Hospital Impact: What one health system executive learned from shadowing frontline staff

Doctor and nurses wheeling patient in gurney through hospital corridor
Before shadowing their team members, healthcare leaders should ask themselves: What goals and standard processes does your team set to improve quality and patient experience and lower costs? (Getty/Sam Edwards)
Scott Kashman headshot

Over the past few months, I’ve taken on a new role, working with all our hospitals. It’s been a great experience getting to know what we are doing really well and consistently across our hospitals and what we could still do better. That includes standardizing and spreading best-known practices where appropriate.

Our focus is similar to many other organizations: Improve quality and experience and lower costs.

One great way to learn what’s going on with your team is by shadowing its members for a couple of hours. You get a chance to appreciate the culture, the challenges, the camaraderie and the pride that exists at every level.

RELATED: Hospital Impact: To boost care quality, engage frontline staff

Before shadowing, ask yourself: What goals and standard processes does your team set to improve quality and patient experience and lower costs?

And as you shadow:

  • Determine whether the team has clear standard processes to support the system’s goals. If not, explore what your leadership team could do to facilitate the necessary support
  • Evaluate what communication systems are in place for frontline staff and leaders to provide feedback. This should include what’s working well and what processes could be improved
  • Solicit the team members’ feedback, thank them for sharing and let them know what action, if any will be taken based on their feedback.  More leaders need to proactively ask for feedback—and accept it graciously

I’ll share a few of my shadowing experiences:

Shadowing house supervisors made me appreciate the challenges they are up against. While placing patients in a timely manner was a main function of their role, it seemed to include 700 jigsaw pieces to pull it together. In addition, placing patients was just one part of their role—they really need to have a strong grasp of the entire hospital operations while taking call after call.

In one situation, the house supervisor pointed out an intensive care unit (ICU) supervisor, who was in the emergency department (ED) and was looking to bring clinically appropriate patients to the ICU. You could tell the ED team enjoyed having him there, and it made it much easier to coordinate the care from one level of the hospital to the next.

Shadowing a couple of our physician advisers, I had a chance to see a multidisciplinary team discuss patients, understand the key clinical issues and address post-acute care options. They also had great dialogue where there were challenges, really showing that one person could not make every decision—it takes the input of many to care for our patients.

In another experience, I went undercover. Well, not really—I put on scrubs and worked for Ben L., one of our emergency techs in the ED. I was about to let him know he could be direct with me and feel comfortable to provide direction. That was not necessary, though—before I could open my mouth, he asked me to help him lift a patient and assist him to the bathroom. He paused, looked at me and said, “and keep up with me!” He was a great teacher and stuck with me even as I fumbled my way through some things.

Each experience helped me look myself in the mirror and better understand how our role as leaders must include how we support our frontline staff every day and how we solicit their feedback to make processes better. In turn, our patients and families are the benefactors.

Here’s some advice I learned from the staff:

  1. Set clear goals, expectations and processes
  2. Show discipline: Share the top priorities and ensure they are under control before moving to the next priority
  3. Show you care
  4. Ensure you are fair
  5. Be there for your team and enjoy your co-workers. Healthcare is a team sport

I look forward to hearing some of your experiences.

Scott Kashman is the chief acute care officer for Lee Health, a health system based in southwest Florida.