Years ago (during the 1970s to be more exact), as I stood in front of a classroom teaching music to high school students, I never thought that I would eventually become a healthcare executive nor—even more astonishingly—rely on what I learned in that classroom to revolutionize and reorganize hospitals.
But that is exactly what happened. And now, as I stand much closer to the end of my professional journey than its beginning, I wonder, genuinely wonder, why so many of my peers seem unable to see what I see when it comes to such issues as Transparency, Kindness and Compassion, and Patient, Student or Employee-centeredness. These are topics I’ve been writing about, involved in, and literally living for decades now.
My passion for this philosophy has not waned during that time, not even for a nanosecond. Its core is centered on humanizing experiences and on being transparent, engaged, supportive and nurturing. It is all about focusing on employees, staff, students or patients in ways not previously considered even before the United States government began to attach reimbursements to patient satisfaction scores in hospitals.
The good news is that hospital by hospital, school by school, and business by business some individuals—often against incredible opposition—are working toward a kinder, gentler world. Will they be successful? Can they change a structure that has long since been openly criticized as dysfunctional?
I believe that many of them will be successful. In fact, this effort is directed toward all of those who believe that they can and will find a better way to deliver care and, in the process, make life better for all involved.
For me, the journey began years ago.
I started my professional life dreaming of becoming a great trumpet player. Eventually, that dream morphed into a teaching job, which lasted ten years. During that time of trying to instill the same passion I had for music into a roomful of teenagers, one thought kept playing over and over again in my mind: “How would you like to be treated?”
My teaching led to a discovery that seemed unique at the time, at least to me: junior high and middle school aged students had an unbelievable capacity to learn and to excel. This breakthrough in my thinking back then was affirmed recently in an article which appeared in a special edition of U.S. News and World Report, “Secrets of Your Brain,” by Nancy Shute entitled, “How to Deploy the Amazing Power of the Teen Brain.”
Until Ms. Shute’s article, I had no scientific evidence to back it up what I discovered as a young teacher. Before the use of MRIs beginning in the 1990s, it was impossible to know what nuanced changes were occurring in the brains of teenagers. Of course, the neurologists still don’t understand the myriad details of those changes, but they can make certain not-so-speculative statements about these changes. According to the article, what they found astonished them: The brain’s gray matter, which forms the bulk of the structure and processing capacity, grows gradually throughout childhood, peaks around age 12, and then furiously prunes underused neurons.
Because these changes begin in the back of the brain and move forward, sensory and motor skills mature first. These are followed by the prefrontal cortex, which is responsible for judgment and impulse control. According to the scientists at the National Institutes of Health, the prefrontal cortex isn’t done developing until men are in their early 20s. The following quote from the article, however, should be the basis for all of the arts education in the United States: “Neurons, like muscles, operate on a ‘use it or lose it’ basis: a teenager who studies piano three hours a day will end up with different brain wiring than someone who spends that same time shooting hoops or playing video games. “
When we consider that during the teenage years, emotion and passion also heighten attention and tramp down fear, that brief time period presents the perfect opportunity to master new challenges. According to Frances Jensen, a neurologist at Children’s Hospital in Boston, “They (teens) can do things now that will set them up later in life with an enhanced skill set.”
Of course, the 1970s in semi-rural America did not harbor all of the challenges that we now face for our teenagers, but challenges did exist. What I had discovered in my work was that, by treating teenagers more closely as adults than subservient children while still maintaining control, by allowing them to work with you to select and enumerate their goals, and finally by encouraging them along the way, their passions and intensity would take the music and their performances to heights that would have seemed otherwise incomprehensible.
Music arranged for teenaged performing groups typically was watered down and lacked both emotion and challenge. I chose to make musical scores available to them that would have been considered too mature, too challenging and too far beyond their comprehension. The trade off, however, was that we were careful never to let them hear any of those “too hard” descriptors.
The results were stupefying. The kids worked endlessly and tirelessly to make sure these musical scores were mastered. (A critical factor in this, I believed, was that their parents were, in many cases, second generation immigrants. So they worked to ensure that the kids had: 1.) Plenty of sleep, 2.) A healthy diet, 3.) No drugs or alcohol and 4.) Unconditional love.
The U.S. News article concluded with something that was instinctive to me: “Nature had a reason to give adolescents strong bodies, impulsive natures, and curious flexible minds.” It was the stuff from which scholars, great artists and future leaders were made.
It still sometimes astonishes me to think that a music teacher with a passion for the trumpet would someday find himself running a hospital and founding two genetic research institutes. But mostly, when people began to gravitate to our facility, (e.g., physicians, scientists, patients), it always felt like there was a greater power at work, a larger orchestrator, conductor and/or choreographer behind the scenes.
And for the two decades as a hospital senior leader, I prepared myself for work each and every day by playing the same digital recording in my mind in a continuous loop. What if it was your mother, your wife, your daughter or son who was being treated today? How would YOU personally want them to be cared for by us?
It has been a lifelong mission for me to create an environment for employees, students, patients and customers that first and foremost acknowledged them as fellow human beings and then demonstrated respect for their dignity. In teaching it was the immediate abandonment of the parent-to-child interactions that so frequently represented the style of my peers; in healthcare, my goal was to ensure that we provided a caring, compassionate, and nurturing environment for employees, families, and their loved ones.
The creation of a truly healing, nurturing atmosphere that empowered the workers and the customers–where patients had an opportunity to take part in their care and to make decisions about the type of care they received—was always my goal. In my view, the perfect environment was one where the staff was embraced as the primary resource of the organization and then was rewarded for their efforts. It was about creating a place where Care Partners provided support for their loved ones and where they could actually participate in their loved one’s care.
Most significantly, this environment could not be superficial, the kind found in so many institutions that proclaimed the value and importance of the individual but who eventually would be exposed as frauds merely seeking “good PR.” On the contrary, for this to work it had to be genuine, from top to bottom.
Well, in 2001, a Harvard physician by the name of Dr. Wayne London visited us and explained it was no accident that a musician was in charge, because my instincts had led me to build an ensemble of players who, in a sense, could provide unique and beautiful healing sounds through their science and their work. He also advised me to stay humble because he believed something much larger than me was trying to work through me.
That was both humbling and a little scary to hear. Whether or not I believed it at the time, all I knew was that during my time in health care administration, the efforts of our team resulted in our infection rate dropping to a level that was, on average, consistently around or below 1percent, or eight points less than the 9 percent national average. Additionally, our lengths of stay, readmission rates, restraint rates, and death rates were all well below our peer hospitals.
So what does it all mean?
Ask yourself this question: If you are in hospital administration and have little or no competition, what would happen if a new competitor arose who allowed patients to access their medical records; if loved ones were invited to stay and become part of care giving teams; if there was 24-hour-a-day, 7-day-a-week visiting hours; if employees were always treated with dignity and were respected, rewarded, and recognized for their work; if patients were always at the center of their own care?
What would that mean to your institution?
Perhaps a universal question focuses on whether or not our hospitals will go on treating “organs” or will they begin to treat people? Will we focus on prevention rather than cleaning up train wrecks? Will we embrace kindness, openness, transparency, healing, and respect? Most critically, will we acknowledge that the value of a human being is not based upon the assessment of his or her estate but on an ability to give and receive unconditional love? When this happens, your patients, your students, and your customers will come running to you.
Patient-, Employee- and Student-Centered Care should be the new world order and it represents a demystification process. It represents an open spirit of communication that allows individuals to make the same types of informed choices that they have been entitled and encouraged to make in every other aspect of their lives.
Our vision, our mission, our goals, and our communications are all based on the spiritual connectivity of humankind with one another and with a universe that is larger than any mere mortal can grasp. It’s based on a spirituality that embraces the thought that race, religion, nationality and political beliefs are all moot points here. It’s based on the unconditional love and respect that have become our drivers.
It’s within all of our grasps.
We merely need to be willing to reach for it.
