Storytelling—Bringing the Human Back Into Healthcare

Carolina Nieto, LCSW

Challenge & Selection

There are few things, if any, in life that can shake us to the core more than a threat to our health or the  health of our loved ones.  For those of us in healthcare, we are entrusted with the awesome  responsibility to care for and comfort people who may be experiencing the worst day or scariest  moment of their life.  Most of us who entered healthcare did it because of a passion for helping and  connecting with people. However, in a the current landscape of large health systems working under  insurance driven models, healthcare providers can get easily trapped in the vicious cycle of chasing  productivity driven goals with the patient as the widget to help achieve said goals and for healthcare  administrators to become so far removed from the actual patient care that a human life becomes but a

number on a report. In my opinion, storytelling is one of the most powerful tools that can bring the  human back to the center of focus and remind those of us in the healthcare industry why we are here  and why we get up and go to work every day.

In the video lecture, “storytelling Tool”, Carlos Hermosillo describes storytelling as a tool we can use  to connect to the emotions of the people when giving them the information we would like to share. It  allows us to share information and messages that have logic, but to present that information in an  interesting and interactional way that evokes an engagement in a purpose or cause, not just a  transactional dynamic of one person providing information and another person receiving information  that information.  I cannot think of a situation where it is more important to remember and emotionally  connect with the cause and purpose than it is in healthcare. There has not been a time in my healthcare  career when there has been so much focus on numbers, reports, ratings, and finances and so little focus

on the human recipient on the other end of our workflows. I believe we can use storytelling as a tool  in which to reconnect and refocus on the human beings we care for.

Application

I had the opportunity to create a new service line that included a team of providers that are charged  with providing a holistic and wrap-around approach to a group of Medicaid recipients with significant  struggles with co-morbid mental health disorders and chronic diseases, with the goal of lessening the  group’s overall healthcare spend. The care approach was fluid and flexible allowing the providers to  provide care in the way that most makes sense. Sometimes this meant the providers would work with  the clients in the community, in their homes, in healthcare offices, or via an electronic media. The  requirement for reimbursement for the model included providing at least one episode of care to each  client no less than once a month.  I created a tracking system to ensure that every client was served  each month and our budget was built on the assumption that we would serve at least 90% of our clients

each month, leaving room for the possibility of 10% of our clients not being available or having lost  contact with them.

I realized, that while the business model appeared solid, it was failing because of the lack of human  connection. I had allowed the human connection and our purpose for the work to get lost among our  team when I started to see a pattern of providers serving all of their clients only one time per month and  their efforts to serve any more clients stop as soon as they reached 90% of their client list.  I had allowed  the business and financial requirements to take priority of focus over the client care.  Through the use of  storytelling, I brought real-life examples of our clients to the team. I shared emotional stories of  successes of clients who received excellent care when providers went above and beyond one encounter

a month because that is what the client needed at the time.  I shared stories of struggles of some of  our isolated clients who felt abandoned and forgotten when they had higher needs, but their provider

stopped meeting those needs after one encounter. And I shared stories of those with the most acute  emotional and physical needs who have essentially been given up on by much of the healthcare care  providers because of their “lack of compliance” with treatment and missed appointments and shared  our team’s opportunity to be the only people in their world who will not give up regardless of missed

appointments or environmental barriers.  It was these stories that provided the reminder and  connection as to why the providers entered the field to begin with. The result was the team  conversations  and focus shifted from making the financial productivity goal to meeting the service  excellence goal.  Ultimately, it was this shift that allowed for a better financial outcome and in a more  sustainable way as the team was emotionally connecting to the reason for service—helping fellow  humans, not just to the work-place expectation of checking the box so a bill could be dropped.

Insight & Approach

If I were to summarize the insights I made in the application above in one sentence, it would be:  As a  leader, your team will follow the story you tell, make sure you are telling the right story.  In  retrospect, I recognize that early in the program development, my philosophical goal was always to  create a great service with an excellent experience for our clients, but my daily focus was that of  creating a financially viable and sustainable service line for my hospital. I expected my team to do what I

said, not what I did and hold a different primary focus than I.  I now realize that stories are not just  pre-meditated presentations to business leaders or consumers in efforts to sway their opinions, but  stories often come out in the every day actions with our peers and clients. I need to remain more

cognizant of the story that I am telling and make sure it is the story I intended to tell.

Ultimately, I am pleased with the storytelling approach used in the application above and I believe it

was successful. However, next time, I think that the stories can be shared and portrayed in more ways

than an oral presentation at a staff meeting. I need to immerse my team in the story I want to tell.  I

might supplement the oral stories with visualizations.  I could include pictures around the office  depicting the struggles and success of our clients and the healing power of the relationship between a

provider and client. I could also use journey mapping to remind the team of the complicated and  frustrating social and health system their clients have to navigate each day, thus reminding the  providers of a tangible purpose of their job. I would create more space/airtime for team members to be

active participants in sharing their clients’ stories, struggles, and successes.  The first use of  storytelling outlined in the application was a very important component to setting the stage for the

program. The constant use of storytelling is an absolute necessity in keeping the human and  emotional connection alive.

