by James Nataro, MD PhD MBA, Chair, Department of Pediatrics
During a recent conversation, Executive Vice President for Health Affairs Dr. Craig Kent noted that the people working in our institution rate us poorly on empowerment. He asked if that resonated with me; I said yes. Then he asked what exactly people mean when they say they do not feel empowered. I did not have a ready answer, but I promised I would try to find out.
Since that discussion, I have been on a mission to learn: do our people feel empowered? How do we improve it? And perhaps most important, what does empowerment (or lack thereof) actually mean in our workplace? The first thing I did was release a survey monkey to all the department of pediatrics faculty and staff. Three questions were asked: do you feel empowered in the clinical arena, do you feel empowered in nonclinical areas, and do you feel empowered at the department level? We scored poorly in all areas.
I enlisted Billy Petersen to help out on the Medical Center side, and we began a dialogue. We asked people what they meant when they say they did not feel empowered, and we asked what we needed to do to improve the situation. We have gotten many different responses. It perhaps is easier to think about what a clinical environment looks like when people are, in fact, highly empowered. My father was a dermatologist in solo private practice and I spent considerable time in his office during my childhood. He was thoroughly empowered to effect change in his own practice. He decided what hours he kept, how many people were employed to perform different tasks, what everyone was paid, how he dealt with patients including how much time he spent with them, etc. I also spent two years working in a primary care pediatric practice at the beginning of my career, and I saw the same thing. In private practice, there’s a control over many elements of the service and of the patient and provider experience. In our massive academic medical center, in contrast, we can’t possibly have that kind of control of our environment. But is there an empowerment “sweet spot” in our academic medical center?
Since we have started to address empowerment, we have put several things into effect. The first is the Empowerment email, which I curate in partnership with Billy Petersen. The purpose of this email is to provide a single source to for communication, a single point of contact if you want something addressed. This is in response to the common complaint that folks were just not sure to whom to address a complaint or comment. With the firstname.lastname@example.org email address, you don’t have to know where to take it – you simply send a message. Billy and I have read and responded to every message we have gotten. We don’t always effect the change requested, but there is always closure of the communication loop.
A second initiative recognizes that people in our organization deserve a voice in how financial investments are made. We took the opportunity to engage as many people as possible in the decision regarding how to invest the revenue received by UVA under the Fortify clinically integrated network. Speaking to many people in the clinical setting, it became clear that they needed additional support infrastructure, and they thought that the personnel working at the point of care needed to realize some financial benefit from their hard work during the pandemic. Susan Gray has done a great job in distilling the opinions down to a workable plan which we will now execute.
The third element of an empowered clinical environment is having the support staff (social work, care coordination, nutrition etc.) that one needs to be successful, deliver care, and operate at the top of one’s license. To address this issue, Billy Petersen and Karin Skeen are working to develop a staffing model for our clinical enterprise so that all services get the clinical support they need. We may not be able to afford to give everyone what they think they need, but having some level of support, and more importantly to be heard with regard to the support that’s needed, are essential to an empowered workforce.
We are not finished addressing empowerment, and most importantly we are not done listening to what people mean when they say they are not empowered or that they need to make changes in their work experience. Watch for updates on this evolving topic, and of course for follow-up surveys.
Thanks so much for the great work you do in the service of our patients and their families.
Filed Under: Features