Have you ever wondered how company culture in health care can impact patient care? Join us for an insightful chat with Lori Cabbage of Brightstar and Dr. Louise Short, physician and expert on population health, on the role of company culture in health care. They delve into leadership's influence, employee engagement strategies, and the link between health care workers' satisfaction and patient care quality. Tune in as we discuss the future of care and the transformative impact of a positive healthcare workplace culture.
If you liked this episode and want to learn more about all things home-based care, you can explore all our episodes at alayacare.com/homehealth360.
Have you ever wondered how company culture in health care can impact patient care? Join us for an insightful chat with Lori Cabbage of Brightstar and Dr. Louise Short, physician and expert on population health, on the role of company culture in health care. They delve into leadership's influence, employee engagement strategies, and the link between health care workers' satisfaction and patient care quality. Tune in as we discuss the future of care and the transformative impact of a positive healthcare workplace culture.
If you liked this episode and want to learn more about all things home-based care, you can explore all our episodes at alayacare.com/homehealth360.
Welcome to Home Health 360, a podcast presented by AlayaCare. I'm your host, jeff Howell, and this is the show about learning from the best in home health care from around the globe. Hi everyone, welcome to another edition of Home Health 360, where we speak with leaders in home care and home health from across the globe. Today, we have a nice fireside chat about company culture. Lori Cabbage is the SBP of Business Development for BrightStar and, as a health care professional, she has managed operations in more than 20 states. She's also the secretary for Ideal, who we had on a few episodes ago, and Michelle Pickering is one of our highest rated episodes ever, so the bar is set pretty high here, Lori.
Jeff Howell:Welcome to the show And we also have Dr. Louise Short, a physician and an expert on population health. Her firm is called Brown Brown. We're a clinical officer and Brown Brown is an HR, health, employee benefit, property and casualty insurance organization And, if I've done my research correctly, I think it's also the fifth largest insurance brokerage in the United States. Brown Brown provides services to various sectors, including healthcare employees. Dr. Louise, did I get all that right?
Dr. Louise Short:Thank you so much. You got most of it right. So it's healthcare employers and employees through our employee benefits division, and I'm the National Clinical Leader for Brown Brown.
Jeff Howell:Got it. And I did notice that your stock ticker symbol being Brown. Brown It's bro. Did I get that?
Lori Cabbage:right, that is absolutely right.
Jeff Howell:That was my takeaway, being the meathead, i am Sounds pretty hip.
Dr. Louise Short:Right, bro, is your star I bought some stock immediately.
Jeff Howell:Why don't you two tell us a little bit more about your backgrounds and how you two came to me?
Lori Cabbage:Okay, i'll start, if that's okay. Louise, we actually met through chief. Louise and I are in the same core group together, so I'm going to give a little shout out to chief. It's an executive organization for women And we just happened to have an extremely fabulous core group And we've all connected together. So when I was asked if I'd be interested in this podcast, i immediately thought of Louise to do it with me. I've been actually in the home care industry for over 32 years. I'm giving my age away when I say that I was 10 when I started And I've done just about everything you can think of in home care and long term care. I've also run assisted living, so seeing the industry change quite a bit throughout the many years that I've been involved And I've had the honor of working in a multitude of payer groups private pay, medicaid, medicare insurance you name it pretty much been involved with it. So it's been a great journey. I love this industry And I look forward to a few more years of working at Brightstar.
Jeff Howell:Louise over to you.
Dr. Louise Short:Yeah. So, as Lori said, we met through chief and I will also give chief a shout out. It's really a networking learning development organization for professional women, And I'll also give a shout out to Brown and Brown that sponsored me to be a part of chief, which I very much appreciate this year, And I think it's been a great opportunity and wonderful to meet people like Lori through chief. So my background I, as I said, I'm the National Clinical Leader for Broad and Brown.
Dr. Louise Short:I run our population health practice And what we do is consult to employers of all sizes, from 200 up to several hundred thousand on population health, really helping them improve outcomes or develop strategies to improve health outcomes and also to mitigate medical costs, if you will, so we can keep benefits affordable for everybody, employers and employees alike. I've been in this type of consulting for 11 years five years at Brown and Brown, six years at another national organization. Prior to that, I spent 11 years working at carriers two major national carriers as a medical director, chief medical officer, And I've also worked at health management vendors and at the Centers for Disease Control and Prevention, as well as been in clinical practice. So a lot of my 30 year career dating myself to here, has been developing and implementing strategies and programs in a data-driven way to improve the health of populations.
Jeff Howell:That's great, Lori. why don't we start with you? What do you believe that are the most critical pillars to creating a positive company culture, which is what we're here to talk about today?
Lori Cabbage:Yes, it has to be a top down And through my years of working in this industry, i've worked for two different types of organizations where it wasn't, and then others where it was.
Lori Cabbage:In an organization that fails to have the leadership really demonstrate and be a part of creating that positive culture, it just doesn't work right. It ends up blowing up. So there are companies that we've all experienced before where the vision, mission and value statements are on the wall but that's all it is And in the leadership you do not see those behaviors. But I'm so fortunate to work for an organization right now, ceo Shelly Sun who really does embody that belief in what we're doing, the higher standard of care, and she experienced it herself, which is why she got into the industry. But it is top down And because that exists and every time we talk about our core values it's somehow related to the employees that work at this company it's so much easier to embody Not to say we still don't get frustrated, right, and there's a lot of expectations but it's so much easier to work really hard when you know that it is going into a better product and that everybody's going to benefit from it.
Jeff Howell:How about you, Louise?
Dr. Louise Short:Yeah, i agree with Lori that it has to be a top-down phenomenon And through the pandemic we've seen, i think, much more of an emphasis, at least in our book of business, with our employer clients on culture and particularly in healthcare, realizing how important it is, how people have worked through the pandemic and been very challenged. That top-down is really critical And I'll give an example Our CEO is Powell Brown, so Brown and Brown is a family business, even though we are a public company. And during the pandemic, powell Brown, he started to give these weekly podcasts, slash updates, anywhere from five to 10, 15 minutes just talking about the pandemic, about the business, thanking everybody for doing what they're doing. And he loves music, so he would always talk about a different band, he recommended books, just really human. But he would always say this is the order in which you need to do things First take care of yourself, then take care of your family, then take care of Brown and Brown, and I think that type of message is really critical and it makes you feel cared for. It really is a culture of caring.
Dr. Louise Short:When we've been working with healthcare clients, particularly through the pandemic, we've really emphasized leading with empathy, so really being able to listen to people to understand their challenges. We've done a lot of manager trainings on how do you lead with empathy, and I think that is just so critical. We have a behavioral health pandemic. It really started before the COVID pandemic. It's going to last a lot longer than the COVID pandemic. It was really accelerated by the COVID pandemic and made a lot of people realize we really do have a behavioral health pandemic, and so I think that these concepts of leading with empathy and really de-stigmatization of behavioral health in the workplace have become so much more important to employers over the past couple of years.
Jeff Howell:It's great to see I love the word de-stigmatization like mental health is really there's an overdue bright light being shying right on it. You know we're also covid, fatigued, and we're coming out the other end where, for the most part, most people's lives are back to normal. but i'm curious, like caregiving Is subject to burn out and fatigue to begin with, and then you got through three now three and a half year journey. i'm curious to hear, like, what do you guys think is the state of caregiving today?
Lori Cabbage:In home care. It was such a interesting phenomenon during covid right, because we're going into homes very unknown do these individuals have covid? are we bringing covid into the home? We were asking a lot of our workers right, and how do we get them through that? obviously it was through the empathy that we were able to get our arms around it. We Continue to care for people throughout the entire piece. In fact, we actually did clinical trials for one of the vaccines and the later medications to treat. So we were in and out of homes on a regular basis of individuals who had covid And initially it was the shock of it all and just trying to keep everybody Educated as much as we could and supplied up right.
Lori Cabbage:Everybody needed the ppe and that was a great shortage, so it was hard to not panic.
Lori Cabbage:Once you get through that and i think you're right there's just such a fatigue that existed for a while and we did see a lot of individuals exit. The majority of our main stay people stayed with us because previous to covid we already had that culture and the empathy and the understanding and i think we just ramped it up And that today in the news they were saying today mark the day that we're no longer in a pandemic, but just what we says. We cannot sell short the fact that all of us, but mainly our caregivers, people that took the burden in the home are still so fatigued and even though we think, or we want to say, we're getting back to normal, there's still a lot to overcome and we have to continue to support. I think the worst thing you could do at this point is to say, okay, it's over, back to normal. None of us really are our close, still don't fit, and we're still trying to figure out how we get out the way we used to And feel that same way again.
Lori Cabbage:our workers who really went through it. They're tired to and they need that support a lot longer. And maybe we also understood, or began to develop an understanding much more than we ever did in the past, of How difficult it is to do these jobs and that we need to offer a lot more mental health and support for the people that are working in the health care industry. So i'm hoping that all of this empathy remains with us, that we don't lose it.
Dr. Louise Short:Yes, i'll add to that. We work with a lot of health care employers, large health care systems, position groups, etc. And what we're finding is that there's a real challenge in terms of attraction of talent As well as retention of talent, and so a lot of what we do is focused on how the benefits and health programs that the employers have or could have, i can make develop a strategy with those programs and benefits to help with attraction and retention. And so behavioral health is on every employer's mind and burn out, particularly in health care, and so some of the things that we work with employers on our, as i mentioned, destigmatization, increasing access to mental health services whether that is, tell me, enhancing their employee assistance programs, whether it's choosing a different vendor, maximize what they have, increasing the communication.
Dr. Louise Short:There been just a number of behavioral health slash, mental health point solutions, digital health solutions that have sprung up over the last several years that particular area What crazy in terms of funding during the pandemic. So you've got things like cognitive behavioral therapy, online resiliency, training, all of that, and so there's a whole universe of solutions that we try to kind of decode for employers and help them figure out that they'll fit into their strategy. There's also behavior health navigation, but what we try to do is develop a strategy is called the mental health front door, where access is improved And communication is improved and triage navigation is improved through these various different levers.
Jeff Howell:What's one takeaway that listeners can implement right now that would have a big positive impact in their company culture?
Lori Cabbage:What i think the most important thing, or one of the most important things, is to listen. You gotta listen, you have to be willing to listen. So isn't it common we throw those employees out there and then we never do anything with them, which makes it even worse. And I really hope that during the pandemic, leadership realized we better figure out how to listen and we need tools to be able to understand how to listen and what are we going to do after we hear what they have to say. So you have to ask questions, ask the questions, but when you ask them, you better be prepared to at least be able to say we can't deal with that right now or here's what we can deal with, and then show legitimate action items on what you're doing in order to deal with it. And again, this has to come from leadership down Pre-pandemic.
Lori Cabbage:A lot of employers just threw those surveys out there like, oh, look at us, we do surveys and then maybe took a non-consequential item out of them to address. We all learn now that's just not going to work, that's not going to fly and definitely, as we have different generations entering into the workforce, we have to pay attention, we have to listen and we need to understand and you have to be willing to say here's what we can do and here's how long it's going to take us to do that, and then you better show the results.
Jeff Howell:So, Lorraine, your experience. Then what are the common things that you think that the average home health agency out there would be seeing from those surveys?
Lori Cabbage:I think a lot of it is communication. Isn't that the hardest thing to do? We all think we're communicating so well and we're not. So we need to understand that the vehicle by which we use to communicate needs to be able to hit all levels of our staff. So I think that's one thing that has to be available. So in the home care industry, we have home health aides, companions all the way to nurses. You could have pharmacists, whatever. So you have to have opportunities that meets those individuals where they are So saying oh, i have a career track for a home health aide. What does that mean? How do we meet them where they need to be met, and what is it that really will impact their life?
Lori Cabbage:A lot of times we fail to understand that you can't just one side says it's all. We have to be able to be open and listen to everybody's needs. And how can I make this work for all of our employees? And then the age difference is also very important. People entering the workforce right now do not behave the way we did and we say about the millennials, but really it's the other generation, so we can't just ignore it. We have to listen and we have to be willing to flex.
Jeff Howell:What do you think, Louise?
Dr. Louise Short:Yeah, i completely agree with everything that Lori has said, and I'll just call out listening as being really critical, because I've seen so many times where we've done surveys of employers and employees and we survey employers on what they think the employee population needs and wants, and then we survey the employees and the results are often quite disparate. I think getting the perspective from the employees on what did they want or need in terms of culture and health is really critical.
Jeff Howell:So what would be an example of that?
Dr. Louise Short:I can give you an example of a one healthcare organization that was a physician group, and there were some things that the employer was thinking of doing during the pandemic talking groups, online activities and things like that to make people feel more connected. And then they surveyed the employees and what did they really want? There was no parking at the hospital, so they wanted to get Uber certificates so they could Uber to work, or some subsidized because it was too much. They were having trouble with childcare. Some of the common things like the employers were going to send meals to employees and they were like, yeah, that's good, we like that. That was something that came up for them too. So there was some commonality, but there were definitely some differences as well. The employer learned a lot from that, because it was daily activities that these people needed help with.
Jeff Howell:Yeah, the dopamine of a free meal can go a long way. We, during the pandemic, came up with a new benefits package. that doesn't matter who you are. There's something about getting something for free, no matter what the cost is We were able to. initially it was work from home stuff, but then we have wellness reimbursements, so gym memberships or anything to get you outdoors and moving and everything that's like. upstream, on these factors about social determinants of health, aside from surveys and listening, how do you measure culture?
Lori Cabbage:That's an interesting question. Probably everybody has their own way of doing it. I agree Surveys are very important. Obviously everybody looks at retention rate. How many people are walking out that back door? You may have great recruiting program going, but if they're all walking out the back door it doesn't do you any good. So retention is a huge piece And I think too, we forget about.
Lori Cabbage:every time you lose somebody. it costs you quite a bit of money. That's old news. It's just that we don't always pay attention and do what we need to do to keep people happy. I think what really is the most important is being able to measure it before it gets to be a problem.
Lori Cabbage:The minute you see an uptick on any unhappiness people are leaving. you're seeing like the quiet quitters, they're not as available. They're not. you can see them on all my teams remote. So we have such a great interaction. If I start to see a downward trend on the Zoom calls and the joking and having fun, i know I got a problem. So we have to make sure that we're again paying attention and willing to confront it and then willing to create a solution. And maybe we cannot create a solution exactly the way they want, but every time somebody says to me at least okay, i'm hearing you, i think these are the things you want. I can't do that, but I can do half of them, or I can do two of them. Don't we appreciate that? Because then we know wow, they at least listened and they cared enough to come up with the plan in order to resolve it. And we have to do that in all parts of our organizations. I believe that that is how you can keep a good pulse on what's going on.
Dr. Louise Short:I agree with everything that Lori has said And I think the other thing is, when we think about employee surveys, it doesn't have to be like every year or organizations will do like a whole survey, often on employee engagement, but I think it could just be a pulse survey Do you feel like we have enough fresh food in our cafeteria, or yes or no? So just a quick pulse on the population, sometimes on specific issues, can be really helpful. And I think focus groups can also be helpful. Just running focus groups on people from diverse backgrounds sometimes creates really good perspective, like I've worked with healthcare employers where we brought in, like you know, we've got physicians, nurses, food service workers and maintenance on the same focus group talking about a particular cultural or health issue And I think it's really important for them to hear other perspectives.
Dr. Louise Short:I think also, as Lori said, participation attitude. It's hard to measure those kinds of things Just even like, obviously, productivity. If you have some way of measuring that, depending on what your industry is and your organization, that's one piece. But I think also, are people participating in events, whether they're virtual events or whether you have some kind of volunteer event, and are people bought into those kind of things? Honestly, i think that one of the best measures of culture is business results. I think culture is really strongly tied to business results.
Lori Cabbage:I'm glad you said that, because in the back of mind I was thinking you cannot ignore the numbers, right? If you have a strong culture and strong processes, you're going to be a strong business that produces numbers, and we have to be fiscally responsible, otherwise nobody's going to be happy. I think that being open and talking about those numbers and making sure that everybody is also bought in to the health of the company is very important. You can be an empathetic, caring organization who also produces really good numbers. In fact, you have a higher tendency to produce really good numbers when you are that, so I think it's good to talk about it.
Jeff Howell:I had Todd Austin of Home Care Puls on recently And the thing that he brought up that I thought was really interesting, because you measure and you try to make changes over time.
Jeff Howell:And the two thoughts that entered my mind were number one is when we get our internal NPS results, i actually take a look at what our executive team answered versus what our employees, and you don't want to have a huge gap as well.
Jeff Howell:You don't want to have management who thinks things are fine But really we've got certain problems. And then the second thing is that what Todd Austin said is that in their Home Care Pulse survey they're seeing a decline in client satisfaction, which is something that we don't really talk about too much because everyone's talking about the caregiver shortage, and yet it's. What you just said is that if the company's doing well, it's probably a byproduct of everyone being happy and loving the work that they do, but also if the clients are unhappy, then there's a big problem as well, and I think that he was referring to the longitudinal nature of this is that if clients are always at a certain level of an unhappiness because of the lack of staffing in the industry, the more important thing is that's actually on the decline, and that's kind of a troubling concern for the industry.
Dr. Louise Short:Yeah, and you bring up a great point, jeff, because particularly in healthcare there really is a very big correlation between the happiness and fulfillment of the healthcare workers and patients and clients. There's something called compassion fatigue. When healthcare workers are burnt out and they just really have trouble taking care of people and they become cynical, and a lot of that is related to support and culture, right, and then there's also a component of literature correlation between burnout and medical errors and quality of care. So this is particularly important in healthcare.
Lori Cabbage:Absolutely. I think the thing is where we're kind of hitting goes back to a little bit what I was saying before. Yes, we've been blaming the fact that we've not had enough employees. Right, we can't fill all the slots, we don't have enough caregivers, and therefore I'm sorry customer, i'm sorry patient, that you're not getting exactly what you want. I just don't have all the workers.
Lori Cabbage:We're doing the best we can, but now we're sort of hitting a point where our patients, our clientele, are tired of hearing that And they're just being on that too and they just want their needs met as well.
Lori Cabbage:We need a different narrative and we have to figure out how we want to be the employer of choice, so the employees come to us and then we're able to take care of everybody else's needs. But the only way to do that again, as Louise said, we have to be willing to talk about. You know, if you're burned out and you're demonstrating some of those behaviors, you have to have that conversation with the employee and then offer them resources on how to fix that. Maybe it's some time off, maybe it's who knows what they need. We got to listen to them and figure it out. But I do believe we're sort of. At a point now and I can actually see it with our owners We're about done being able to say we just don't have enough staff anymore. And now you have to figure out how you're that company that attracts the employees And we have to start moving on from that.
Jeff Howell:Yeah, and the demand for care is just going to double over the next few years as well. And everyone's in the same boat. I can totally empathize with a default perspective that the fact that the workforce is in the field, it's a mobile workforce. I can see how most people are of the mindset that you know, hey, i'm sending you shifts. You should just pick them up and go and deliver the services. And it's a real extra challenge because I've always felt like culture is created first and foremost or most easily in person, where you can have hugs and handshakes and you can collaborate with people that are in different departments as well. We're bumping up against our time. Why don't we get you guys out of here on a positive note? Give us a reason to be optimistic about the future of care in the place where clients call home.
Lori Cabbage:I'll go first. I think that COVID opens so many new doors, like I'm so excited about some of the things that we're involved with, and out of a really bad thing has come some really great new innovative techniques, way to care for people, different ideas to keep people out of emergency rooms. It really did turn our thinking around and maybe we almost needed a jolt of that to get us out of somewhat of a rut. So I'm excited. We're involved in some really new and innovative projects that I think and our workers love. The employees love participating in these, so I'm excited to see where all this goes.
Dr. Louise Short:Yeah, i would say the same. I think that COVID really brought out the importance of a lot of issues that employers are paying attention to now. So one is behavioral health, as I said, and we're working with many employers, particularly healthcare employers, on behavioral health, creating supportive environments. They're really realizing how important that is, and so it's a very exciting time. The other piece is access. The rise of virtual care has been huge during the pandemic. We're reverting a little bit to in-person care, which is fine, but I think the whole virtual space is opening up a lot of opportunities and a lot of technology too to kind of augment remote monitoring, how to reproduce the physical exam virtually. We've got virtual primary care now virtual health plans, virtual specialty care, so there's just a ton of opportunity to perhaps deliver care at a lower cost to a broader population in a more efficient manner. I mean, i'm not saying there are drawbacks also to virtual care, but everything has this plus and minuses, but that's something that I'm really excited about.
Jeff Howell:Yeah, it's certainly an exciting time in the space and you know actually even my entire voice. This is just a deep fake powered by chat GPT.
Dr. Louise Short:That's a whole different conversation, that's another podcast.
Jeff Howell:I can sense the passion from both of you. It's been a real pleasure meeting you both today. Keep up the great, noble work. Thanks for being on. Thank you so much for having us.
Dr. Louise Short:Thank you, have a great day.
Jeff Howell:Home Health 360 is presented by AlayaCare. First off, we want to thank our amazing guests and listeners. To get more episodes, you can go to alayacare. com/homehealth360 that's spelt home health 360, or search home health 360 on any of your favorite podcasting platforms. The easiest way to stay up to date on our new shows is to subscribe to Apple podcasts, Spotify or wherever you get your podcasts. We also have a newsletter you can sign up for on alayacare. com/homehealth360 to get alerts for new shows and more valuable content from AlayaCare right into your inbox. Thanks for listening and we'll see you next time.