Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 120 | December 1, 2020
Elevating the Patient Experience
Jason A. Wolf
President and CEO of the Beryl Institute
Welcome to Difficult Conversations with Dr. Anthony Orsini. Do you want to feel more optimistic about healthcare? Well, today is the day because on this episode, my special guest is Jason Wolf, a passionate champion and recognized expert on patient experience. As President of the Beryl Institute, he has led the growth of the organization into the leading global community of practice and thought leadership on improving the patient experience. Jason is also the founding editor of the Patient Experience Journal and serves as President of the Patient Experience Institute. Jason is a sought after speaker, provocative commentator, and respected author of numerous publications, including two books on organization development in healthcare, and over 25 white papers on Patient Experience Improvement. As always, Dr. Orsini keeps his promise about two things, that you will feel inspired, and you will have learned valuable lessons to be a better and more compassionate communicator.
Jason tells us about himself and his personal journey. Dr. Orsini and Jason discuss how patient experience is in front of medicine right now. Jason talks about why the patient is so different than they were ten years ago, and he shares a great story about his grandfather who was a pediatrician. We hear a little story from Dr. Orsini about a doctor that he was very close too and was a mentor. Jason describes patient experience and how important communication is to success. Dr. Orsini asks Jason why executives keep putting patient experience as a top priority but many haven’t provided the proper resources needed. Jason tells us that until we do what we need to do to match that disconnect we’re going to consistently be at risk in healthcare of not meeting the ultimate needs of our patients and families. Jason explains why “Patient experience shouldn’t be a thing to do” Jason explains how COVID affected us and he points out that it has shown us what is possible in a moment of dire need and the highest level of exhaustion in healthcare. We end with Dr. Orsini sharing a touching story of patient experience with a friend of his and Jason mentions that humanity is so essential to medicine and so essential to healthcare and so prevalent.
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Jason Wolf (1s):
When you look at what consumers say and we look at the data again, and again, back to the things we
talked about it. Listen to me, communicate to me in a way that I can understand, treat me with dignity and
respect. Those are the things that are at the top on the lowest level of the scale for them is the best food
ever parking is easy, all of these things. Yet, we spend all our money on the side that matters the least to
patients. And we call that patient experience in investment. And therefore we leave ourselves unbalanced.
Instead of working at the fundamentals where a leader can model the kinds of behavior they can suggest not
only just suggest but demand that that’s the way in an organization operates. And you’re creating an
experience with little to no resources, except having very smart people, guide that process and having the
right people involved in your organization execute on that every day in every interaction .
Welcome to Difficult Conversations: Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr.
Orsini is a practicing physician and the President and CEO of the Orsini Way. As a frequent keynote speaker
and author, Dr Orsini has been training healthcare professionals and business leaders, how to navigate
through the most difficult dialogues. Each week, you’ll hear inspiring interviews with experts in their field who
tells her story and provide practical advice on how to effectively communicate. Whether you are a doctor are
faced with giving a patient bad news, a business leader who wants to get the most out of his or her team
member’s or someone who just wants to learn to communicate better this is the podcast for you.
Dr. Anthony Orsini (1m 35s):
Well, I am honored today that the Orsini Way has partnered with the Finley project to bring you this episode
of Difficult Conversations Lessons I learned as an ICU Physician. The Finley project is a non profit
organization committed to providing care for mothers who have experienced the unimaginable, the loss of an
infant. It was created by the founder, Noelle Moore, whose sweet daughter Finley died in 2013. It was at that
time that Noelle realized that there was a large gap between leaving the hospital without your baby and the
time, when you get home, that led her to start the Finley project. The Finley project is the nation’s only seven
part holistic program that helps mother’s after infant loss, by supporting them physically and emotionally.
Dr. Anthony Orsini (2m 19s):
They provide such things as mental health counseling, funeral arrangements, support, grocery gift cards,
professional house cleaning, professional massage therapy, and support group placement. The Finley
project has helped hundreds of women across the country. And I can tell you that I have seen personally
how the Finley project has literally saved the lives of mother’s who lost their infant. If you are interested in
learning more or referring a family or donating to this amazing cause please go to the Finley project.org.The
Finley project believes that no family should walk out of the hospital without support. Well welcome to
another episode of Difficult Conversations: Lessons I learned as an ICU Physician.
Dr. Anthony Orsini (2m 59s):
This is Anthony Orsini and I will be your host again today, you know, before we start, one of the best
decisions that I really made is to do this podcast. I really do believe that it provides a unique opportunity for
healthcare professionals and business leaders, to learn more about communication, about leadership,
culture change, then how we can really do better. In our professional and in our personal lives, just by
understanding the human to human interaction. But really one of the best things about hosting this podcast
is I get to meet people and connect that I thought I otherwise would never get to meet. I’ve been really
fortunate to actually to keep in touch with many of the guests that has been on this podcast. So I would feel
Dr. Anthony Orsini (3m 39s):
Now at one person I’d been trying to meet is, our guests today and Jason, and I’ll introduce him in a second.
Jason is a very busy man. He’s very approachable. He’s a great guy, but boy, when I meet him, there are
thousands of people around him. And so I shook his hand, but I’m sure he doesn’t remember, but thanks to
Diane Rogers and some mutual friends. I was, if you ask me a few months ago, will I be interviewing Jason
right now? I probably would have said no way, but last month we did it, hit it off. We spoke on the phone and
he’s been kind enough to come on to this. Now, before I introduce Jason, I want to tell everybody out there
that if you are in the health care industry and you’re listening to this and the majority of our audience is , I
just want you to tell your friends about this, please go ahead and share with your, whether their hospital,
administrators, nurses, or doctors, anybody who has anything to do with patients, because we’re really going
to talk about something that’s near and dear to my heart and something that’s really important.
Dr. Anthony Orsini (4m 31s):
And that’s the patient experience. So it just pick up the phone and call your friends and tell them that you
have to listen to this. Today I have, the distinct honor of speaking with Jason Wolf. Jason Wolf is a
passionate champion and recognized expert on patient experience. As President of the Beryl Institute, Jason
has led the growth of the organization into the leading global community of practice and thought leadership
on improving the patient experience. A central leader in expanding the patient experience movement, Jason
is also the founding editor of the Patient Experience Journal and serves as president of the patient
experience Institute, which is a non-profit committed to continuing education and professional certification
prior to leaving the Institute Jason designed and led the organizational change service and leadership
development strategies with HCA health care working with over a 45 facilities on improving and changing
Dr. Anthony Orsini (5m 23s):
We also conducted groundbreaking research to identify the characteristics of high performance health care
organizations, which I hope we we’ll get to speak about. Jason is a sought after speaker provocative
commentator and respected author of numerous publications, including two books on organizational
development in healthcare and over 25 white papers on Patient Experience Improvement. Jason lives in
Nashville, Tennessee. And in his spare time, I’m told he likes to watch the Nashville MLS team and a run to
his kid soccer. Welcome Jason!
Jason Wolf (5m 54s):
Thanks for that. I really appreciate the chance to be with you and really humbled to be asked to be a part of
Dr. Anthony Orsini (5m 57s):
Thank you so much. Please call me Tony. I’m just Tony to everybody. Only my mother calls me Anthony and I
can’t get her to stop.
Jason Wolf (6m 4s):
It’s our Jersey roots I got you, you know what I mean? You know,
Dr. Anthony Orsini (6m 7s):
Let’s talk about that. I want to tell your story, but you know, this was actually a question down the line when
you and I spoke up and it turns out that we grew up, I checked it on Google today. We grew up about nine
miles from each other. So that’s pretty amazing and we’ll talk about that later on, but I really want to get into
patient experience. So I want to get into the communication, but I always usually like to just start about just
the letting the audience get to know you. So if you don’t mind just telling us your journey, how did Jason Wolf
Jason Wolf (6m 35s):
Actually, you mentioned your mom and I think I got to thank my mom first, right? I mean, it’s not growing up
in a household that was run by my mom with my brother and I, and her, she instilled a real sense of purpose
in me from the beginning. And this is not just because I hope she’ll listen to this one day, but because it’s
true. I think that the, you know, I mean, when you are supported and, and believing yourself and have the
privilege to have that, and I will acknowledge that and then are challenged to be your best. And to know that
there is greater good that you can do in the world and caring for other people, you know, that inspires you to
really think big, there are roots there that I have to acknowledge those seeds for any journey like this, that
Dr. Anthony Orsini (7m 13s):
That we are where we come from.
Jason Wolf (7m 15s):
And, you know, so for me, I’ve been fortunate. You now have a background in, I believe it or not. And in
international relations, So trained in being a diplomat, but found myself in the organizational world and
ultimately in healthcare. And I think like many that kind of an interesting and winding youthful journey that
really found my way into focusing on an organization Improvement and in particular, doing that within health
care. And as you noted within that in particular in the HCA healthcare system was my last stop on that
journey. During that time, they are really discovered there was a huge opportunities. You know, we were in
the living in the core measures era, and also at the beginning of sort of in the United States, the caps
evolution, an application at that in practice, but being a student of culture and being really a student of
diplomacy in life at the edges of relationships realized how important that was, and also acknowledged and
seeing not only our system, but looking at health care as a macro system, we were struggling with
collaboration, with connection, with the sharing of ideas, with the rising of the tide, for all that participate in
health care and really was an inspiration for what it was to become the Beryl Institute in its form today in that
reality was that if we could create a place that wasn’t trying to sell anybody, anything wasn’t associated with
a vendor or a product wasn’t associated with one provider institution or another, but it really became a safe
place for people to come together, to share ideas, to support one another with purpose, and to acknowledge
that the knowledge that people share is so vital and important to do that we could create something that
potentially had an opportunity to the way we looked at health care, the way we thought about what health
care could do, and ultimately the impacts that healthcare could have.
Jason Wolf (9m 2s):
And so it was kind of a, if you build it, will they come? question 10 years ago, just a little bit over 10 years
ago now to the fact that people have shown up and this journey for me of realizing that when you can hold
the space kind of grounded to those initial seeds, I was talking about around think, finding your purpose,
being clear on what potential is and acknowledging the power in others, and then supporting kindling,
fostering, and, and bringing it together. You can accomplish great things. And, you know, in this last 10 years
have now grounding the Beryl Institute with this idea and growing it into this global organization that you
noted has been incredibly significant to me personally, because, and it’s never been about me, you know,
that in our conversation, not even about the Beryl Institute, but it’s about the potential that we all have to get
at the essence of this work to elevate the human experience in healthcare.
Jason Wolf (9m 56s):
And so to see these tens of thousands of people from around the world contribute knowledge, ideas,
thoughts, but also compassion. And shoulder’s at times of need. And, and in particular, Elevating, they’re
support for one another in times of crisis like we’re in right now has been incredibly moving, an overwhelming
to see. And so the kind of impact that we’ve seen this global community of practice as a global network, be
able to have as a result of the passionate work, such as the work that you are doing, being filtered through
this entire global infrastructure has been incredibly powerful and moving. And so that’s the way I see my
journey. It’s not so much all these milestones along the way, but one driven from seeds of purpose that has
really enabled me to do everything I was taught back in those days from my mom.
Dr. Anthony Orsini (10m 40s):
I think that’s a beautiful way of thinking about it because we all are whoever we come from, the patient
experience is, you know, its come a long way from being this, saw it kind of soft skill that, yeah, that’s kind of
nice. And you know, my journey as you know, is from Physician and I started out really being interested in
communication and how the doctors break bad news. And so I was always kind of into that communication. I
find it really fascinating, but as time went by, it went from, yeah, yeah. That’s kind of nice too. And I think the
Beryl Institute, has a lot to do with that. I mean, right now the patient experience is in the front of medicine
Dr. Anthony Orsini (11m 23s):
And, and what I really love about just to put aside, what I really love about the Beryl Institute is that is it, it is
independent. And you said, you’re not looking, trying to make money. And I’ve been to several of your
conferences. I even spoke at one of them and it is really kind of like a family. And I think you’ve done that.
And when you are walking around, everybody wants to hear about what you’re doing and what I’m doing.
And so do you think it’s a generational thing? Or why do you think that all of a sudden the patient is totally
different than they were 20 years ago? Now the patient is understanding that my experience is really
important in that I do deserve to be treated better.
Dr. Anthony Orsini (12m 3s):
Why do you think that’s changed over the last 10 years or even more?
Jason Wolf (12m 6s):
Yeah, I think it’s definitely been quite an, an arc of evolution. I think in the way that health care has operated
and in the way that health care consumers react it to their engagement in health care. My grandfather was a
pediatrician. He was a pediatrician in Patterson, New Jersey. I remember watching him, he would literally put
on his fedora and his suit in his little black bag and walk across the street. Cause he literally live across the
street from his hospital. He’d spend time, you know, doing his rounds, he’d meet with his residents. He
actually stop and had lunch with this nurse’s and they would come home across the street that afternoon.
And in the afternoon, open his one room practice and see children and their family.
Jason Wolf (12m 47s):
And you know what I saw it, you know, in watching my grandfather do that was even though as a
grandfather, he was actually a little scary to me was this compassionate guy, almost this Norman Rockwell
picture of a black and white checkered waiting room with a wooden panels walls. But these toys and books
were, he would get them on a knee when he came out to bring the next child back and talk to the child and
acknowledge the parents and walk everybody back together. And you know, even in the moments like that,
where I know the system that he was operating, one is one of hierarchy. Right? Do what the doctor says, go
to your appointments, go and do what you’re told the potential for that connection always existed. But I think
what we’ve found has evolved over time is the realization of the power of that as part of really the
prescription for health and wellbeing became more and more evident.
Jason Wolf (13m 36s):
That it wasn’t simply the science of medicine that mattered. But the research has evolved dramatically from
the aspects of care. To, a rapidly evolving consumer population that has access to more information is driven
to make different choices. And so I think it’s the kind of this inflection point of a shift in the way people realize
they could deliver on medicine that expanded their own capacity. That really drove them back to their
purpose. Right? My grandfather was a McGill graduate raised in the Ostler methods. He was taught that
person centeredness. It is that connection to people as important, but yet it in practice, we started wiped that
out. But I think what happened is all the purpose that drove.
Jason Wolf (14m 16s):
I’m sure you, in so many others to choose the clinical world is a profession wasn’t because I, you know, I am
a science whiz, even though you need to be incredibly smart at that it’s because you have a bigger purpose
for caring for the person in front of you. And I think we created a space for that to come out. I think the
consumers asked for that to come out and they started making choices as a result of that. And so that
evolution of the reality of moving beyond just the mechanisms and science of healthcare, I think was this arc
of life we’ve been on now, it’s been inspired yes. By things like surveys and other things in particular in
United States, like the CAHPS survey that made measurements of experience have a financial priorities
while for organizations.
Jason Wolf (14m 59s):
But I think that when you look at what people do, it’s beyond simply the fact that they are reacting to a
survey. And in fact, the places that succeed at this are the ones that worry least about the survey and more
about the overall experience they wanna provide. But I do think it’s been an evolution of how we practiced.
It’s been an evolution of the demands that have been placed on us by the typical health care consumer. And
those continue to evolve at a place where we are finding this incredible opportunity for mutual partnership to
drive the best outcomes overall. And then I think that’s been an exciting evolution to see.
Dr. Anthony Orsini (15m 31s):
And for people who may not know this, and I find that a lot of people don’t know, this is not a soft skill. As
you said, it really affects clinical outcomes. That’s really clear how it affects your net profits. I talk about it on
my book, how that affects physician burnout, right? And if none of that gets you, that it’s just the right thing to
do. So I had was really fortunate to talk about your grandfather and I have a role model too. Of course my
parents who are amazing people and they raise me amazing and I’m so indebted to them, but there was
somebody in my life who was a Physician, I’m the only non non-cop in my family, you know, but I was a very
close to Dr. Merk and Dr. Merk was a family doctor in Newark, New Jersey, and he did everything.
Dr. Anthony Orsini (16m 13s):
He delivered babies. He was a pediatrician and Dr. Merk practice for so long that he delivered me. And he
was one of the first people I rotated through medical school with it was at his office. And the reasons why
this is so important to talk about him in my book is Dr. Merk. And when I watched him, his patients lit up
when they came into his office and Dr. Merk had a way and you know, and the more I learned about patient
experience, the more I understood that why Dr. Merk was so successful, he practiced 50 years. He never
got sued. Jason, that’s amazing. And his patient’s loved them so much. And he could taken off the wrong
finger and they wouldn’t have sued him.
Dr. Anthony Orsini (16m 53s):
But r. Merk had this way of connecting with people and we talked about burnout, why it’s related to burnout
Dr. Merk, He loved his job so much. He practiced for 50 years because he was happy. He was relating to
patients. And I really do believe that this is all about patient experience, so that it gets to my next question.
Patient experience is really about the ability of the provider to form a relationship with their patients. And I
want you to comment a little bit more about that and, you know, there’s so many different aspects of the
patient experience, but that’s the most important thing is how do you describe patient experience? I know the
Beryl Institute if you want to give people that definition, but what do you think communication falls in the
importance of all this?
Jason Wolf (17m 37s):
Yeah. Well, I would say to answer that question first at the top, that’s an unquestionable data point, not just
an idea. And I think exactly to your point, it was actually one of the very first papers. We every wrote at the
Institute we spoke to are exactly the point you raised. That when we have open honest, transparent
communication between providers, physicians, and patients and family members, we have better outcomes,
but we also to your point, see little to no legal recourse are all of the mechanisms that get in our way of
building stronger relationships and better outcomes. And in fact, they, it creates that positive feedback loop
that you were speaking about, right? I mean, if I’m there and present as a physician like you are for your
patients and they give you that feedback, they re-energize you.
Jason Wolf (18m 20s):
And to what that purpose was that brought you into that cycle in the first place. And all of that comes down to
this communication component that you speak about. I mean, I think when you know, our data over the
years and in particular, even just as recently as are most recent PX polls that we do in conjunction with
Ipsos, once a quarter, we reinforce that people are saying, you know, what matters most of my experiences
that might health, you know, ultimately improves, that it’s safe. So safety and outcomes are up at the top.
And if they are parallel by not above or below, but paralleled by, you listened to me and communicate to me
in a way that I can understand. And so what a general consumer is saying that if you can show me that
you’re caring for me in a safe quality way, and you’re communicating to me and listening to me and in a way
that I can understand we’re getting it all right.
Jason Wolf (19m 9s):
And in fact, I think when you invert that and say, well, from a provider, I could almost turn this around a new
it’s like, you know, from a provider standpoint, if you feel like you have a healthy, vibrant, engaging
conversations with your patients and, you know, you’re providing them the best in outcomes, that’s an
enlivening outcome for you was a doc. And so we create this kind of positive, outward swirl that really
generates the best of health care can be all around that ability to communicate that does drive the best in
outcomes. So I think it’s not even a question of whether it’s a thing that should be considered. It is essential
and fundamental to the experience overall.
Dr. Anthony Orsini (19m 44s):
As the Beryl institute would tell you in their definition, that is really, it’s the continuum of the patient
experience from the moment they walk into the door. And so that’s why it’s so important to you and I are
talking about patients and doctors right now, but it’s how you are greeted by the receptionist and how you
greeted by the security it’s the signs in the hospital. The room, you know, in the name of the book is all the
Delivery. It’s how you say it makes a big difference, but you know, talk about communication. We did an
informal study. We asked the mother, a father in a pediatric setting. What makes you feel more comfortable?
Someone walked in and say, I am one of the doctors whose taking care of your child, one of the senior
doctors, or I’m the intern responsible for your baby’s care?
Dr. Anthony Orsini (20m 30s):
And Jason 60% of them said, I’d rather have the intern. And we looked at them and I said, you know what an
intern is, right? they just got out of school. And the response that we got very often was, but that’s my intern.
She’s taken responsibility for my baby and its all about that connection and building rapport. And that’s what
I think Dr. Merk did so well. And that’s what I think the best Dr do. They take the time to sit down and build
the rapport and find a commonality and example of when you and I spoke it, didn’t take us very long in to
find commonality within three minutes, we knew that we grew up next to each other. So you are younger
than I am, but communication has been an issue with this, but I think we’re getting better at it.
Dr. Anthony Orsini (21m 14s):
I think that we are starting to teach it in medical school a little bit, but I want to move on to difficult
conversations with hospital administrations and leaders. I think there was a study. I believe it was in Beryl
that said that 64% of hospital, executive leaders named patient experience in the top three priorities for the
year. And that was back. I think the 2011, I believe. And yet I speak to the patient experience managers all
over the country. And I know you do a lot more who asked me questions, asked for help and say, I’m on an
Island here, Tony. They give me no budget. You know, it’s a 300 bed hospital and I’m told just to go around
and fix the patient experience, why do you think executives keep putting it in a top priority?
Dr. Anthony Orsini (22m 3s):
But it still hasn’t put their money where their mouth is in many cases. And how should that conversation go
Jason Wolf (22m 8s):
It’s a great question. And that, you know, I think it almost comes back to your mentioned of the definition of
patient experience itself. So as we define patient experience, as a sum of all interactions shaped by an
organization’s culture, that influence patient perceptions across the continuum of care. So every touch point
and it is even well beyond anyone ever enters any clinical setting to well after they leave. That’s a part of the
experience that they have. It’s the stories they tell it’s the lasting impact of those efforts. And so if you think
that every interaction, every touch point makes a difference and the experience and ultimately the story that
people will tell about your institution is that it is grounded in and the evidence continues to prove it’s
grounded in the kind of organization you build, the kind of organization you say you will be the behaviors you
espouse and require of people that are part of that organization.
Jason Wolf (22m 57s):
The story is that you tell us about yourself in your own communities. It is an interesting disconnect. And I
think here’s where, and at least in my observation it happens. I don’t think anyone out there from a
leadership standpoint will tell you that the experience they provide people in their care, isn’t important? And I
think that if they say that it isn’t true than they are definitively in the, you know, the wrong business or if you
got to have their priorities upside down, or the challenge with it is that we have operated at least from my
perspective of health care. So much as sort of tactical operationalizing of so many buckets that we have
made for some where some have chosen to make a patient experience or experience overall a thing to do.
And when it becomes a thing to do, you have to prioritize it among other things to do, you have to budget it
against other things to do.
Jason Wolf (23m 44s):
And here’s the reality, whether you have the most beautiful patient experience strategy in the world, or none
at all, the next person that engages in your organization. Like I said, whether it’s on the streets, talking to a
friend at Walmart or they’re sitting in the discharge area of waiting for their instructions, they are having an
experience and whether we plan for it or not they are having an experience. That Experience builds is the
stories that they will tell. And those stories will be told. So you can either choose to have it, be part of the
strategic framework of how you operate your organization and then support that in a way that matters or you
leave at all to risk. And here’s where I think we have a huge opportunity to stop seeing patients experience
as a thing to do it is who organizations are, the experiences that the organizations provide, reflect everything
about all they do clinically, operationally, financially priority-wise strategically, we’ll get every l word in there.
Jason Wolf (24m 38s):
Right? And it’s part of what an organization espouses to do. It’s the disconnect with making it a thing that we
have to put in the list that it then gets deprioritized or are underfunded or those kinds of things. Yes, there are
tactics and tools and resources that we need to invest in to ensure even greater levels of experience
excellence, but it doesn’t require us to do huge amount of things. When you look at what consumers say,
and we look at the data again and again, back to the things we talked about, listen to me, communicate to
me in a way that I can understand, treat me with dignity and respect. Those are the things that are at the top
on the lowest level of the scale for them is the best food ever parking is easy. All of these things yet we spent
all our money on this side that matters the least to patients, and we call that patient experience investment.
Jason Wolf (25m 25s):
And therefore we leave ourselves imbalanced instead of working at the fundamentals where a leader can
model the kinds of behavior they can suggest not only just suggest but demand, that’s the way in an
organization operates. And you are creating an experience with little to no resources, except having a very
smart people, guide that process and having the right people involved in your organization, executes on that
every day in every interaction. So to bring this all back to the sum of all interactions shaped by an
organization’s culture, if we can get that part, right, this doesn’t have to be an issue of prioritization are
missing. It shouldn’t be a fundamental fabric of any organization. If they’re looking to drive the outcomes that
Dr. Anthony Orsini (26m 4s):
Absolutely. I just spoke to someone last week whose head of patient experience at a 200 bed hospital. And
she said to me, I said, well, what kind of resources do you have? And she said, it was just me and the CEO
is on board yet. And I have her support. But every time I try to do some kind of training for the nurses or, or
work with them and talk to them about communication skills. I got an HR guy who’s not so convinced that
this is how we want to spend our resources. And so she was very frustrated. I get this all the time, but I don’t
know what to say to her. What would you say to her, how we can approach that? Because I feel helpless to
Jason Wolf (26m 41s):
It has to come back to me. The conversations that have worked have been in the, t that you have to be very
clear that it’s just not another thing to do, but if you work from the end back in, we want our patients to feel
cared for her, to be heard, to get the best outcomes in order to do that, we need to provide an experience
that enables all of those things to happen. And we have to ensure that our people in our organization have
the resources necessary to enable that to happen at every moment in every interaction. And if we can make
that argument and build backwards from there, it’s not just a, we’re going to go do patient experience
training, but we are actually building the fundamental fibers of the kind of institution kind of organization kind
of care provider’s we wanna be. For everybody in this organization, ’cause you never know where that
experience can go right or wrong.
Jason Wolf (27m 25s):
Right. As you said, it could be the person changing out the garbage. It could be the person parking. It could
be the person that literally wearing your badge in the supermarket that you run into. That’s rude to you.
Right? And so all of those moments matter. And so providing the core skills to ensure that those moments
matter and they matter well in each encounter is so significant. So that’s the way I would approach it. And it
usually advice. I give people, you can’t approach it as just a okay. It’s a thing in my strategy that I need to do,
but it’s really driven towards our broader organizational intent.
Dr. Anthony Orsini (27m 55s):
Absolutely. Where The Orsini Way has been most successful. It, I think the reasons why we do a program on
communication is the cultural change is almost permanent. Yes, because what I try to do is explain to them
while we give them a really cool communication techniques on how to build a rapport. But in the end, they go
home happier with her job, which we have business leaders on this podcast all the time. And employee
engagement is so important. And in the hospital, your nurses and your doctors are in your employees. And
so they’ve left a meaningful relationships with their patients, even if they just met them for four or five
minutes, and everybody loves their job, they go home and it’s infectious, right? It’s just it’s infectious, but we
are still struggling.
Dr. Anthony Orsini (28m 37s):
We’re getting better. I’ll tell you a quick story. We were going to do a communication training program at a
hospital. It won’t tell you what it is, but I got a call right before were ready to do it. And so we have to put it on
hold. And I said, why? And they said, well, one of the nurses, she put a complaint in with the union that she
didn’t want to be forced to take Dr. Orsini’s workshop and her quote was, she said, it wasn’t in her job
description to be nice. And so we’re fighting this, but overall what’s so amazing is that when people start to
understand that it’s not only benefiting the patient, it’s benefiting, your hospital has benefiting you. You are
going to go home happier. And it’s not that hard, right?
Dr. Anthony Orsini (29m 17s):
Jason it’s, it’s not that hard.
Jason Wolf (29m 19s):
Right? Well, the argument is right. It is in your job description to provide the best outcomes for everyone that
walks in this institution. And so therefor, this helps you do that. I mean, and that’s the point that we have to
continue to reinforce, right that, you know, the, you know, if anything that people take away from these kinds
of conversations I have is that if we continue to think of Experience or patient experience, as a phrase is a
thing to do, we’re going to always miss because it’s going to be something that we can prioritize. And then
something, we can also draw the line through and until we realized that we have to make it fundamentally
part of what we want health care to be, and then invest in the right resources to do that. We’re not going to
necessarily be there. And our patients and our families, the general consumer is saying, that’s exactly where
they want us to be.
Jason Wolf (29m 59s):
And so until we can do what we need to do to match that disconnect, then you know, we’re going to
consistently be at risk in the health care of not meeting the ultimate needs of our patients and families.
Dr. Anthony Orsini (30m 9s):
And the patient experience. People need to be involved with everything, including how you design the office.
You know why it was at the hospital the other day where the, the new office is literally had the computer, you
know, in order for the physician to look a lab value up, she literally had to turn her back to the patient. And so
we need to be their from the ground up and say, let’s imagine your the patient. I think we got along way to
go. But I think thanks to the Beryl Institute, I’d been so excited because this turns me on, I love this stuff. I
think it’s because it’s so nice when you leave work and you’re happy. Yeah. I just have to figure out the best
way to have the conversation. And I’m sure you do this all the time with that. CEO saying you don’t need a
Dr. Anthony Orsini (30m 51s):
Let’s invest in a little training for you and lets talk about patient experience because in the end like you listed,
what was so important to me is that TVs didn’t even come up. Its not, it doesn’t matter how big the TV is.
Jason Wolf (31m 2s):
You mean the lowest number thing on of our rankings. This is in this last study and it was even in 2018 was
a healthcare facility that provides amenities. It’s extremely important to less than 10% of the US consumer
base, less than 10% is extremely important. It’s not even very or extremely important to just 20% of people.
So one or two out of five people, that’s it? That your amenities matter to the other four are looking to you for
the things that really matter to them. That is the point in all of this, right? I think, you know, we have the
evidence, we have the practice and we have the purpose altogether in a way that should drive people in the
Dr. Anthony Orsini (31m 40s):
How many resources out there for a hospital administrators who want to improve this through the Beryl
Institute and you have so many training programs for patient experience people that I really do believe that
this is a ripple effect, then I think we can kind of get away from that. Let’s just make the waiting room prettier
and everybody will be happy. And I think that, you know, well back when I’m sure when you started, there
were a lot of people who are treating the hospital’s like hotels, let’s make the lobby nice And in a hotel a big
TV is probably much more important than it is in the hospital because what’s important in a hospital is that I
relate and form a relationship with the doctors and nurses. And so I think we’ve come a long way.
Dr. Anthony Orsini (32m 20s):
I want to ask you before we leave about two more questions. So yeah, you can’t get it from an interview right
now without talking about COVID right. And I know that I was doing a lot of speaking about patient
engagement, patient experience, and then COVID came and everybody, and I don’t blame anybody, but
every hospital administrator was running around with their hair on fire and all of a sudden Patient Experience
was pushed way down and employee engagement was pushed way down, but in some ways it’s really been
more important. So how did COVID effect us in the last seven months or eight months?
Jason Wolf (32m 54s):
You know, there’s so many layers to that question and you know, seriously, it’s like, you know, in general it
made healthcare consumers more cautious. I mean I think, you know, again, back to our PX pulse and
watching the data, less people were participating in direct care. So first of all, you know, at the same time, it
reinforced and really heightened the importance of the relationships we built with people because you know,
in the majority of cases out there and still to this day, if not that they came back and are now going there
again because of the surge in cases. So many places around the world is that the only relationship that our
patients have and a lot of our facilities right now is the staff around them.
Jason Wolf (33m 37s):
Their family member isn’t with them, their loved ones or care partners cannot be at the bedside necessarily.
And this level of strain, I mean the weight that puts on our care teams, the delivery side of our care teams is
so significant. I say that only because I see care teams as involving patients and families as well. But I think
that the reality is that we’ve had to really fine tune and hone the ways in which we build that connection. And
even the most simplest of ways to be there for someone to listen when we can get health care has done
more in innovation. I think in the last six months where they said, Oh, it’s going to take us another year and a
half to implement tablets in our hospital to do with it in three weeks, write all of a sudden magically, we found
budget an the capacity to implement hundreds of tablets in places to give people access to information or
communication with their loved one’s.
Jason Wolf (34m 28s):
It’s showed us that we can be agile in the moment when we need to do it, probably helped to see we can be
agile in any moment, not just a moment of crisis, an elevated the realities that we have to build stronger
relationships with our patients and family members and find a stronger way’s in fact, to connect with an
engaged family members in care partners, because their absence is clearly felt. And I believe their absence
is actually having an impact on safety and outcomes overall, I would wager and I’ve had other folks say this
to me that they believe people have not made it because their loved one couldn’t be there with them or that
they didn’t have the information they needed to care best for those patients because someone wasn’t there
to help inform them. So it has shown us what is possible in a moment of dire need.
Jason Wolf (35m 11s):
And at the same time, it has made us stronger in the face of what I can only say. And I’m sure you are
experiencing and you have to walk into a hospital every day anymore. The highest level of exhaustion. I
have seen it in a health care workforce ever. Yeah, because you’re not only just carrying the clinical burden,
you’re carrying the emotional burden of having to do everything we just talked about. So in all of that and all
of that chaos, I guess it’s the optimist in me. I see the reality is that everything we just spent all of our time
talking as important to have only been elevated as critical to the overall outcomes that we provide an
healthcare. We’ve had to find two in and sharpen our focus, but I don’t think it’s meant we’ve diminished
focus on experience and unless people see it as the thing to do, like we talked about before, and we’ve done
a lot of work to try to care for our employees, but we were acknowledged a stress.
Jason Wolf (35m 59s):
You know, we have set up a food banks and we have set up the respite rooms and all of the things that
we’ve done, that, you know, it probably a care provider team actually would’ve liked all along the way to care
for them in their busy lives. So we have discovered things in it. So I’m gonna be the optimist to this and say,
we’ve reinforced the important things. We have established practices that shouldn’t go away as a result of
this crisis, eventually hopefully are receding. It also really elevates the importance of why this focus is so
essential and it’s going to be challenging. I mean, we’re in our, what do they say are the four darkest months
in particular you’re in the United States, right? We’re going to have to rely on each other and a lot more in
significant ways than we have. So all of the principles that you have, and I believe in all of the things we’ve
talked about over the last 10 years on our journey of the Beryl Institute are essential and central to a
conversation of literally survival with this moment.
Jason Wolf (36m 49s):
And I think we have to realize that and not just throw it out because right now we’re just caught in a churn of
Dr. Anthony Orsini (36m 55s):
So to emphasize and follow up with what you said before is a patient experience. Shouldn’t be a thing it
should just be yes. And what I’ve seen during COVID is amazing, beautiful, compassionate motions and
things that I have a personal friend whose mother died in the hospital from COVID he couldn’t visit in. So I’m
seeing this around the hospital, the nurse, or the Dr is, you know, got the N95 mask covered from head to
toe, that is holding the iPad so that the son or daughter can say goodbye right. Easily get choked up. So I’m
getting choked up right now, but how beautiful that is and when I see that I go, there’s the patient experience
right there. And he didn’t even know you were doing.
Dr. Anthony Orsini (37m 36s):
And it was, you know, I do this thing in the way. I talk about this book about being a friend in the business,
you know, you want a friend in the business. And when I look at those beautiful moments in health care,
people are really, I still believe are heroes who get caught up in tasks sometimes, but let’s say, and look at
that, you look at that beautiful thing and, you know, let me tell you something, those N95 masks are not easy
to breathe through right. There is sitting there with those patients for hours and holding the iPad. So
grandma can say goodbye. And I just look at that and I’m really proud to do what I do and say, nobody’s
saying I’m doing this because I’m improving the patient experience. It just is. And I loved that when we
stopped thinking about it as a thing, it will just happen.
Dr. Anthony Orsini (38m 18s):
And I love that. So
Jason Wolf (38m 19s):
That’s a, a a hundred percent, but it takes me back to the image of my grandfather who was as tough as a
nail. Physician getting done in his knee and saying hello to the child. That was so scared because they have
to go to the doctor and instantaneously easing his pain because he was willing to be there, not as Dr. Wolf,
but simply as this gentleman who cares about you as who you are, and that’s what we’re doing right now in
this moment, that is the, you know, if we are looking for that glimmer of hope, that moment right now is that
humanity. That’s so essential to medicine. It’s so essential to the health care is so prevalent and it’s
exhausting, but it’s there. And I think that at the end of this, when we look back, that will be the proudest
moment that Healthcare was able to contribute that not only the, you know, clearly the clinical outcomes and
all that we will do for people, but the fact that we, whether someone made it or not brought such dignity and
compassion, connection, and communication in a way that literally impacted people’s lives and will have a
ripple effect, like you said earlier for years to come.
Dr. Anthony Orsini (39m 22s):
Yeah. And those health care workers left exhausted. Yes. As you said, but they left with a sense of pride that
they did something that is, as I say, consistent with their core beliefs and values, as opposed to just seeing
25 patients, because someone told you needed to, it adds purpose. When we add purpose to medicine and
we add relationships to the patient experience just follows in so many thanks to you, and the Beryl Institute,
we’re snowballing here. What do you think ?
Jason Wolf (39m 48s):
We’re trying? I mean, I think, you know, like I said, from the beginning, it’s never going to be about me are
the, Institute so much as it is the contribution of so many in the conversation. And if we can ensure exactly to
your point, if that conversation snowballs that we create, you know, not just a small but significant ripples
around the world and what really matters. And we’re going to end up with the best outcomes we can and
really raising this tide in a way that hopefully we will have a profound and lasting impact. And that’s what
we’re all in this for, I think at the end of the day.
Dr. Anthony Orsini (40m 16s):
Okay. And I know you say it’s not about you, but you are the one who is bringing this up and, and helping
Beryl really be what it is. I mean, what’s the average number of people that are at a conference last time I
was at a conference, it’s a huge conference
Jason Wolf (40m 29s):
A thousand plus people at the conference, you know, we’ve got, you know, close to 60,000 people around
the world that are participating. I mean, just this week alone, we did our first webinar in Portuguese for those
folks in Brazil, you should have heard me trying to speak Portuguese. And you know, we’re going to do a
session here in just a couple hours for folks in Asia and Australia. I mean, this is a universal, or let me say
global. I don’t know that people are on other planets or doing this yet, but it is a global conversation that
really matters. And you have to be able to see so many committed people from so many walks of life, from
all segments of healthcare, like you said, this is not just hospitals. It’s a long-term care home health hospice.
Jason Wolf (41m 10s):
It’s an ambulatory settings. It’s in an EMT. It’s just the places that you see people committed to the human
connection and healthcare is boundless and our capacity to impact that is as well.
Dr. Anthony Orsini (41m 21s):
Well, I promise my audience every week that they’ll be inspired. And if you aren’t inspired by this episode,
then I don’t know what to tell you because I’m inspired. And this is, you know, what I love, but it really does
lift up my heart. And it makes me feel really optimistic about health care. We talk about money and funds
and whether what kind of medicine we are going to have where there’s going to be socialized or private. But
in the end, it comes down to the human to human interaction. And no matter what we do that is going to
have to be there. And I think if we’re getting there, so Jason, this has been awesome. I learned so much
from you and the Beryl Institute conference is coming up, but that will be a virtual?
Jason Wolf (41m 59s):
Yeah. Elevate PX. Now, is there a new name. so it’s going to be a global event, bringing people together
from all of the continents and conversation, and Elevating the patient experience. So we were really excited
Dr. Anthony Orsini (42m 12s):
They can go on the Beryl institute.com
Jason Wolf (42m 15s):
BerylInstitute.org. The, with the BerylInstitute.org, you can find information on that as well as all of our
resources, as, as you talked about it, you know, pretty much half of what we do is open to the world. Our
Journal is open access. We really want this information in people’s hands to make a difference. That’s our
Dr. Anthony Orsini (42m 28s):
That’s the right thing to do. And I will put that for everybody listening in their car, I will write all that down and
put it in the show notes. So please don’t pull over and, and write it down. We want you to be safe. Jason
thanks again so much. This has been awesome. And I really appreciate taking the time of your busy
schedule. I hope that we’ll be speaking many times, just like I’m doing with my other guests now.
Jason Wolf (42m 47s):
Of course we will. And I just am again and humbled and honored to be able to talk to you, you, your
listeners, and, and really appreciate the invitation. So thanks for all you do.
Dr. Anthony Orsini (42m 55s):
Thanks Jason. If you liked this podcast, please go ahead and hit subscribe. Please tell your friends about
this. If you want to find more about the Orsini Way you can go to the Orsini way.com and he could also
contact me through that website. Thanks again Jason! Well, before we leave, I want to thank you for
listening to this episode of Difficult Conversations Lessons I learned as an ICU Physician and I want to thank
the Finley project for being such an amazing organization, please, everyone who’s listening to this episode,
go ahead. Visit the Finley project.org see the amazing things they are doing. I’ve seen this organization
literally saved the lives of mothers who lost infants. So to find out more, go to the Finley project.org.
Dr. Anthony Orsini (43m 37s):
Thank you. And I will see you again on Tuesday.
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