This blog is one in a series about burnout and moral injury in behavioral health. This post and those that follow will dig into some practical solutions that you could apply in your organization. The most effective changes in large systems start at the bottom with those who are impacted most. If you are motivated to solve burnout and moral injury in healthcare, keep on reading! Read the original blog here.
Radical Candor: Listening To & Understanding Feedback
Open dialogue is crucial. Issues can fester for months or years under the surface of an organization and that destroys a culture. You’d hope that in behavioral health, we’d all be skilled communicators but there are always power dynamics, fears, and anxieties that get in the way. Here are a few of the things we do at AHV to promote radical candor and a free exchange of ideas and information throughout the organizations.
Here are the three documents that we use at Green Hill and Advaita Integrated Medicine (collectively, Advaita Health Ventures) to provide clarity to individual clinicians.
Weekly staff meetings that include providers, administrative support, and leaders that discuss patient-related issues as well as the metrics we are tracking (which flows from the expectations listed above).
Weekly one-on-one meetings between each supervisor and their direct reports, whether they’re clinical or administrative. These meetings are used to get a pulse on how each person is doing, both personally and professionally.
Real time feedback is also crucial. “Transparency” is one of our core values and we say that “We communicate with radical candor,” which is true most of the time. To give candid, real-time feedback, you need to have established clear goals and expectations – it’s also crucial that you’ve established a caring professional relationship, otherwise the candid feedback can come across as snarky or aggressive.
Values-based onboarding, training, and feedback are how we build a cohesive culture. It’s not enough to tell someone, “we expect you to communicate with radical candor”, because it’s a skill that must be trained! By creating a set of shared values and giving feedback that are aligned with those values, you’re able to create a culture that values feedback and the learning that feedback provides.
Ultimately, feedback is used to smooth out the rough edges between expectations and reality. An example of this we recently encountered was around appointment scheduling and the administrative burden one of our providers was experiencing.
We had agreed on “how we practice medicine” at AIM, which basically just means we have appointments that last 30 minutes or more (none of the 15-minute pill mill stuff); however, onboarding existing patients into a new EHR was more burdensome than expected. In response, I, as the P&L leader, said to continue having 30 minute appointments but to block them for one hour to allow the clinician to update records.
If I didn’t receive the feedback that the psychiatrist was experiencing a higher than expected admin burden, I could have pressed harder which would lead to burnout.
We had agreed on “how we practice medicine” at AIM, which basically just means we have appointments that last 30 minutes or more (none of the 15-minute pill mill stuff); however, onboarding existing patients into a new EHR was more burdensome than expected. In response, I, as the P&L leader, said to continue having 30 minute appointments but to block them for one hour to allow the clinician to update records.
If I didn’t receive the feedback that the psychiatrist was experiencing a higher than expected admin burden, I could have pressed harder which would lead to burnout.
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