Essentialism and Enhancing Healthcare Experiences: The Strategic Pursuit of “Less”

As an individual dedicated to improving healthcare experiences for patients/families and staff/clinicians your daily work requires a host of decisions, distractions, and deadlines. We continuously strive toward the pursuit of more improvement. Healthcare leaders face pressure to serve more patients, to recruit more clinicians, to generate more revenue, and to see more improvement across measures of safety, quality, and experience. Amid these tensions, I propose the strategic pursuit of less.

The book “Essentialism: The Disciplined Pursuit of Less”¹ by Greg McKeown urges us to consider our highest contributions by focusing on what really matters. As I strive (and struggle) to apply these principles to my life, the following questions emerge: How can we focus attention on the essential few elements impacting improved experiences? How might we avoid “shiny objects” that promise quick fixes? What energy and resource investments deliver the biggest impact?

Two fundamentals of Essentialism in Healthcare Experiences:

1. Pause to discern what really matters. Metrics around patient and clinician/staff experience reflect multiple domains and the response to each survey item feels important. While each item is indeed worthy of notice, not all are worthy of immediate attention. Which survey items should you focus on now and why? How can you and your team set firm priorities? What units, individuals, or populations need most immediate attention? What tangible and immediate actions can you take as you address what matters most?

2. Say “no” to everything except the essential. Healthcare experience professionals encounter multiple, sometimes competing, priorities around improvement. We must say “no” to some projects today so that we can say “yes” to the work (and fun) that really matter tomorrow. Where are your opportunities to decline projects, suggestions, and ideas that may distract you from your highest contribution? With careful attention, we can differentiate the most vital tasks and opportunities from the many (dangerously distracting) vendor solutions, process improvement projects, products, etc.).

I encourage you to review EVERY article in this issue. Topics include: A systematic review of CG-CAHPS surveys; Mapping the patient journey; Connection in an opioid crisis and caring connection; Emergency department provider behaviors; Patient activation in pulmonary rehabilitation; Supporting caregivers in pregnancy; Chronic pain on patients’ quality of life; Family experience in weight management program; Pharmacist–patient communication; Dental patients and attitude and behavior; Cancer patient lived experiences.

Each submission by every JPE author provides a new and valuable contribution of findings and perspectives. However, I challenge you to review this issue through the lens of an essentialist. Discern what matters most to you and focus on activities that fuel your highest contribution toward healthcare experiences. The disciplined pursuit of less represents the road less traveled and it has the potential to make all the difference.

ON THE COVER

By Regina Holliday

Regrounding

While I painted Lori Marx-Rubiner’s jacket the lights were flickering in the high winter winds. My eldest son complained about the constant loss of WIFI. I called a Comcast technician and continued to paint. When the technician arrived, he showed me wires that were melted due to power surges and encouraged me to call the electric company. The lineman inspected the high wires and explained the problem. We had lost our neutral ground and our house needed regrounding.

I was inspired by a life that I read about and I life I lived as I painted “Regrounding.”

Lori was a 15-year breast cancer survivor. She was diagnosed at 35 after having a baseline mammography. She was married with a three year old son when she was dealt this blow. She rapidly went from a “why me” mentality to the stance of an empowered patient. She fought cancer, but she did not fight alone. Her entire community stood beside her. That is a wonderful thing. A family going through cancer treatment so desperately needs the support of a wider community. In the years hence, Lori became part of an even larger community of advocates. She spoke out about cancer and breast cancer and attended medical conferences to share the patient view. In a life we are blessed with so much energy. That energy can be used in destructive ways or for healing. Lori chose to be a grounding agent and thereby helped so many.

Lori Marx-Rubiner 1966-2017

Regina Holliday is a Maryland-based patient advocate, artist, speaker, and author known for painting a series of murals depicting the need for clarity and transparency in medical records. This advocacy mission was inspired by her late husband Frederick Allen Holliday II and his struggle to get appropriate care. Her artwork became part of the national health-care debate. Regina regularly paints and speaks at medical conferences throughout the world.

She also started the “Walking Gallery” movement, where more than 450 volunteer members wear patient story paintings on the backs of their business suits when they attend health-care conferences. The jackets, which were painted by Holliday or one of 49 artists, depict the story of a patient or an element of medical advocacy. These jacket paintings combined with the tools of social media have spread the word about the importance of the patient's voice in health-care discussions. She recently wrote a book “The Walking Wall: 73 Cents to the Walking Gallery.” For more info about the Walking Gallery or Regina's work, please visit http://reginaholliday.blogspot.com/

Essentially Yours,
Laura
Laura Cooley, PhD
Editor-in-Chief, Journal of Patient Experience
Senior Director of Education and Outreach, Academy of Communication in Healthcare
Assistant Clinical Professor, Department of Medicine, Vanderbilt University School of Medicine
Twitter: @LauraCooleyPhD