The impact of the COVID-19 pandemic on the workplace has been widely experienced, but the full effects will only be understood after more attempts at societal reintegration have taken place. For some people, the expansion of the virtual work environment provides an opportunity to balance their work and home lives in ways that suit their personal preferences. For others, the new work–home life integration diminishes both experiences. Many have a new work–life relationship that falls somewhere between the total freedom found by some and the drudgery experienced by others. One thing is certain: The line between what happens in the workplace and home has been forever altered. It is time to think about the relationship between our work and personal lives as a major component of the eventual exit from COVID-19’s restrictions.
One feature of the new work–life relationship that healthcare leaders need to address is the expectation that we will always be available at a moment’s notice. The proliferation of electronic communication channels that started with e-mail on our workplace desktop computers has spread to texting apps on our personal phones, and they are now never more than an arm’s length away. In this “always-on-call” phenomenon, texting shifts from a communication channel for private conversations to a substitute for in-person workplace interactions, a movement that has accelerated amid the physical isolation of COVID-19. A second contributing factor to the always-on-call phenomenon is that many people changed their work schedules to hours that fall outside the normal 9-to-5. Some tended to children schooling from home. Others sought a better fit with their circadian rhythms. Still others took the release from the workplace as an opportunity to change their geography and time zone completely. By initiating these temporal shifts, our colleagues effectively expanded the workday for everyone, and now we are all expected to respond at a near-real-time pace.
As the “new normal” unfolds, healthcare leaders need to reestablish norms for both communication channel discipline and workplace hours of operation. To that point, I offer the following seven recommendations.
- 1. Create a manual. A communication guidelines and best practices document should cover which channel (e.g., phone call, e-mail, video conference) is appropriate for each particular type of topic. Two tips: If an e-mail message requires the reader to scroll, chances are the topic can be handled more effectively by phone. And the ALL CAPS lock, with its typically false sense of urgency, should be removed from all devices.
- 2. Stop using texts. Text messaging by phone should not be used for work conversations. Instead, electronic organizational communications should pass through secure systems that create a record. Texting may violate some privacy regulations, as well.
- 3. Establish a core hours schedule. Organizational communications should be confined to normal working hours for your time zone. Employees should be allowed to rest assured that an e-mail that comes in the dead of night will not require a response until the workday begins. One good model is to set the hours between 10 a.m. and 2 p.m. or 1 p.m. and 4 p.m. for online meetings, project collaborations, and e-mail exchanges, with the remainder of the day a meeting-free zone.
- 4. Break bad habits. E-mail is not a real-time mode of communication. The most effective workers typically address e-mail communications twice a day. Moreover, they generally do not make that task the first and last activity of the day. They reserve those periods for their most important work and attend to e-mail at other times.
- 5. Be present in meetings. Although virtual meetings are easy to create, they should be as well planned as in-person meetings. To ensure that participants are engaged in the discussion, they should be asked to turn on their cameras. Many participants tune out when their camera is off.
- 6. Track screen time. Have your employees track their phone screen time and views. Many will be surprised to see they are spending 4 to 5 hours a day on the phone, checking it more than 200 times. Nobody does their best work on a phone. Simply knowing the amount of time spent can change behavior.
- 7. BLUF (Bottom Line Up Front). If you want someone to do something, ask first and explain why later. Most e-mails are simple requests, and people are happy to comply without a detailed reason. It likely is quicker for them to do the requested task than it is to read the rationale. Get to the point!
Leaders need to both model desired behaviors and correct people when they lapse. Consistency is the key to maintaining good relationships. Having employees audit their communication patterns will make for better communication. You cannot manage what you do not measure. Getting communication right is a good first step toward a better work–life relationship for us all.
Keeping in the vein of actionable advice, the interview in this issue of the Journal of Healthcare Management features Diane M. Howard, PhD, FACHE, chair of the Department of Health Systems Management in the College of Health Sciences at Rush University in Chicago. Dr. Howard recaps her career trajectory in and out of academia, and finally back again. My favorite part of our conversation, though, is when she reveals what is on her bookshelf and explains how she juggles multiple topics simultaneously.
The yearlong Essential Innovation series continues with Allison Amrhein’s piece, “Investing in the Front Line: Leading a Cultural Innovation Revolution.” As the director of operations for iNET, the Veterans Health Administration Innovators Network, she encourages employees to try new ideas. Traditionally, big organizations are risk averse, and creating programs to change that culture can be a challenge. As Amrhein points out, the rewards of risk can be well worthwhile.
Paul Kempinski, FACHE, president and CEO of Children’s Mercy Kansas City, contributes to this issue’s Great Comebacks column. In “The Culture Imperative: Preserving Your Organization’s Soul,” he also highlights the positive power of a strong culture. He describes how Children’s Mercy Kansas City has relied on its organizational culture to prevail over the pandemic.
The peer-reviewed articles begin with a submission from Bruna Stella Zanotto; Ana Paula Beck da Silva Etges, PhD; Miriam Allein Zago Marcolino, PT; and Carisi Anne Polanczyk, PhD, MD, of the Federal University of Rio Grande do Sul in Porto Alegre, Brazil. They provide a rigorous systematic review of value-based purchasing program studies that will be of great interest to their colleagues across the world.
David E. Marcozzi, MD, FACEP, of the University of Maryland School of Medicine, Baltimore; Ricardo Pietrobon, MD, University of Maryland School of Medicine; James V. Lawler, MD, University of Nebraska Medical Center, Omaha; Michael T. French, PhD, University of Miami, Coral Gables, Florida; Carter Mecher, MD, U.S. Department of Veterans Affairs, Washington, D.C.; Nicole E. Baehr, PMP, University of Maryland School of Medicine; and Brian J. Browne, MD, University of Maryland School of Medicine provide a timely piece on assessing facilities’ abilities to deal with a surge in patient admissions. As COVID-19 made abundantly clear, many if not most U.S. facilities struggle to manage the rapid influx of complex and contagious patients. Employing metrics such as those that Marcozzi and colleagues studied should be an integral part of hospital operations going forward.
The article by Dmitry Khodyakov, PhD; Christine Buttorff, PhD; Lea Xenakis; Cheryl L. Damberg, PhD; and M. Susan Ridgely, JD, of the RAND Corporation has both methodological and applied importance in recognizing the differences between subjective and objective assessments of organizational performance. They use both qualitative and quantitative techniques to measure the performance phenomenon, and then they compare the two sets of results. The applied importance becomes clear: We as managers are not very good in our subjective assessments of performance.
Danielle L. Terry, PhD; Patricia Hui, MD; and Shirley Buntoro, DO, of Guthrie Robert Packer Hospital in Sayre, Pennsylvania, look at the impact of the pandemic on rural providers. The results they found are troubling. The psychological toll of caring for COVID-19 patients has been tremendous. Moreover, our rural safety net is already fragile, and this study indicates that we have much work to do in reinforcing it going forward.
I hope you enjoy this issue and find that it makes your work–life relationship a happier one.