Caring Through Crisis

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How Chief Experience Officer Rick Evans and the resilient team at New York-Presbyterian Hospital banded together and innovated on the fly to serve their community during the initial surge of COVID-19 in the U.S.

 

Show Notes

Rick Evans and his team at New York-Presbyterian Hospital were at the American epicenter of the COVID-19 crisis in early 2020. They had an incredibly harrowing year. And though their community endured a profound sense of loss, New York-Presbyterian was both a beacon of hope and a pragmatic system of action that helped save lives and make the moves that led a path forward in the pandemic.

In this episode of Breakthrough Builders, Rick speaks with Susan Haufe, Chief Industry Advisor for Healthcare at Qualtrics. Rick offers an insider’s look at the battle to stem the first surge of COVID-19 in the U.S., and shares deeply personal reflections about the far deeper and older scourge of systemic racism in America. Rick and Susan combine to leave us with a vision of the future of patient experience, issuing a call to action to the industry to join them in continuing to repair broken experiences that have persisted in healthcare for too long.

Guest Bio

Rick Evans

Rick Evans, MA, is Senior Vice President & Chief Experience Officer for NewYork-Presbyterian. In this role, he is responsible for overseeing NewYork-Presbyterian’s efforts to enhance the patient and family experience across the continuum of care, and developing and implementing a comprehensive strategy to increase patient satisfaction across the enterprise. Previously, he served as the Chief Experience Officer for Massachusetts General Hospital and its physician organization for four years, overseeing the patient experience along with physician leadership programs, visitor education programs, and the referral management office.


Susan Haufe (Guest Host)

With 20 years of experience combining the tools, discipline, expertise, and passion to design and drive a customer-centric culture, Susan Haufe is known for organizational transformation built on brand promise, purpose, and values. She currently serves as the Chief Industry Advisor for Healthcare at Qualtrics. Prior to joining Qualtrics, Susan served as the inaugural Chief Experience Officer for Yale New Haven Health, developing the vision and roadmap to support the execution of critical initiatives, including centralizing patient experience functions across the health system.

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+ Episode Transcript

Rick Evans [00:00:00] Our people stepped up. They took care of patients. They took care of one another. They put themselves in situations where we didn't know a lot. We just ran to the emergency. That's what New Yorkers do, that is what healthcare workers do, we run to where the help is needed. And that's what our folks did to a great degree.

And with great distinction, I think.

Jessie Purewal [00:00:34] From Qualtrics studios, this is breakthrough builders, a series of conversations with people whose passions, perspectives, instincts, and ideas fuel some of the world's most amazing products, brands and experiences.

Hey, it's Jesse. This week on breakthrough builders, we're shaking things up a little bit to celebrate patient experience week. We wanted to feature a conversation between two health care leaders about how the pandemic has forever changed the way that hospitals and other providers will design and deliver patient experiences.

So on today's episode, we're featuring a conversation between Rick Evans, the chief experience officer at New York Presbyterian hospital and Susan Haufe the chief industry advisor for healthcare at Qualtrics. Rick and his team at New York Pres were at the American epicenter of the COVID-19 crisis in early 2020.

They had an incredibly harrowing year. And though their community endured a profound sense of loss, New York Pres was both a beacon of hope and a pragmatic system of action that helped save lives and make the moves that led a path forward in the pandemic. In his conversation with Susan, Rick offers an insider's look at the battle to stem the first and most potent surge of COVID in the U.S., as well as his deeply personal reflections about the far deeper and older scourge of systemic racism in America. Rick leaves us with a vision of the future of patient experience and he issues a call to action to the entire industry to join him and his team in continuing to repair the broken experiences that have persisted in healthcare for too long.

Rick's story is riveting and passionate, resolute and pragmatic. It begins with his firsthand reflections from the embattled healthcare front lines, just one year ago.

Here's Susan kicking off the conversation with Rick Evans.

Susan Haufe [00:02:29] So today is April 13th, 2021. And when I said that date to you, you had a reaction because a year ago it was a pretty significant day. Tell me what was going on last year.

Rick Evans [00:02:41] Yeah. I had a very strong reaction to it because I think that was the day where our health system hit the peak of the number of patients who were in our facilities.

We have 11 facilities around New York and in the boroughs. And I think it was that day, we were close to 3000 inpatients, nearly a thousand of them on ventilators and in the ICU. That was one of the hardest days of the entire spring. We didn't have all of the equipment that we needed. We thank God, never ran short of the things we needed, ventilators or masks, but it was a day by day effort to make sure that we had what we needed to keep all of our frontline and our patients and families safe.

We were trying to figure out what we were dealing with in terms of the virus. There was an enormous amount of fatalities. So it was as scary a time as I've ever seen in healthcare.

Susan Haufe [00:03:39] The world wasn't prepared for this pandemic. How did your organization literally change overnight to begin responding?

Rick Evans [00:03:47] On many levels, we had to change very, very quickly as the numbers began to increase exponentially almost every day.

For a long period of time, we had to turn rooms that had no connection to patient care into patient care rooms. We had to create ICUs. We had to, have patients in our ORs as ICU beds. We got enormously creative and we made sure that we never ran short of what we needed to take care of patients. In addition, we could not be with each other. Patients needed their doctors.

We had to stand up a very extensive network of telemedicine. So we learned that we could change very rapidly and adapt very rapidly if we needed to. And we did.

Susan Haufe [00:04:31] How did your teams respond to this need to work very differently than they ever had in the past?

Rick Evans [00:04:37] Our people stepped up. They took care of patients. They took care of one another. They put themselves in situations where we didn't know a lot. We just ran to the emergency. That's what new Yorkers do, that is what healthcare workers do, we run to where the help is needed. And that's what our folks did to a great degree. And with great distinction, I think.

You know, when I first got into healthcare, I can remember being told in the orientation, you know, if we ever have a crisis or an emergency, we may ask you to do something that, you know, you don't do in your normal day job. In other words, be redeployed and people did that. Everyone stood up and said, look, I'm in the back office.

What can I do? Well, I can deliver meals. I can transport patients. I can be a runner. I can clean rooms. I'll never forget one of my team and the patient experience team. I was heading out in this spring to do some rounds in our emergency department. And I ran into him cleaning bathrooms. The feeling of gratitude that I felt at that moment,

I got really teary about it because here was somebody who wasn't hired to do that, but that's what we needed. So that's what he did. And there were hundreds, thousands like him that just stood up and did whatever was needed. Even today, we have hundreds of patients as we are dealing with the end of what we hope is the, the last surge in the virus.

People are rising to the occasion, through their exhaustion, through everything they've been through. They're still here doing their work. And I have never been prouder in my entire life to be part of a team like that.

Susan Haufe [00:06:15] One of the things you and I have spent some time talking about is the leadership of your organization and the need to be more vulnerable than they ever had been in the past.

There were hard things happening in your organization. You were losing coworkers. There was a tragedy with one of your dear colleagues in the emergency department. Tell us a little bit about how the leadership team, the culture really shifted during this time.

Rick Evans [00:06:39] Sure. I think many people around the country read about Dr. Lorna Breen. She was a physician leader in our emergency department and a magnificent human being. And she not only became sick during this, but took her own life. And I have to say that was the absolute darkest day of the entire pandemic for many of us and our heart still goes out to her family. But I think that made a lot of us realize that we had to really reach out. And make sure that we were caring for one another, not just the, you know, how are you doing, but really asking that question and waiting for the answer. And understanding what we might need and actively recommending that people get support or help if they need it. We stood up an entire array of services to make sure that our frontline had what they needed, food, clothing, shelter, emotional, and psychological support, childcare.

It's really important for us to acknowledge how we're all feeling sitting here in front of you today. I'm tired. You might even hear it in my voice. I'm exhausted and I'm not nearly as tired and exhausted as the people on the frontline and we have to make it okay for people to say how they're feeling, what they're experiencing, tell their stories.

And to know that it's okay in healthcare to not be great and to ask for help and to reach out so that we can support one another.

Susan Haufe [00:08:07] I couldn't agree with you more. I want to shift just a bit because in the midst of this pandemic, something else happened. Our country faced a historic awakening to the racism that exists in our society and our culture.

What impact did this have on your organization?

Rick Evans [00:08:25] An enormous impact. So this is New York City, one of the most diverse cities in the country, maybe in the, in the world. One of the reasons I love living here in New York, everything that exists in the world exists here in New York. As you can imagine, our workforce is enormously diverse as well.

And when George Floyd was murdered, or other incidences that we all know about, the entire country was moved. New York was certainly prominent in that time. I do feel the need to say that despite what was often in the media, what I saw were lots of nightly, very peaceful demonstrations and protests in favor of fighting for, advocating for racial justice.

Those protests, those marches went right by our hospitals. They went right by the front door of where I live. And it was a very, very powerful experience. And we realized, I think along with the rest of the country, that there's, there's another pandemic much longer lasting than, than COVID. And that is the scourge of racism in this country.

And it was a chance for us to renew our commitment to that, to be very clear about where we stood on those issues. I think many people remember there was a lot of rhetoric in the country. Not all of it was positive or productive, and we wanted to stand for our values and make sure that we were clear on what we were about, which is that every person matters, every person belongs and that we stand against racism, not just not agreeing with it, but we stand against it and we've done a lot since then to make that stand even clearer and more efficacious in the communities where we serve and where we live.

Susan Haufe [00:10:12] Yeah. I know this is also very personal to you. Would you be willing to share the story of Joshua and the experience you had with him?

Rick Evans [00:10:20] Sure. Yeah. So my family, my partner and I adopted a beautiful boy, his name is Joshua. He's going to turn 10 this spring and he's African-American. So we are a diverse family and proud of it. And so I've come to understand being Joshua's Dad in a very visceral way, what a lot of my black colleagues have felt and known for a long time.

So I'm a newcomer, but I'm beginning to see it in a way I never did before. And I mentioned earlier that these protests, these marches went by our house and one evening Joshua and I went to our window and we were watching as they walked by. And I'll never forget it. As long as I live, they were chanting Black Lives Matter, Black Lives Matter. And Joshua turned, looked up at me and said, look Dad, I matter. And I'll never forget it, because he does.

Susan Haufe [00:11:12] Thank you for sharing. I think I won't forget it. I have told that story several times since I first heard it, Rick, and I think we all need to be committed in new ways. And so thank you for sharing that, so we can all begin to understand what we need to do to really change.

Rick Evans [00:11:26] Susan. If I might add one more thing, which I think is important, you know, I mentioned I'm a white man raising a black child. And I would say to all of my white colleagues, that it's time for us to be allies and to really understand the experience of Black Americans or in this pandemic, Asian Americans, we've heard horrible terms like the China virus, for example; and really put ourselves in the shoes of our, of our brothers and sisters, and really think about what it would take for us to be allies, to people who are not like us. And, and I just want to challenge my white colleagues to think about that.

Susan Haufe [00:12:08] I accept that challenge with you.

And I think not only in our industry, that's near and dear to us. But really everyone, regardless of work they do, or where they live, or what their family looks like. The challenge exists that we need to figure out a different way. So Rick, there has been so much that has happened in the last year that we now have to make sense of as we begin to see hope and meaning.

We look towards the future. What lessons has your organization learned that you'll pull forward into the future?

Rick Evans [00:12:38] I think we have a couple of notions of what we've learned. I quite honestly think there's still a lot of processing and learning that will need to be done. One thing we've learned is that healthcare can change much faster than we ever have.

Now you sit there and think about, you know, we've done away with waiting rooms because waiting rooms aren't safe. Well, why didn't we do that decades ago? Quite frankly. I think if our patients and customers had the chance to give us this feedback, they are clearly saying move faster, guys. This needs to be not only great healthcare, which our hospital has always provided, but it needs to be convenient.

It needs to meet my needs. It needs to meet me where I am. And it needs to be faster. So I think we learned a lot about our ability to change much quicker than we used to. We're a global community. We need each other, we can't live in isolation. This was a pandemic by definition. It impacted the entire globe.

And so we've got to think how our behaviors, how our systems work together in a way that I think we never have before. And we are starting to think about what it'll mean to recover, to come back together. Again, we know we'll have to take steps to put ourselves back together and to put our culture back together.

We're envisioning a time where we'll be able to erect the proper memorials to the people we lost. To tell our stories, because what we've done here, we believe is make history. I believe that most of us living through this period, our grandchildren will ask us, what was it like when you were living through the pandemic?

What was it like to take care of these patients? So we need to pay that respect to the experience we've been through. We need to record it in many different ways and we need to share it with each other, but also leave it there for future generations. And then there's simpler things. Being able to open a break room.

And have lunch together. Again, being able to spend time with each other, as colleagues in, in our workplace, those are things that also need to be celebrated. So we're thinking now, even as we're still dealing with patients and issues that we're turning our thoughts to recovery and putting ourselves back together again,

Susan Haufe [00:14:50] I think there will be a lot to celebrate, but I think the pause to honor and heal is going to be a very important part of that recovery.

Rick Evans [00:14:59] I agree with you. Totally. In fact, I think it's really important. And in healthcare we tend to be, okay, done with that, onto the next thing. What's the next initiative. And we do need to keep going and we do need to do new things, but we also need to pause and honor the experience that we're just beginning to come out of.

I think there will be other culture lessons to be learned, particularly as we put ourselves and our organizations back together. And I think that will be a period, the period we're entering into now, which hopefully is one of recovery, will be an opportunity to really think about our cultures going forward and maybe leave some things behind with the pandemic.

Susan Haufe [00:15:40] You're in an interesting new role or your role has continued to expand this year, where you're now thinking about access, which is a new task. Talk to me a little bit about, how you've stretched your brain in a year that's already been so challenging to take on new ideas.

Rick Evans [00:15:56] I'm really excited about where it's gone.

I think if, if I had to summarize it, it's thinking of people both as patients, but also not being afraid to think of them as customers. And you know, sometimes in healthcare we get like, Oh my God, how could you call a patient a customer? Guess what? I think it dignifies the notion of a patient. Meaning we acknowledge that patients have choices that they have preferences.

That they want their healthcare delivered in a way that works for them in their life, that they are consumers who are looking at options and that they can make those choices. And we've got to make it easy for them. We have to remove friction. We often, I think all of us have experienced with healthcare, where we'll say, look, you know, that's, that's not the way I wanted it to go. I had to put enormous effort just to get to the person who I needed to take care of me, we need to remove that. So that's what we're doing here. We're thinking about not only the patient experience, but the consumer experience, how our front door is structured, whether that's the literal front door of the hospital or websites or contact centers and how we can make those things so much more responsive, so much more human, so much more convenient than they are now.

And so that's a big part of what my organization is thinking about and what I lucky enough to be helping lead at this point.

Susan Haufe [00:17:13] I think you and I have been having conversations for over a decade about patient experience. And to think that this is the kind of strategy that we're pushing the industry to think about is refreshing and exciting because at the core we're talking about humans who need it to be easy at the most vulnerable time in their lives.

And we haven't done that very well.

Rick Evans [00:17:34] They deserve it to be easy. Clipboards and checklists and waiting rooms and waits on the phone. None of those things feel acceptable. And if we could change this fast to respond to the pandemic, then we ought to be able to improve those things much faster than we've done.

I think we owe that to our patients and our families, because we've already proven we can do things quickly. So let's not use a lean, need, a pandemic to improve faster. Yeah.

Susan Haufe [00:18:02] We've talked a lot about patient experience being very connected to employee and provider experience, but we haven't traditionally done a good job of linking those things.

What do you think the answer to that is, or do you have some nuggets of what you're going to be trying to do at NYP to help link those things? So we think about them together.

Rick Evans [00:18:24] I guess what I'm taking from it is making sure that the array of supports that we have for our, our frontline, our staff are more robust than they've been in the past.

And I've, I've always felt really proud of what New York Presbyterian does for our employees and how proud we are of them and how much we want to support them and recognize them. I think the pandemic has helped us see our colleagues as more multidimensional than we ever really understood before. Not just sort of workplace needs, but psychological needs, emotional needs, spiritual needs, and that we should be doing something to invest in, better attending to those needs.

I know my title is chief patient experience officer, and I'm passionate about patients, but I'm really passionate about our staff and passionate about helping them succeed in the work that they do every day and connect to patients in the way that they want to. And I think caring for our staff has become even more of an imperative after we've come through this pandemic together.

Susan Haufe [00:19:27] All right. So I have one more question for you - thinking about the world as you've helped build it. What one piece of advice would you leave for our audience

Rick Evans [00:19:37] I have learned that what gives life meaning is helping other people. I know that sounds a little Hallmarky, a little cliched, but it really makes everything feel different when you're making a difference for another human being.

And I would also say that I would give advice about just being your authentic self, that a leader doesn't have to be totally buttoned down. That, particularly in what we've just been through that showing your emotion appropriately, of course, showing people that you have good days and bad days, that you can be tired too, that giving people permission to be where they are and to talk about their needs and state of mind beyond just work, I think has made me a better leader.

So I would share that with all of you, just be who you are, be more transparent. Don't be afraid to show the highs and the lows to the people you work with because it makes it easier for all of us to do that. And that brings us together as a team, it allows us to support one another. It allows us to come together in a much more profound way.

Susan Haufe [00:20:43] Rick, I have such gratitude that you've been willing to share the story of the people of New York Presbyterian and the heroic work that they've done in the past year to really care for your community. You've given us meaning of how we're going to figure out how to take the next steps together. And I just thank you and honor, the people that you work with every day.

Rick Evans [00:21:03] Well, it's, it's my privilege to be able to tell the story of the wonderful people I work with here, you use the word heroic. I think in the spring, when people were stepping out on their balconies to applaud, it did feel heroic. It feels something different now, a little bit of a mixture of heroism, survival, perseverance, determination.

I think all of those things describe the people that I have the privilege to work with every day. So thank you.

Jessie Purewal [00:21:41] Well Susan, it was a pleasure to have you on the show. Thank you for sharing your time and your energy with us. Great conversation. Great perspective from Rick.

Susan Haufe [00:21:50] Yeah, he's pretty amazing. And I feel incredibly privileged to call him my friend. And have done this work of being warriors in patient experience for many years together.

So thanks for giving us a chance to hear about the amazing team at New York Presbyterian.

Jessie Purewal [00:22:05] Yeah. You two talked on the show about how COVID was a forcing function to get rid of lots of bad or broken parts of the patient experience or the customer experience as he, so aptly put it. As somebody who talks to a lot of leaders across healthcare, Susan, I want to get your view on what are a few elements of the patient experience that you think are gone for good, and maybe what are some that are here to stay?

Susan Haufe [00:22:29] That's a really great question, Jesse. You know, I have been talking to a lot of healthcare leaders and similar to the grappling that you heard Rick struggling with of how do we put this in perspective? I think the entire industry is doing that. I think people are excited that this notion of, we can't do things, is going to be gone for good, that we saw pretty clearly overnight that actually we can do a lot of things.

And so I'm hopeful that that mentality will lead to something that's here to stay. And this continued commitment to innovation and just doing the right thing and figuring out how to get it done. And so I think those things will go hand in hand. I also think there's a concept that will be gone for good, that healthcare happens inside a building. You know for a long time we've as healthcare providers thought about what happened in our four walls. I think the notion of how do we take care of our communities? How do we create health in our communities? How do we provide healthcare, that that's going to be different forever.

And it's going to be certainly in those four walls, hopefully again, someday in a much more normal sense, but I think it's going to be in a lot of other channels as well. And healthcare is going to have to figure out how to do that. I'm also hoping that one of the things that is gone for good is how we listen to patients and families and staff and providers who were doing this.

The government did a really good thing for healthcare about 20 years ago by mandating a survey process. But it's pretty old school. We go to a visit, we get a paper survey. Several days later, we fill out 80 questions and it felt like in the midst of this pandemic, that became really irrelevant. And how do we, how do we take this opportunity to really ensure that we modernize how we do things because we're moving fast and we've got to move faster than waiting for something to come back in the mail.

So I think those are some of the things that I think are gone. Hoping to stay, I think people have been a tremendous focus this year. The people on the front lines who have given their hearts and souls and sacrifice so much to take care of their communities. And they, they worked together in teams in ways that I think healthcare had never seen before.

And I hope that focus continues to be the center of what's good about healthcare. And I also hope that the ability to change quickly doesn't go away. The ability to realize that what we're doing, isn't the very best and to find another way to do it quickly, because I think our patients and families and the caregivers who are doing this work need us to be able to adapt rapidly.

Visitation has been really hard in healthcare during COVID. We haven't allowed visitors because it wasn't safe to allow visitors. Over 500,000 people in our country have died alone this year because we haven't been able to allow visitation. I also started thinking about how important families are in this experience of healthcare.

And hopefully we'll get back to a place where they can be back at the bedside.

Jessie Purewal [00:25:32] It's a powerful reflection, Susan. Thanks for sharing it. You and Rick in the dialogue also hit on the broader experience in play, like how to connect patient experience to employee experience. And what's going on on the provider side, where are you seeing innovation and connecting those kinds of experiences, Susan?

And what advice do you have for chief experience officers in and around healthcare who are thinking about how to close those experience gaps?

Susan Haufe [00:25:57] So as we think about innovation, I think there's opportunities to begin to see how those things are actually inextricably connected, that we can't pull them apart.

And in one silo, talk about patient and experience and in another silo, talk about employee experience and then have any hope that they're going to get better together. So I think the innovation that we have the opportunity to think about is how do we bring those things together? How do we listen to those constituencies, those stakeholders that have so much meaning and voice in this experience, we call healthcare.

And rather than looking at those voices separately, how do we bring them together? How do we integrate that data in a way that we can simplify what our focus is, the healthcare industry is overtaxed and under-resourced. So we don't have a lot of extra space, extra time, extra money, extra, extra, anything to have a long list of initiatives.

And so if we can figure out a way to help integrate how we listen so that the work plans become integrated and the things that we're doing to make it better for our patients are the same things that we need to be doing to make it better for the people doing the work. I think healthcare is going to win in that way.

So I think the way they listen is going to have to change, the way they integrate data is going to have to change. But I think that's the only way we're actually going to make any progress.

Jessie Purewal [00:27:15] Thank you for being a part of breakthrough builders and for leading such an insightful and emotional and reflective and empathetic conversation with Rick on the show today.

I appreciate you. And I think our audience will get a ton out of it. Let's do it again soon.

Susan Haufe [00:27:31] I would love that.

Jessie Purewal [00:27:38] Thanks for listening to Breakthrough Builders. You can subscribe to the show wherever you get your podcasts. If you enjoyed the show, I'd be grateful if you could spread the word by leaving a rating and a review; it really does help other people find us. And please tell your friends. Breakthrough Builders is a Qualtrics Studios original, presented and produced in collaboration with StudioPod media in San Francisco.

The show is hosted and executive produced by me, Jesse Purewal. Our writer is Todd Bagnull. From StudioPod media, Deanna Morency is our show coordinator. Editing and production by Katie Sunku Wood. Additional editing and music is provided by Nodalab. Our designers are Baron Santiago and Vansuka Chindavijak. Website by Gregory Hedon.

Photography by Christy Hemm Klok. Special thanks to the entire breakthrough builders crew at Qualtrics, including Ali Rohani, James Wadsworth, John Johnson, and Kylan Lundeen.

Season 3Jesse Purewal