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Connecting Behavioral Science and Technology in Health Care | Quality Time with Dr. Schaal

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0:00 | 36:22

In this episode, Dr. Brian R. Spisak — organizational psychologist, author and senior partner at Csuite Growth Advisors — discusses the intersection of behavioral science, leadership and emerging technology in health care. Dr. Spisak shares his personal journey from burnout in behavioral mental health to a career dedicated to understanding and improving organizational well-being.

Expert: Dr. Brian R. Spisak, chief people and communication officer and senior partner at Csuite Growth Advisors, Program Director of AI and Leadership at the National Preparedness Leadership Initiative at Harvard University and author of Computational Leadership: Connecting Behavioral Science and Technology to Optimize Decision-Making and Increase Profits.

Notable topics covered:

  • Self-determination theory
  • Organizational well-being
  • CAR-driven needs: Competency, Autonomy, Relatedness

Links:

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DR. SCHLOMIT SCHAAL:

Welcome to Quality Time, a Houston Methodist Leading Medicine podcast. I'm your host, Dr. Shlomit Schaal, a clinician scientist and a retina specialist, and I serve as the Chief Physician Executive of Houston Methodist, located in the world-renowned Texas Medical Center. I passionately believe that quality is the heart of healthcare, and a commitment to quality is essential for every healthcare system. Join us each month as we discuss the latest advancement in quality in healthcare with clinicians, researchers, physicians, industry experts, and thought leaders who are as passionate as I am. Today I'm excited to welcome Dr. Brian Spisak. He's the Chief People and Communication Officer and Senior Partner at C-suite Growth Advisors. He's also the program director of AI and Leadership at the National Preparedness Leadership Initiative at Harvard University and a faculty member at the American College of Healthcare Executives. Dr. Spisak is author of the bestselling book,

<i>Computational Leadership:

</i><i>Connecting Behavioral Science</i><i>and Technology to</i><i>Optimize Decision Making</i><i>and Increase Profits.</i> Thank you for joining me today, Dr. Spisak. So, tell us a little bit of how you got into your field.

DR. BRIAN SPISAK:

Yeah. So, it all started, really, just after my undergraduate, which was in psychology. I started in behavioral and mental health, and what I saw very early was I didn't have much of a say in treatment and how things were being developed, and I really felt like I was just sort of a cog in a wheel, just there to basically take notes, and that's all I was doing. And so, that really, on top of that, dealing with difficult patients sometimes very much led to stress and a sense of burnout, and that's really all I needed to push me to go back to do my PhD, and I'd been wanting to do my PhD, literally, in my high school yearbook, my last words were,"I'm going to get my PhD in psychology," so that's what I did. I particularly wanted to work with one particular individual, so I moved to the U.K. About halfway through, he accepted a position in Amsterdam, so that's why I moved to Amsterdam. All the while, I was looking and have always been interested in human behavior and trying to understand how we operate in organizations, things like motivation and burnout, and what can leaders do about it? That's always been connected with a strong interest in technology. How can we scale solutions with technology? From the early days, I was looking at how can we use technologies like face recognition technology and face perception technology, looking at how can we use machine learning to handle large amounts of data to make more accurate predictions? How can we use technology, like agent-based modeling, to better simulate human behavior at scale? Then, ultimately moving into now with generative AI, because that's just what everybody else is doing, and I want to make sure that we do this in the most safe and responsible way. My journey started from really my own healthcare journey of that feeling of stress and burnout, which pushed me in this direction. And I've always then been thinking about, how can we use this technology to improve outcomes for employees, and what is the psychology to understand that and the data, and then ultimately, how does that improve patient outcomes? So, yeah.

DR. SCHAAL:

I love it that you moved from your own story, your own personal experience, and then into really research and finding solutions to help others. I was thinking, as you were talking, about my own evolution in healthcare, and how I moved from a physician taking care of patients, using handwritten notes that nobody else could read but me, into really adopting electronic healthcare records, like everybody else in this country, at least in the United States. I have to say that it was very rough and difficult, and still today, maybe two decades after, we're still experiencing a lot of burnout from the technology itself, so what's your perspective?

DR. SPISAK:

Yeah. Isn't that a wonderful irony? The technology is meant to ease challenges and remove some barriers, and in fact they add them. I think, as a sort of foreshadowing what's coming with this emerging AI technology, say in the Gen AI space, we run into a similar ironic problem where a lot of this might actually add, so that was my concern. I think this is why I've looked at the intersection of proven social science, data and technology, and how to bring that together seamlessly to improve outcomes. I think there's a problem there, is it was being developed, say the EMR, by engineers, but maybe not understanding the journey that it takes from coming up with an idea, developing a solution, and then actually having people use it in an effective way, and there's a journey that you need to map out when you're doing that, and I fear that that journey was maybe rushed, and it wasn't fully thought out.

DR. SCHAAL:

One thing that comes to mind is that, really, who is the customer? This electronic healthcare record, was it built for the user who is a physician? Was it built for the patient, or was it built for billing services, or maybe it was built for other purposes? Talk a little bit about that. When we design solutions, what are you redesigning for?

DR. SPISAK:

So, this is a lot of the work that I do now in my new role as a senior partner at C-suite Growth Advisors, and I've been doing this before as an independent consultant for many, many years, is trying to guide people that are developing solutions in an effective way. Sometimes we forget to develop for the user and for the stakeholders and we develop for whomever is going to purchase the product, and we're trying to show that we're ticking all the boxes and there's going to be this ROI. I just was on a call with an early stage startup yesterday, and he asked me a question. He said, "What's one thing that I shouldn't do?" I said, "Don't lose sight of your users, of your real stakeholders. Don't just build this for the people you're trying to sell it to." Those are sometimes two very different groups. The decision-maker, say at the C-suite is one thing, but at the same time we cannot lose sight of we're developing it for those stakeholders, for the clinician, for instance, and also, so that it improves the outcome for the patient. In the rapid pace to develop quickly and get to market, we sometimes forget that we're not just developing for the people that are purchasing. We have to develop for the actual user.

DR. SCHAAL:

So, tell us about psychology of human beings. Why is it so difficult for us to change, and what can we do to make change easier for us, for our organizations, for anyone?

DR. SPISAK:

So, the big thing I see, and this is why I went back and dedicated my life, for many years, to really dive deeply into the science of it, we tend to take an intuitive approach when it comes to human behavior as leaders, which is not necessarily bad. It's a good enough approach, but when we really want to lead at scale, we need to understand the science of, say, what motivates people. There's a mountain of science applied research out there to be used, the same thing about stress and burnout. We need to define it clearly, and we need to then be able to understand the mechanics of what creates stress, what leads to burnout. This is something that we tend not to do, and that's what I'm really on a mission to do, is to bring the science of it. I look at it like I'm a doctor, not a medical doctor, an organizational psychologist, but I'm doing the same thing that a medical doctor will do, in terms of diagnosing an issue, just that I'm doing it at the organizational level. I'm diagnosing, I'm creating a treatment plan, and then I'm going to work on interventions.

DR. SCHAAL:

So, what motivates us? We are different human beings. Obviously, we have, here at Houston Methodist, 30,000 employees. They're not all the same.

DR. SPISAK:

Yes.

DR. SCHAAL:

So, how can we motivate people? Is there a formula?

DR. SPISAK:

There is. There is, actually. So there's something called, that's probably one of the leading models of motivation, called self-determination theory, and it's the one that I use and underneath that, and I take some of these complex psychological models and try to bring them down so they're immediately usable. I break that down, and it has three primary factors, which we know, from a bunch of research, there's three factors that motivates pretty much everybody in unique ways. So, it creates a profile, but it's these three factors,

and I call it CAR-driven needs:

competence, autonomy, and relatedness. CAR. So, if you understand those CAR-driven needs and what is the unique profile for, say, you or me, some people need a stronger sense of competence. Some people like me, I need a strong sense of autonomy. I really need to feel like I can impact my environment, and some people really require relatedness, and when you understand that unique profile of an individual, then you can scale it. I can scale that from N equal 1, to N equal to 30,000 that you just talked about. What it requires then is, if I have that sort of diagnostic tool, I then need the data to create these unique profiles of what motivates you and what do you need to stay motivated at work. Once we have that, then we can monitor and treat.

DR. SCHAAL:

So, let's break it down a little bit because I like the CAR acronym. That's nice. Competence is not the same for everyone, right? Competent surgeon, competent medical doctor, competent nurse, competent front desk person. Competence is different, so do we, as C-suite people, how do we drill down and make sure that all our employees feel competent or feel that we support them in their path to increased competence?

DR. SPISAK:

A good start is asking them, and that's where the leadership component comes in here. A good clinician has the diagnostic tools, but it really comes down to the clinicians' ability to use those tools effectively. It's the same thing, and the same way that, with patients, you need a good dialogue to understand, it's the same thing with your employees. You need a strong dialogue to understand what does make them feel like they understand what's going on in their environment? Where are there perhaps gaps, where their knowledge needs some improvement? And that's making them very nervous, and that's what leads to the stress and potentially the burnout, so it starts fundamentally with leaders having a strong, meaningful dialogue with their people.

DR. SCHAAL:

In gaps in knowledge, in healthcare, we know new things, and treatments are evolving very, very fast and actually getting faster. We all lived this during the pandemic, where we had a virus we didn't know anything about. Then, to the creation of vaccines and treatments, and the way that we did things in healthcare changed so much and so rapidly. And so, the gaps in knowledge, the way to address that is through programs, is through mentorship? How do we do that?

DR. SPISAK:

Again, that's where the leadership comes in. It has to be personalized for individuals. Some people like to learn at their own pace in a sort of more passive way. Some people want to attend courses and do it in a more active way. This is where leaders -- it's now time for leaders to step up, because things are picking up pace. There's a lot of complexity. There's a lot of unknown and unknown unknowns, and the only way we can kind of keep pace with that is first establishing a deep understanding of our people and our processes. I have this motto that I live by,"Leadership first, tech last." We have to understand our people and our processes before we get to the technology. So, by having that dialogue and by understanding the unique way that we can serve our people, we can then say,"What resources do we have to create a unique treatment plan for my people to keep them as healthy as possible in a proactive way?" Rather than the reactive approach that we try to avoid. But again, it comes back to dialogue,

DR. SCHAAL:

So just throwing tech at people can paradoxically increase the stress, rather than relieve --

DR. SPISAK:

EMRs, right? I mean, the medical, exactly. It was throw the tech, without trying to understand what are the real needs of people, and how do I build this technology around my people, so that it's still people-centered? That's where we need this leadership first, tech last approach with all this emerging technology we have coming now.

DR. SCHAAL:

So, competence is one. Autonomy. Autonomy, as we hire physicians, and I'm the CEO of our Houston Methodist physician organization, and people who work for the physician organization, they are employees and they're physicians. We try, we, I mean the executive team, we try to standardize things, make it fair, make sure that we have a return on investment according to how much we pay our physicians and how much they bring in, so we don't bankrupt, and yet we serve our patients, want to make sure that we have high quality, but that really takes away autonomy because these physicians do not operate as an individual in their own clinic. They are really part of a larger organization, and so you're saying that, according to the self-determination theory, we're actually taking away autonomy. What can we do to mitigate that?

DR. SPISAK:

Here's simple things. Reduce the number of button clicks to get a medication or something ordered, right? So, by bogging people down with paperwork and button clicks and things like this, the more we can automate in that sense, the more can just allow clinicians to apply their competence and get out of the way. So, a good leader also knows when to get out of the way, and if we can automate things to get out of people's way, that can increase that sense of autonomy. Now, when you're talking scale like you're talking about, that's not always possible, because we do need to standardize for quality and everything else, so we can compensate, and we'll get to that next factor in a minute, with the sense of relatedness. But again, it comes back to having that dialogue with your people, and then there's also a whole battery of tests, so you can understand where people's need for competence really is, where people's need for autonomy is. And then, you can actually quantify that. So you know where you're starting at your baseline and where you need to go, but before all of that, and I don't want to get into all the tests, it's first about establishing dialogue, as leaders being leaders and doing what they do best.

DR. SCHAAL:

And then, the relatedness, what does that mean?

DR. SPISAK:

That means more than a pizza party, right? So, bringing people together and creating a sense of relatedness is more than a pizza party, and it's more than a wellness app. It's about creating a sense of community that we're all contributing, no matter where you are in the hierarchy, to patient outcomes. I don't care if you're a janitor or if you're way up in the C-suite, we're all contributing to this one outcome, which is our patients, our people, and if we can create that narrative so that we understand that we're all part of a community and a sense of community, right? So pizza parties, for instance, can counter-intuitively decrease that and increase a sense of social isolation. So, you can bring people together, but that counter-intuitively can make people feel very apart if they don't feel like they're connected to each other. Then, it's right in their face that we're not connected, so you don't need that. You need to find clever ways that are unique to your group to create that sense of community, but it must revolve around this narrative that we're all contributing to this greater good. I know 99.9% of people in healthcare, they fundamentally know that they wouldn't have gotten into healthcare in the first place. That's what got me into it, seeing an opportunity to help. When I felt like I was a cog in a wheel, not able to actually contribute to treatment the way I thought I could, that's when I lost that sense of relatedness, and that's when I moved and I looked for a group that invited me, and that's where the academic community did for many years while I was doing my PhD. So, that's what we need, that sense of community.

DR. SCHAAL:

So, it's interesting. As I am hearing you talk, I'm thinking we need more of our physicians in our committees that really look at our operations in a grand scale and get more input of physicians. It's hard to do. But we need to encourage that, and we need to have these physicians really lead their own communities, because Houston is enormous.

DR. SPISAK:

Yeah, but the more you get them involved, then you tick all three boxes, right? Because then you're allowing them to exercise their competence, they're feeling like they're contributing, so they have a of autonomy, and they're also contributing to the greater good, so they're also getting that sense of relatedness. So, by involving more people, I know that can sometimes slow down decision-making processes, though with emerging technology, we have workarounds with that, but the more people you can involve in that kind of way, the more you're going to create people that are more embedded and committed to the organization.

DR. SCHAAL:

So, let's talk a little bit about Gen AI. Everybody is talking about it. First of all, what is it, and how can we use it for our benefit? I know that there are many kind of a dark, gloomy predictions over there, out there if you want to read them, but then how really can it help us in healthcare?

DR. SPISAK:

So, I try to be as balanced with Generative AI as I can, so just Gen AI, basically, is just what it says on the tin. It generates output, like relatively new, unique output, be it text, video, images, whatever. I'm trying to stay balanced with it, but I'm not as bullish as some about it because of the issues that we have with hallucination, issues with reliability and accuracy of, say, summarizing documents, for instance. So, the document might say,"Stop taking this medication," and it can hallucinate and say, "Continue taking this medication." Just a small example. That's a real example that actually happened.

DR. SCHAAL:

Why does it hallucinate, by the way? Why?

DR. SPISAK:

Yeah. So without getting into the technical details of it all, it's not designed to do that. It's designed to be more creative. It's predicting one chunk, a token, so a word you can break down into a token, and basically, all it's doing is a fancy regression. Again, not getting too technical. It is just predicting one token after the next, so it's only predicting what is the highest probability of,"This should come after that." That's not about accuracy. It's just giving you probability of what's likely to come next, and it's selecting that, so that's a good point of what I am excited about with this, is because of that, it can help us break out of our bias blind spots. It can help us think in different ways on how to deal with issues. So when we're leaders, for instance, talking about,"I've got an employee that's having, say, a crisis of competence. How can I help them?" We can sometimes get set in our ways, tunnel vision, when it comes to thinking about things. If you think about Generative AI more as a creativity engine, you can say, "Give me 20 different ways to deal with an employee that's dealing with this." Now, don't share specific details because of privacy issues, but you can give a persona, and this is the persona of an employee, this is their crisis of competence. What are 20 different ways I can solve that problem? And it will give you some creative ways, so it can break us out of our bias blind spots as leaders. There's where I'm a bit more excited about this technology. Rather than what I know in healthcare everybody's talking about, with documentation and ambient intelligence, which can be good as long as, then, doctors don't take their hands off the wheel. I think, so that could also add to more oversight and more button clicking, rather than less button clicking, because then you go from developing the document to editing documents, which can actually be more time-consuming than less.

DR. SCHAAL:

So, it's interesting, when I think about quality in general, it's more about standardizations, following guidelines, following protocols, being the same, less about being creative. Maybe creativity, you talked about Gen AI as being this creativity engine. Maybe it's dangerous for maintaining quality.

DR. SPISAK:

Well, it depends on what you mean by quality then, too. If we're all talking about quality of leadership and an ability to serve our people, it can be used, like I said, in that example, where employees are having a crisis of competence. How can I help them? And it can give us different ways to approach that and create a plan of action that's a good starting point to engage with that employee. So, there can improve your quality as a leader and your ability to address those issues about competence, autonomy, and relatedness. Where it can become a problem, if you're trying to do things that require high levels of accuracy and relatedness in a high stakes environment, then it can be a nightmare for quality. That's where we want to avoid issues, because it can reduce standardization. There's a bunch of technologies or techniques now, and I'm working on one, to try to improve that output, but fundamentally, the technology isn't designed, necessarily, for standardized output like that at its core, so we must keep that in mind.

DR. SCHAAL:

So, that's interesting. We have obviously, as many other healthcare systems, implemented different technology, piloted different technologies in our clinics, and one of them is really to summarize the note, you kind of mentioned it in passing, in summarizing the note or ambient listening, where the physician talks to the patient and immediately, within seconds, you have the summarized note. The feedback both from the patient, the physician, and also sometimes the physicians that gets the referrals, is that the note is much better than any human physician note has been so far.

DR. SPISAK:

Yes, I completely agree with it and I think that's great. So, the analogy I like to use with this, though, is we have to be very cautious, so the closer we get to fully autonomous vehicles, the research shows that it actually becomes more dangerous, because it fools us into taking our hands off the wheel, and it's the same thing here. We have to make sure we're still reviewing that note. We can't just assume that that note is going to be fully accurate and a fair and accurate representation of what was said, for instance, or if it's a discharge document, we can't just assume. We have to go through, so we have to still be vigilant. I'm not saying it's bad technology. I think it can do a lot. Now, here's the second point to this too. There's also the leadership component, so say this does save 15, 20%, and say the clinician is always vigilant about making sure that it's accurate, okay, we have a 10 to 15 to 20% time save. Now, here's the other problem; what is leadership going to do with that 10 to 15 to 20% time save? Are they going to reinvest it to allow the clinician to further build that relationship with their patient, give them some time to build their own sense of resilience and well-being, or is the leader going to take that 20% and invest in just more burnout-inducing tasks? And so, that's the other concern I have with it, is not just the technology, but what leadership will do with that technology, and we need to be prepared for that.

DR. SCHAAL:

Yeah, that's a fantastic point, because I'm hearing so many things like,"Okay. I'm going to give you this technology. It costs money. Then, you need to see two more patients a day to pay for that technology," and maybe seeing more patients a day adds to the burnout. We talked about motivation. What causes burnout?

DR. SPISAK:

Yeah, so there's where I use something else, a different model that I bring in, called the job demands resource model. This is probably one of the leading frameworks in social psychology and organizational psychology, for understanding the science of what creates stress and how that stress leads to burnout and ultimately turnover. Again, it is exactly what it says on the tin, job demands and resources. So, it's about understanding what are the different types of job demands, and they're broken up into, again, very sort of -- they're delineated. So, we have cognitive job demands, emotional job demands. We have organizational job demands, material job demands. How many times I hear from people I'm working with, say, employees,"I need a printer." I hear that more than you'd expect, and that can cause stress, and so all of those different job demands are like little bee stings or paper cuts. They can add up through your day into a meaningful amount of stress, and so, what I do is I use this diagnostic tool, again, to create a unique stress profile of everybody I'm working with. Again, with technology, you can then scale that once you know what data capture. Then, what I do on the back end of that, we work with leaders, because again, leadership first, tech last. We work with leaders to take stock of all the resources that you have available to address all those unique job demands. Then, we start connecting those dots, and if there's a dot that we can't connect between a job demand and a lack of that resource, that's where we have to have a good, strong conversation, an honest conversation about why that resource isn't there and how do we get it. When you have that unique profile, and then understanding what resources you have at your disposal, that gives the leader then clarity to be more effective at addressing those job demands and reducing stress of your people.

DR. SCHAAL:

I love that model. What is the job demand? What is the resources? It's funny that mentioned the printer. We went here, at Houston Methodist, on a Joy in Medicine tour. We called it a JIMI tour, our JIMI Initiative, Joy in Medicine Initiative, JIMI. And as we were talking to physicians, one physician stood up and said, you know,"I need a printer." I was shocked like, "Really? We can't get him a printer?" It sounds like it's easy to do. It took us like two weeks to get him a printer that is working, but aligning the resources with the demands and understanding the demands, and you mentioned cognitive demands. Sometimes for cognitive demand, the resource is time.

DR. SPISAK:

Yep, exactly. So, that's what I mean about we need to sometimes have difficult, honest conversations with time, and so if we bring in this ambient intelligence, it can give back time. And so, that's something that we look at at C-suite is how do we give back time? How do we make up and give back time? If leaders don't realize that that's the resource that I need to give that physician, not just tack on two or three more patients, you're going to burn them out, and then you're going to have to go and find somebody else. But again, it goes back to we have to take away an intuitive understanding of stress and burnout, and we have to bring in the science of stress and burnout. So, we know the diagnostic tools, we know what the data supports. It gives the leader a map of understanding stress and a stock take of the resources that they have, and then you start seeing, and you crunch the numbers, you see, "Wait a second. If I actually don't add on any more patients and I give them back time, I'm actually going to see a return on investment, because I'm going to keep them happier and healthier. Patient outcome is going to improve, and I don't have this massive cost in turnover." The printer one is a no-brainer. Turnover costs, relative to a $500 printer or whatever it is, I don't have to have a PhD in mathematics to know that that one just makes sense, but the only way we know how to do that, and I think sometimes that's what happens in the leadership situation, is that we just don't know because we don't have those tools, because we haven't incorporated that methodology, so that's where I come in and try to just bring that clarity.

DR. SCHAAL:

So, tell us a little bit about your book. We have this new book,<i>Computational Leadership:</i><i>Connecting Behavioral</i><i>Science and Technology</i><i>to Optimize Decision-Making</i><i>and Increase Profits.</i> What's there in a nutshell, and why should I read it?

DR. SPISAK:

Well, I'll tell you what it's not. It's not just a book filled with, "Here's how you can use Generative AI." It's a book that I show how you tie together proven social science, high quality data and emerging technology, and use that as a leader for various issues. For instance, employee well-being is one chapter. Another chapter is sustainability. Another one is, say, hiring and retention and dealing with things like burnout that we've just talked about. Then, I, on top of that, at the end of all those practical chapters, I then interviewed senior leaders from Microsoft, from Merck, from WebMD, a bunch of different leaders to see how they're doing it in their organizations, and they're leading the way in their organizations, for instance, in this. So, it's about how do we combine science, data, and technology, and the most effective way to create a tool for leaders and how leaders can leverage it. Then, in the second half of the book, it's how leaders can then use that thinking to create their own solutions with this computational leadership lens that blends that science, tech, and data seamlessly.

DR. SCHAAL:

So, you talked about the fact that the computational side or the tech side is really a co-pilot where the human is still the pilot, and a human in that case is the leader, but also the human is the employee. Correct? You need human beings to be there and the tech to just help and make it easier. Has anybody solved that burnout/turnover crisis yet in healthcare?

DR. SPISAK:

I don't know if you'll ever solve it, especially in a place like healthcare. It's, by its very nature, is a crisis environment, high stress, always going to have that. What you are trying to do and -- By the way, I'll say that clinicians are the most resilient people I know. They really, really are. I hate when it tends to get put back on the clinician,"Well, you need this wellness app, and you need to take more mindfulness." I don't think that's the case in many ways. Clinicians are already super resilient. Super, super resilient. A lot of the times it's a structural issue, and that's where the big problem is. That requires leadership then. It's not about the individual clinician. It's about the organizational structure, the processes that are turning this into a meat grinder in an already high stress environment. So are there organizations in healthcare that are doing it? Yes, but I think one of the reasons I've chosen to focus on healthcare is it needs the most work, and I mean that in the best possible sense. I think there's an opportunity there, because fundamentally people here care, but if you look at all the numbers, healthcare is trailing behind on all the good numbers, like engagement, satisfaction, and motivation, and leading the way on all the bad numbers, stress, burnout, and turnover.

DR. SCHAAL:

I thought that was lawyers. No?

DR. SPISAK:

Nope. No, healthcare. I wish I could say that, but yes, I hate to say it because I'm embedded into this, but I mean, at the same time, that's what also motivates the hell out of me. It gets me up in the morning and it kind of keeps me awake at night, and how can we create these solutions?

DR. SCHAAL:

No, fantastic. Throughout this conversation, I was thinking in my head about the framework that we follow here at Houston Methodist. It's a framework that we adopted from PWAC. It's the Academic Consortium for Physician Leadership. You probably know about it, and it's really three things. One of them is what we talked about a lot today, is really automating and bringing the practice of medicine to be as efficient and less clicks and less harassment as possible, so really working on the efficiency side of the system. So, this is one. The second thing is what you a little bit mentioned, is really how do we help our employees become more resilient? And for physicians, you are right. Physicians are very resilient; however, we sometimes need to teach physicians to let go, to delegate, to trust somebody else --

DR. SPISAK:

Absolutely.

DR. SCHAAL:

To cover for them when they're on vacation. So, that's the personal resilience. Then, the last thing, and perhaps very important, is really the wellness culture of the organization, and this is what you talked about leadership, is how the leaders care about wellness, not only about quality of patients, number of patients, profits, and all of the things that we do care about, but how do we really care about the people that are providing care? So, that's our framework. It's really a summary of all you talked about today. I would like to close with a question that I ask all my guests on this show, and it is,"What does quality mean to you?"

DR. SPISAK:

That's a big question, and I'd love to just write a paper about that. If I could be a little poetic about it, I would say, for me, quality is systemic sense of wellness, so the wellness of our processes, the wellness of leadership, the wellness of our data, the wellness of our people, the wellness of our patients, and continuously focusing on that sense of wellness in a very systemic way. Again, from the very foundations of the data that we have, is it quality? Is it high quality? Is our data going to contribute to wellness? Are our processes contributing to wellness? Are our leaders contributing to wellness? Are our people contributing to wellness? And if we can do that in a systemic way, and continuously focus on that, and always work to improve, I think that's what quality means to me, because at the end of the day, that's what we're trying to get, right? Our ultimate outcome is a sense of wellness, mind, body, and soul, and if we can do that systemically, we have so much opportunity.

DR. SCHAAL:

Dr. Brian Spisak, this was really a wonderful conversation. Thank you so much for being a guest on our show today.

DR. SPISAK:

Thank you for having me. I really enjoyed this conversation.

DR. SCHAAL:

And thank you for listening. Quality Time is part of Houston Methodist's leading medicine series of physician-led podcasts. So that you never miss an episode, subscribe to Quality Time. New episodes will download to your podcast device. If you enjoyed our conversation today, please consider rating this episode and sharing it with your colleagues. I appreciate your support. Thank you, and until next time, I am always listening.♪ ♪