb? What are we gonna do here? What did you learn? How can I help? What barriers are there? So does that answer the question Jerrod?

Jerrod: 15:44

It does. And and one small follow up is, and this might be a little bit of unfair cause it, it varies, but what percent of these one-up managers you think exists in an organization? Is that over 50%? Is that you're an 80 or or is it much less?

Quint: 15:58

Well everybody has a one-up. So everybody has somebody they report to and that's how we classify a one-up. So if I'm a nurse manager, my one up is the director, the director is the VP of nursing or the chief nurse officer challenge we've had, Jerrod is truly getting the one up to realize you've got to help this person develop. And and one of the reasons we do it is just looking at the newness. I , I think the biggest metric missed today in performance is looking at experience. Cuz we've never had this type of inexperience before. And I go into organizations, I was with the Dean of Health in Chillicothe , Ohio last week, all the nurse me , there are a lot of nurse managers in the room and I had, you know, raise your hand and I said , um, with the new nurses coming now and is your first thought, oh my gosh I've never seen people so prepared and qualify today as I do today. They go, oh no, because during the pandemic many of the nurses missed the simulation, they missed the role play , they missed everything you guys do. And so we've got to play catch up , but we've gotta do it in bite-sized pieces. That's the other thing I've seen. Mm-hmm <affirmative> , it's gotta be bite-sized. Cause if it's not bite-sized we overwhelm them . Cause they already feel, I don't know if I can do this. So you work on one thing , you know , we call it one skill at a time.

Jerrod: 17:19

MMMM-mmm <affirmative>. Well yeah. And it goes back to your, is it doable? I I keep hearing that. Is it doable? And , and I love that. And also with our culture overall of everything needs to be instantaneous and everything our attention spans have shrunk so much. So I think the bite size is, is a good way to measure it.

Quint: 17:35

I think our pendulum swung too. And Deb, you've been there with me from oh for you're younger but for a while I think the pendulum has swung and for , you know, again these are all good intentions that have some negative consequences. We got so carried away with validation. We made most managers feel like robots and their job is to validate and make a checklist. And that doesn't develop relationships. Cuz what people want are relationships. They want authenticity. So we're really trying to get people to back away from the checklist, back away from all these questions cuz these are talented people. So with the patient, we'll start off with obviously they're there for a reason. What's your greatest concern or worry right now? Not 18,000 questions for them on an inpatient unit at admit ? What's your biggest concern or worry right now? Well I might think it's this and it might be this. So in the book, the Wonder Drug , um, what they basically showed in , in that book was, but Dr. Patriciak we we saw was in the University of Colorado, 75% of the time the clinician thinks the greatest concern or worry is different than the patient's greatest concern or worry. So let's get on the same page right off the bat. And you can even do this with staff, with managers. What's your biggest concern or worry right now? We, we find with, with staff we use a thing called the battery and we do a big explain, pretend you're a phone and how we c you know, we take care of our phones better than we take care of ourselves. We protect our phones, we guard our phones, we don't let 'em get too hot, too cold. We don't let 'em get run down. We, we bring extra chargers with us. We look around to make sure they're gonna be taken care of. Last thing we look at is our phone, not our partner or spouse. The first thing we look at in the morning is our phone. So what's our battery charge? So we would just say to somebody, we're charged right now if you are a phone and they'll say 80 or 70 or 60 and we all want that. And then we'll if it's low, we'll just sort of see , tell me what's going on. About 50 to 60% of the time Jerrod did something outside of work. And so we've also created lots of free wellness and self-care tools that we give away cuz still only about 1% of people in healthcare utilize any of the self-care that they have available in their organizations. So , but that question gets into the relationship. We just did some skills labs with physicians and they were very uncomfortable asking nurses anything more than what's going on with the patient. And they said , well isn't that prying? When I asked them about their old kids now it's not prying. It shows interest, doesn't it get in the way? They got a lot to do if I ask them how was , what'd you do this weekend? No, it's just showing interest. So we do skills labs like you do on many, many things. Cuz if I can do it in a protected and environment, then I can take it out into the real world.

Deb: 20:37

No, you're very much on target with the relationships are the bigger thing, right? People don't care how much, you know, they don't care what you say. They care about how you make them feel. How, how did you make them feel?

Quint: 20:52

Yeah, years ago a magazine when I was president of the hospital did an interview with the staff on how they liked working for me cuz they'd given me an award and and you know, I'd like him to say , oh gosh, we like him cuz his vision is so good. Or we like him because he's such a great communicator. We like him because he's made tough decisions and this almost, I remember reading this article and sort of like, whoa , I wonder what the other executives will think. They said we really like him cuz he comes up on the unit at night and needs M and M's with us.

Deb: 21:24

<laugh> .

Quint: 21:25

Now I'm not saying that's simple to do it, but it was more than that was he shows he's care, he's up on the unit at night, he shows he cares, he's willing to sit down with us cuz you're doing more than need M and M's are fine. I found out that unit coordinators are vital to them and we had too much unit coordinator turnover. Why? Because we weren't paying our unit coordinators well we weren't training them well cause we thought it was an entry level position. It's not. It's a vital part of that care team. So that's what you learn when you get people to relax when they can sort of share things with you and they share things with people they trust. And in looking at the newest research in healthcare, the pandemic caused a lot of challenges. And one of the biggest challenges for executive teams is they've lost a lot of trust in the workforce. Not because they wanted to but people didn't trust them about vaccinations, they didn't know about supply chain management. You're not in the hospital as much anymore. Of course they're not cuz of the pandemic. You're not up on the units. We're not having town hall meetings, we're not, we canceled all training for three years. So I think senior leaders have a lot of catch up to do, to be regained the trust in the workforce.

Deb: 22:38

Do I , I would agree Now in 2022 you co-founded Healthcare Plus Solutions Group or HPSG to bring various solutions. What are the greatest challenges today and how are you solving them?

Quint: 22:52

Well , first year did you have a comment on my last thing?

Jerrod: 22:55

And do and Deb, great question. But yeah , I just wanna wrap up the, the last one was when you say that there's, you use information from people you trust or that when people are using that you know maybe derives the most value, do you see that the learning from inside the organization is more powerful than that from outside? So for example, when it comes to some of these micro learnings that you were mentioning or when it comes from having a reference for the scheduling piece that you were talking about earlier, do you find it to be more sticky or more powerful from people that they know and that they could already have a relationship with than someone who's not known to them?

Quint: 23:32

I think the way I'd look at that is the most important thing to show it works here in our organization. So when I used , when I go into organizations, I can always show them, hey lemme show you about this er like Cooperman Barnabas er is unbelievable right now. Mm-hmm <affirmative> . So I might say let's connect you with Cooperman Barnabas cuz they can show you some things they're doing. However, Jerrod, I think what you're on, and I agree with you, if they say there's a lot of turnover, cuz everybody's got a lot of turnover right now and we've got a lot of turnover because our benefits are no good, our compensation isn't up to date . I'm losing people for bonuses. Well if I can find examples within their own organization where that's not true, now I not only take away the excuses, but I give them a role model and I can study that role model and find out what are the tools and techniques they're doing. So gimme another example. It is incredible how many people in healthcare accept a job and never show up. If you go to most hospitals today and you just say, can you gimme the number of people that have literally accepted this job but never showed up? It's gonna be a bigger number than you can even imagine. Because they get another offer, they change their mind and so on. So Joy who's a director in TriHealth, what she does is as soon as they hire someone, she starts texting them right away, builds that relationships with them . Then she takes a picture of where they should pull into the parking garage. So when they get there, they're not looking on where to park. Cause remember they probably interviewed in human resources and TriHealth is huge. They could be in a whole different area that they're not used to unless they did practice runs. Then she texts them and shows them a picture of the door that they should go into on their first day. She makes sure they bring their name badge with them cuz they're gonna need it to check in. But then she says, and I'm so excited I'm I'll meet you at the door. She, from the moment they take that job is starting to onboard a relationship bill . Now the fact that she did it in TriHealth and it works and TriHealth has 800 leaders that are hiring and onboarding people, well all of us should do that. So I , I think it really is valuable if you find it within the organization cuz you show that it works, but it's also valuable to bring learnings outside. So for example, if you were working with , we're working with the University of Louisville and we start piloting this thing, instead of asking eight questions and filling out an iPad and a checklist, just say what's your biggest concern or worry. And then we can show the perception of care goes up. I can say, and we've piloted this here to bring here I , I think it's a little bit of both. Does that make sense Jerrod?

Jerrod: 26:24

Definitely. And I love that because it's also to one of your earlier points repeatable. Yes . And so you can have that, this HR manager or you know, the , the new nurse director who's sending these text messages, pictures, it's, it's something that's everybody can do. And it's, you know, to one of your other other comments, it just shows interest. It's like, hey, if I were to put myself in their shoes, what would I want to be done? And I think it just, it creates a soft landing but it also creates retention, high retention as well as the happiness of their first day is already put up at such a high level. Especially if they're moving from somewhere else . Well maybe it was a lower level and then you don't have these, you know, when they're leaving to staffing agencies or recruitment agencies, they're actually staying there because people care about them. Which I think is also lost with the pandemic.

Quint: 27:08

Think of the anxiety when you're brand new, even though you've met maybe some of your coworkers through peer interviewing, maybe orientation, you're walking onto that unit for the first time. You got all sorts of nerves rattles. Mm-hmm <affirmative> , you got that seat that pre that manager walking with you, introducing you, making you feel at home. I'm not saying it's gonna make it no anxiety, but it is gonna have less anxiety. Deb, you wanna go back to your question?

Deb: 27:36

Oh sure. Thank you for those responses. You, once again, you're a thought leader in a lot of this field and in 2022 you co-founded HPSG. So why don't you tell us about the reasons for co-founding it as well as some of the greatest challenges and how you're solving them.

Quint: 27:55

Well at first we needed a name and that was the hardest part of this whole deal because I, we needed a name so we had all sorts of names. So I ended up with Healthcare Plus Solutions Group or HPSG, which is, I have to go by that cuz I can't remember Healthcare Plus it's too much. It's too much. It's too long, too complicated. Um, and I think the hardest part for us is getting people to be feel good about my old stuff. I'm not saying you quit doing it completely, but you change it, you tweak it. It's different now. And, and also some of my stuff really got messed up cuz um, dollars got involved. You know, so people, let's create a software tool. We can sell for a lot of money and that software tool's good, but does it make my life easier or does it make it harder? And that's what I think when you look at software, you gotta ask your question. So what we look at Deb and Jared , we sort of say what should remain hardwired? Cause that's sort of my, you know, that's, I I felt at Christopher Cross, you know, that's my sailing song. Everybody, no matter , you know, I love musicians and they all wanna play their new stuff. They asked Jagger one time , why aren't you guys play any new stuff? He goes, nobody wants to hear the new stuff . That's why. But anyway , so hard . We , we still wanna keep things hardwired. Some things like when you go to the doctor, they should make sure they know what your birthdate is. There's preventative maintenance. We wanna keep hardwired. However, there's all sorts of things we should rewire. So we should rewire things like rounding. We should make it one question which is doable. So Jerrod, you'll, you'll like this, the question is doable. Mm-hmm <affirmative> , I'm a in a hospital and I'm asking a nurse, how many patients do you have on the unit? And she goes, 42. I said, how many questions are you supposed to ask 'em according to your like software device here. Five. I said, what are the odds that you're gonna ask a 210 questions? Oh and how often are you supposed to round on every day? So I said, so what are the odds that you as a nurse manager asking 210 questions per day of 42 patients? And she looked at me and she said, it ain't gonna happen. So now I'm in a position, you're asking me to possibly skew the data that I'm putting on the software tool. So then we said, well what if, what if we could show you that if you just rounded on new admins and ask them one question, you might be able to get better results than trying to hit 42 patients with five questions. Cuz Deb, when I'm doing 42 - 5, I'm making transactional conversations. Cause I gotta get through when I'm asking just every new admin , let's talk about your greatest concern or worry. I'm developing an authentic relationship. So that's, that's the point of what I would call rewiring grounding. And then there's some new wiring. So for example , virtual nursing, well virtual nursing's a new wire , but we're learning on that. Everybody goes in and they think, well the best thing you should do is we'll have a virtual nurse do the admin admission. But then you talk to a nurse and she says, well I like doing the admission cuz that's when I get to know the patient. Why don't they do it to discharge? So we're sort of saying, okay, let's do it . What should we keep hardwired but what should we rewire? And we have to rewire onboarding by the time the persons, they might not even make it 30 days. So we work at Aramark Healthcare Plus and they took our old hardwired that you meet with all the new employees at 30th day and they said, we, we've knowed it now to our first meetings day one cause we wanna make sure they're coming back for day two . So that's the fun about being out in the field and that's what I am all the time. You're out in the field. It's not writing it from some ivory tower anywhere. It's talking to nurses and talking to radiologist. Like I helped a chief branding officer the other day. She just came to a hospital and she put up something called Press Ganey scores. And I just pulled her aside in a loving way and said, you know, I wouldn't call it Press Ganey . Those are patients. And I wouldn't call 'em scores cuz I found , use the word score. Nurses give you dirty looks cuz they hate that word. They're not here to score. They're here to care for, want you to say what we're hearing from our patients. Now she, she wasn't, she's a talented person. But what I'm saying is you've got to help people. I'm in the field. So by being , being in the field, you watch how people react, react how people respond. I , I did a thing with the physician the other day. I said to the physician, cuz we have disparities, social determinants in healthcare , different races feel care is less for them than others. But if I said to you, Jerrod, Jerrod here at University of Louisville Health System, we'd like to treat everyone as an individual. We wanna know what's your biggest concern or worry right now. Then I asked the doctor, if so I did that to you, how would you feel? You know what the doctor said? I'd say hallelujah. But we also handled the disparity issue cause we now are individualizing the treatment to the individual's needs. And I think we really have an opportunity to be better with social determinants and disparity in healthcare with this.

Jerrod: 33:17

I , I love it and , and it makes me think of, you know, treating individuals or patients as people instead of numbers instead of just going through this transactional piece.

Quint: 33:26

And that's what's happened. And I'm okay with transaction when it comes to monitoring things like, you know, blood pressure or making sure the medications. I get that. So I'm not against like the electronic health record, but that's cuz you have many handoffs. But in leadership we are not handing off our employees to a new manager every shift there are, they're working with us. So we don't need all these bells and whistles that we put in cuz all it does is take away from an employee . Employee thinks , Deb, you're only doing it cuz you got to, you gotta turn in a piece of software and you gotta do a checklist. You're not doing it . Sort of like, you know, w w we give people birthday cards and anniversary cards and they sort of expect them on those days. We're not gaining any points, we're just not going backwards on those days. But when you can show people you care about 'em , when it isn't a special occasion, that's when the really the love happens.

Deb: 34:18

Thank you. Thank you. We're gonna go into um, another question. Core methodologies to diagnose, design and execute. What's the , the core methodology? Um, what's the significance of it in in your, within your mind?

Quint: 34:35

Well I think healthcare, including my stuff by the way. They read a book and they say, oh here's a book. Let's do what this book says. Or here's they heard a speaker, let's do what this speaker says. I'm okay thinking about doing what that speaker says, but I still wanna diagnose. So for example, when I look at diagnosis, you, you wanna look at, we just went through this yesterday with an organization, okay, how many patients do come through your ER that are admitted versus how many are direct admits? Is there a difference? Cause there could be, now it could be different than you think of one time I had a co convinced that people came through the ED were less happy than people that didn't. And what we found out, they were actually happier. And the reason was is cuz the physician told the direct admit , I'm directly admitting you to the hospital. They thought they're gonna come to the front door and go right up to their room. Then they , somebody says, whoop you gotta go through the er. So you have to look at that. Um, we look at when the patient was admitted. Were they admitted on a Friday, Saturday, Sunday. Um, you , you start looking at different diagnosis. The the experience of the person that took care of them . Because again we find when do you put, most of our experienced staff works days . So when do our less experienced staff work weekends and evenings? Is that having an impact? Um , give you an example of diagnosis. Um, hospital wanted to save a few bucks. So they had a nurse manager quit and they just had a really good nurse manager and said Why don't you manage both of these units cuz they're right next to each other in the hospital. Well you got a good manager, give her a little bit more. Not only did the one never get better, but the other one got worse. So then you start asking what happened. And you also realize sometimes people want their own boss. And I'm very close to nursing people like their own boss. And a lot of times it comes, where's the office? What unit is the office in? Cuz that's the unit that they're gonna spend most time on. They're gonna build relationships, you know, people are gonna be comfortable running into 'em and seeing . So I look at diagnosis, like I said, the number one diagnosis we're recommending to look at today is experience levels. Cuz that's gonna tell you how things are next. We wanna design collaboratively cuz we really wanna sit down with the people who are gonna have to execute. That's why one of the collaborative things we do, Jared , is we do a whole thing on Doability cuz we can come up with something and design something really cool that looks good if you didn't have all this work. So is this doable? So for example, university of Louisville, they now have three hours every day that they tell people there's no meetings. There are no meetings cuz we have too many meetings and you're not, you're not worth the patients and the physicians and the staff enough cuz you're at some meeting. So that's making it something doable. And then with the execution, Jared comes into that. Even that O S A R we talked about how do we help you execute what resources do you need? And the , the University of Louisville story was a barrier to remove, which was we don't have enough time. And then what resources do you need? The other thing I think you too being quality gurus will, like most healthcare systems do not have any feedback loop on the quality of the resource that they're being provided or they're saying . So I got this idea and by the way I never had it either. So I mean I'm the plumber with leaky pipes here. Mm-hmm <affirmative> , if you haven't seen the movie Facing Nolan about Nolan Ryan, the baseball pitcher, even if you don't like baseball, you will love this movie and you will love his wife Ruthie. So I'm watching this movie and I'm liking it so much and I go to Rotten Tomatoes, it's almost like a hundred percent Rotten Tomatoes people can go in. So I was in the healthcare organization and I noticed they had 18 resources in the area of communication eight . You know cuz when we don't get a results we just throw another resource at people. Read this book, read this article, watch this video, we overwhelm 'em . Yet you, they never ask the user where any of these resources valuable to you and which ones are more valuable than others. So one of the things we recommend is healthcare organizations put in their own, if they don't like the word Rotten Tomatos, their own feedback loop. So they can say, well we , we asked you to watch this video on difficult conversations. How valuable was it to it? Give it a rating and then you can get the quality metrics to know what works. So you know, does this simulation work better than this stimulation? Does this skills lab work better than that Skills lab? Does this video hit it? Does this article hit it? So I think the other thing we haven't done with our teaching material has ever put in a good feedback loop besides the survey, you know, which I do all the time on a one through 10. This really user does it just in time basis based on what they're doing. Cuz if we're gonna go to micro learning, which means we might be learning for your video, we might be learning on our phone, we might be learning on our iPad. We've gotta get people a quick feedback loop to say was this valuable to you? And most of the time when I recommend this, the OD department goes, my gosh we've never thought of that. And not that they're bad people or wrong, I had never thought of it, you know, until I watched Facing Nolan and I had never thought that we should have these type of systems in our healthcare quality measures.

Deb: 40:15

Thank you. Thank you very much. Now as we come to the end of the hour, we really appreciate your time here. Is there anything that you'd like to leave our listeners with from this episode?

Quint: 40:27

Yeah , you gotta tell people you love 'em and I think that's the other thing that's been missing possibly in healthcare. And again, I'm try taking your in people's inventory, I apologize. But my book, the calling, that's the last page of my book and and the calling is a book I wrote that people go into healthcare cuz their d n a calls 'em to be a helpful, useful person. But Stephen Covey wrote about seven essential habits. There's a lot more withdrawals and deposits. So the book's all about how do you create deposits for yourself and then how do you help put deposits into other people's lives. So my friend John Ick who actually June 17th was his birthday and June 30th was when he passed away in 2019 at 54 years old when he was dying and he's much younger than me, but him and I were very close. He was telling people like when you're dying what you want them to talk, giving his children who were all young, you know, high school and mid middle school age, telling his wife what he wanted for her. He was an only child making peace with his father cuz he didn't wanna die and have his father have regrets telling his boss Harold Dawson Jr. How to be a better boss. No better time to finally have that talk when you're on your way out and you can't get fired, I guess. In fact in Harold Dawson Jr . I did a podcast with him. You saw the entire time you're watching, listening to this podcast cuz Harold talks about the impact. So when Harold's a , a developer, so his last apartment building he built was called Inspire for John and the road in front of us called LIC Way . So he told me, Quint, you gotta tell people you love him . I'm so work, work, work. See I , I hold up the mirror on me. I'm a transactional, I'd rather do a transaction than a relationship. I'd rather just give my wife flowers than actually have to have this conversation or something like that. So I , I see, you know, I see characteristics in myself through this journey. So anyway, I'm on the board of Mark's Hospital, TriHealth. I've known Mark since 1992. If you asked Mark am I a good friend of his, he'd say, oh yes, if you asked me I'd say, oh yes. And it's true. I'm a very work-oriented friend with Mark. Do I know his wife? Yeah. Do I he know my wife. Yeah. Do we know we got kids? But nothing like an intimate type of conversation outside of work cuz we both love work, we have joy from work and that's why we think we should be talking about work cuz that's what we're here for.So I'm on the board of TriHealth and I'm John had passed away and the next board meeting I'm at the Baldwin building on the 12th floor at the board meeting. And the whole time I'm thinking about today's the day I'm gonna tell John I. Love him . It's like that today, the day I'm gonna ask somebody out or something, today's the day I'm gonna tell Mark I. Love him . So anyway, Mark is always kind enough to take the elevator down with me cuz I'm the only out of town board member and we wait for the Uber driver to come. So I'm waiting and waiting. It's like mental health. You wait till the last minute to say something. So as we gun down this Uber driver's out there, I look, I finally say, I look at Mark right in the eye, I say, mark, I want you to know I love you . He backed up and said your Uber driver's here. I got the Uber and drove to the airport and I didn't expect him to say I love you too cuz when you change it takes a while . But about two to three weeks later I get real emotional at this. I got a beautiful handwritten note for Mark telling me he loves me. And do you know, since June 30th, 2019 or that next board meeting in 2019, there's probably not a time that we don't tell each other. We love each other when we talk. So if debit , I signed a book for you years ago that said, you make a difference today. I would've ended it with an I love you. And so I think we need to bring love. Maybe we never did, but I just think it's okay to tell people you love them . And I think that's what we've been missing a little bit in healthcare is bringing the emotion cuz we became a transactional healthcare system instead of relationship healthcare system.

Deb: 44:38

I'm a little choked up

Quint: 44:41

Cause I'm watching him on the video here too. And , and yeah,

Jerrod: 44:44

I mean that's u m, so powerful a nd, and also the the courage you have to have to be the first one. I mean, and t o shift from the transformative t o the, t he transactional to the relationship b ase a nd and also just, you know, you gotta you gotta have the courage to say, hey, this is the way we're gonna pivot into our relationship and, and, and a little deeper and and really just go for it.

Quint: 45:05

Yeah, I think that's it. I think too, and I was guilty of this saying families, but when you look today, the healthcare systems that do the best are the ones that really see each other as a family member. I got your back.

Jerrod: 45:19

Well and those that are tight with community and I think that's where so much has been lost throughout the pandemic is because we spend so much time through Zoom and all these other, you know, channels in the worldwide web, it's like you gotta go back to, to where growth happened and love and belonging has felt and that was through community.

Quint: 45:37

Yep . And I think in healthcare, when we go to a family, the other thing I talk about, there are very few organizations that have forgiveness as part of their listed values. Yet forgiveness is a big part of creating the right culture for people to make a , make a mistake. And it's interesting cuz you know, since I've been bringing this love thing up, no one says, oh we're not gonna hold people accountable cuz if you love them , you hold 'em accountable. You love your kids, you hold 'em accountable, you, you love yourself, you hold you accountable. And so it's, it's been really fascinating and it's been sort of interesting because , um, I was at Vizient who was a supply chain management and all that company. And Blaine Douglass who, who runs a big portion of Vizient said, after I left the workshop the next two days, all people did was tell people they loved him . And I love you , loved each other. I think that's healthy. And I want you guys to know I love you. Oh I love what you do . I love what you do and I just love so much this opportunity cuz I can see, just look, you , you know , people are hearing us. They can't see us. But you can just tell the spiritual strength that you're bringing into what you're trying to do in healthcare to make it better.

Deb: 46:44

Well thank you. We thank you so much for this, this time. And with that happy simulating.

iRIS health Solution Tag: 46:52

Thanks again to iRIS Health Solutions Limited for sponsoring this week's podcast. iRIS Health Solutions Limited makes co-designing, sharing, and creating sim scenarios. Quick and easy.

Outro: 47:11

Thanks for joining us here at The Sim Cafe . We hope you enjoyed. Visit us at www.Innovativesimsolutions .com and be sure to hit that like and subscribe button so you never miss an episode. Innovative Sim Solutions is your one stop shop for your simulation. Needs a turnkey solution.