Communicating in the Healthcare Environment with Dan Cashman and Yaakov Klein

Tommy sits down with leadership development experts Dan Cashman and Yaakov Klein to discuss the importance of (and barriers to) effective communication in healthcare. Dan and Yaakov reveal how they've helped clients in the clinical world tackle their industry's unique leadership challenges, and what actions healthcare professionals can take to maintain productive teamwork in high-stakes situations.

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Chapters

• 0:00 Intro
• 1:35 Current Challenges in Healthcare Leadership
• 6:19 Improving Team Communication in Healthcare
• 14:26 Differences in Leadership Development Across Industries
• 18:25 The Importance of the Mission in Healthcare Communication
• 28:46 Advice for Emerging Healthcare Leaders

Transcript

Tommy Re (00:01.444)
Hi everyone, welcome to the Vital Communicator, the show that explores the power of communication in leadership, business, and life. I'm your host, Tommy Re, and today we're diving into the world of leadership development in one of the most complex and high stakes industries we have, healthcare. I'm joined by two incredible guests, Dan Cashman and Yaakov Klein, the principals of Cashman Klein, a leadership development firm with a specialty in the healthcare space. Dan and Yaakov have spent years helping hospital systems, physician groups, and healthcare adjacent companies build stronger leaders, develop more comprehensive teams, and tackle the unique communication challenges of the clinical world. Whether you work in healthcare or you're just curious about what it takes to lead in an environment where every decision can impact lives, you're gonna wanna stick around for this one. Dan Yaakov, welcome to the Vital Communicator.

Yaakov Klein (01:05.644)
Thanks so much, Tommy. Nice to be here.

Dan Cashman (01:06.909)
Thank you, Tommy. Thank you for having us. So excited to be here.

Tommy Re (01:09.402)
Great, glad to have you with me. So let's just start off and dive into kind of the big question. What are some of the biggest leadership and communication challenges in health care right now that you're seeing?

Dan Cashman (01:23.719)
Yeah, no, it's a great question, Tommy. And so, I mean, I'll come at it from the communication side first. you know, when you think about healthcare, right, you know, the first thing that comes to mind is advanced science and technology, cutting edge treatments, et cetera, et cetera. And all of that is forever changing, right? But at the core of care forever and always is gonna be the human connection, right?

Tommy Re (01:29.572)
Mm-hmm.

Dan Cashman (01:52.985)
it's humans taking care of humans, right? And so regardless of what the treatment of the day is or what the technology of the day is, it really is about that human connection between two people. And so that's really a forever challenge in healthcare and that's always gonna be a constant, right?

Yaakov Klein (01:53.164)
Okay.

Dan Cashman (02:14.065)
But to get to the question of like right now, you one thing that's really interesting about healthcare right now is in the last 15 years or so, there's been a big shift ever since Obamacare in 2010, there's been a big shift in healthcare moving from quantity to quality. And there's lots of different ways that they measure that. They look at things you would imagine, complication rates, infection rates, etc. But one of the big areas that they've really begun to hone in on and really put carrots and sticks in place is patient experience. And there are, you know, a number of vendors out there now that provide patient experience surveys because hospitals are mandated to do it and they have to use, you know, a standard survey to do it and they have to query their patients and benchmark them and say, you know, how was their experience? And if you look at that survey, asks all sorts of things. It asks about their communication with their doctor and their nurse and their care transitions and lots of different things.

Tommy Re (03:21.498)
So yeah, that is really interesting, Dan. So on the other side of that, the organizations, what are some of the things that they're doing to help improve those scores? How do they help the healthcare providers, the organization leadership to do that?

Dan Cashman (03:36.209)
Yeah, so. Yeah, it's a great question. so there's the obvious things that you probably think of immediately. There's a lot of customer service type trainings, et cetera. There's a lot of diving into that data and seeing what can they glean from it. Are there any patterns and trends that they can have specific improvement work on? Most interesting is when you look at the survey data, if you look at some of the big players in that industry, so Press Ganey is probably the biggest company that does this kind of work, and they have now millions and millions of data points that they can use to say, what do we know about patient experience writ large? And what's interesting, if you had to guess what's the number one predictor of whether or not a patient is overall satisfied with their care in a hospital, what would be your top one, two, three guesses as to what makes them the happiest or is the biggest predictor of how they're gonna rate the hospital overall?

Tommy Re (04:41.904)
Yeah, I would say their interpersonal interaction with the physician, the quality of the nursing care, and maybe understanding the cost of their health care.

Dan Cashman (05:02.717)
Yeah, and those are, you are right there. You are right in, you're coming in on the bullseye. It is about interpersonal communication. And yes, when you look at the questions that the CMS, the government like mandates, it is physician communication, nurse communication. But what's even more predictive is not even the communication to the patient. It is whether or not the patient feels that the team caring for them works well together. So of course that communication back and forth is important, right? Like you're saying all these acronyms and tests and numbers and I don't know what any of this means the first time I went into hospital. It may be like the 10,000th time you've explained this procedure to someone, but for me, know, a 70 year old person who just had something really bad happen to me in the hospital and I'm not in the best frame of mind, of course that's important. But that's, I always found that so fascinating that it's even more than that is their sense of... Are the people around me on the same page? Are they communicating well? Right? Or is the nurse coming in and saying, well, I don't know, I'm waiting for the doctor to tell me and they don't tell me anything. you know, the, don't know what the night shift was doing here, but they don't do it the way the day shift does it. Right? They feel that. And that actually is the number one driver is that communication point, like between the team, the team dynamic.

Tommy Re (06:16.218)
Wow. Yeah, that is really, really interesting. That's fascinating. So, Yaakov, let's go further on that. Let's talk about, okay, how do we help those teams? From a training perspective, and I know you have so much experience in creating and delivering trainings, what are some of the things that you would include in programs when you go out to hospital systems and groups to talk about how to improve that kind of team communication?

Yaakov Klein (06:50.447)
Yeah, one of the first things I was ever involved in when I started initially working at Mount Sinai Health System in the city was I was being brought in to help out a unit which the nurses and the CNAs were not getting along in particular. Right? And the way they would talk about themselves is blue versus teal, which was the color of their scrubs. And they would say there's the blue side and the teal side. And it's a really interesting conundrum of, well, we know everyone's showing up for the same purpose and the same goal. We know that you're here because you have these patients.

You have their families who want to feel like their loved one is being taken care of. You have this patient who wants to make sure that they're heard. And why is it that even though we're all here with relatively the same motivation and the same goal, we can't seem to get on the same page? Now, I'm not going to say anything that no one knows. You go into any sort of acute health care center, like a hospital, there is a unspoken or sometimes spoken, but usually unspoken hierarchy in the culture that lives in a unit, right? You have the attending physician, you have the specialists and the consults that come from the outside who are physicians. You'll have your physician extenders like your P's and your NPs. You'll have your nurses. You'll have your your sort of assistants and then all the other again, ancillary services, food nutrition maybe comes in and et cetera, right? You have OTPT that will come in as well. So one of the things that we've tried to do is sort of reinforce first of all, understand why is it that you are walking into a situation that you feel like you're at odds with the person next to you? Like, let's do some unpacking here. Let's try to understand it. And it's almost always the same, you know, this podcast is called the Vital Communicator. It comes down to, well, someone said something and someone took that the wrong way and they probably said it because they're in that position and, you know, they always talk down to us and... We just have to follow orders and we don't get a saying. We don't have a voice. And part of that is, I'm sure those incidents are true. I don't want to take away from that. And at the same time, part of it is that there is a leadership communication issue in which this is not being enforced that, we're on the same page. Let's all get together. Let's all play ball together at a leadership level. And so what's happening is that the leaders are sort of telling their folks, hey,

You do what you gotta do. You take care of your own. You do what you have to do. Whatever they do, that's not your problem. And then, so we really not only would we have to sort of unpack what's going on at the frontline level, but we also have to unpack what's going on at the leadership level. And there are plenty of hospitals and plenty of units and plenty of places that have done a great job at this and created good dyads or triads. The dyads usually being nurse and physician leads, a triad being the nurse, physician, and administrative lead together, and really being on the same page always and communicating to their team, hey, here's what we need to do all the time.

Tommy Re (10:07.354)
Have you seen any reluctance for organizations to be able to take the time to have this kind of, to do this kind of work, whether it's in a cohort fashion, I imagine you, you know, having a consulting engagement that lasts for a period of time, extended period of time. Do you get any pushback on that or are people receptive in the healthcare environment? Because it is a busy, fast-paced environment.

Yaakov Klein (10:36.064)
Yeah. There's two challenges that surface often. First is sort of the more practical of when am I having the time to actually do this and take away from there is no healthcare provider, if you walk into any hospital that has extra time. There's no nurse that has extra time. There's no doctor that has extra time. They're not sitting on the side and snoozing. That's just not what they're doing. They're usually, you know, and we could talk about this next if you're, if you're interested in terms of the financial sort of balance that has to happen between the business of healthcare and the care of healthcare. but they're usually staffed to where the administration thinks they should be staffed where it's still relatively profitable. And so what that means is that you're going to have a ratio that is not always the best ratio between clinicians.

So first of all, the practical side. The other one, which is less practical, but will definitely come up is the, you serious? Are you serious that everyone, like people are insulted here? Like we're taking care, we're saving lives and you want to spend time on making sure people feel good? That doesn't make any sense to me. And what usually, again, usually that's usually coming from a higher level of leadership or culturally higher level in the hierarchy of things that might come down. And so someone who is at a higher level might not realize why someone, when I say level, I don't mean necessarily from a leadership hierarchy, but perhaps from a clinical level. And they might feel like, how come I care so much whether the CNAs are insulted or not? The CNAs have plenty, if they would just do their job, they wouldn't have time to be insulted. And so you'll get those sort of challenges and you have to.

Tommy Re (12:08.816)
Right, right.

Yaakov Klein (12:23.474)
really teach at a fundamental level that if you want the people to do their job and not burn out and not quit in over the next two weeks and then you're going to be more short staffed and more burnout and more upset in this, you need to create an environment that is caring and that is understanding and that you're leading by example.

Tommy Re (12:40.176)
Yeah, it really is. It's a big mindset shift for some of those individuals that you're referring to. So I'm curious as to the pathway in an engagement to getting to those folks that need to be able to communicate to the entire organization about the importance of teaming effectively, importance of working in a cooperative way with their colleagues, how's the path been in terms of getting there?

Yaakov Klein (13:13.096)
Yeah. So the, thankfully there's been a lot of research done on this. And when dealing with highly educated, highly skilled individuals, if you don't show up with your data,

Tommy Re (13:22.105)
Mm-hmm.

Yaakov Klein (13:30.096)
and you don't show up with your research, they're gonna be less likely to sort of even give you the time of day. And so the first step is appeal to the logical, intellectual side of, hey, let's just look at what the data says, right? All the data says this, here's churn numbers and turnover numbers and organizations that implement these types of programs. Here is satisfactory and performance levels of employees who are in these sorts of situations. So let's approach from there.

Tommy Re (13:43.6)
Right.

Yaakov Klein (13:57.563)
Then the next part is the very practical, like, you know, let me sell this to you in the most practical way. What do you believe is the better chance? Just forget the science, just appeal to your logic. What do you believe is the better chance that this CNA is going to do the best job possible? You think, are you going to tell me that it's a better chance that they'll do a better job if you're screaming at them? Or do you think they'll do a better job if you're communicating in an articulate, assertive, but respectful and professional way?

And so you begin to try to first appeal to the data and the research, and then you start to appeal to the logic of it.

Tommy Re (14:32.816)
Yeah. So it goes back to one of the things that we talk about a lot with the folks that we work with is know your audience. If you're going into an audience that's used to analyzing data, looking at things clinically, go in with those kind of arguments. Then you make your rhetorical arguments later about how people would respond in this situation, calling upon their own humanity, understanding what's going on. Yeah, that's great.

Yaakov Klein (14:57.346)
Yeah.

Tommy Re (15:00.93)
So Dan, I know that you don't exclusively work in healthcare. What are some of the differences you see between leadership development in healthcare and leadership development in other industries? And maybe what are some of the similarities as well?

Dan Cashman (15:17.393)
Yeah, no, it's definitely something that we've... looked at a lot and thought about a lot and felt very acutely over the years. So, Yaakov and I spent the beginning part of our career and the beginning part of our consulting work in the healthcare arena. And so now, as we branch out into a whole host of different industries, yeah, there are a lot of similarities and there are a few acute differences. Every organization you work with, I'm sure you see this too, every organization is gonna tell you we're different, our challenges are different, our people are different, I'm a unique unicorn farmer in a world full of rainbows right and every snowflake is different. But the, I think some of the similarities are you know people are people right and their evolution is slow and so I think that you know all of the same team dynamics that you're going to see in a healthcare organization, you're gonna see in any organization, right? People follow the leader. Leaders often take a while to realize the weight and the impact of their behavior, right? Particularly as they're first making that transition from individual contributor, you you're working in a sales organization and you become a sales manager or you're working in a healthcare organization and you became, you know, a unit director or something along those lines. There is that jump, right? There is that phase shift where you go from one to the other. And I think that understanding the power of your behavior and your role modeling and your words, right, I think are, is definitely a huge similarity. I think where things are different, you know, where I will always concede to my healthcare folks is... You know, think healthcare is not the only industry, but because it's so large, you know, I think it's definitely the predominant one where they're just, the mission is just so different, right? And I think that, you know, just to piggyback off of Yaakov's earlier point about, you know, when you're getting in and you're getting people's attention, the data, the research, the logic, that makes sense, that gets you in, right? But then when you're actually working with people and when you're trying to reinforce some of this and sustain some of this,

Tommy Re (17:23.728)
Right.

Dan Cashman (17:29.571)
I think you switch from the head to the heart and it becomes about those stories and it becomes about that mission, right? And when you look at, you know, employee engagement surveys, right? Like we've done some work for folks on that and we've consulted internally with folks in healthcare on that. The mission...

Tommy Re (17:34.736)
Yeah.

Dan Cashman (17:47.631)
Any question around that, I believe in the mission, is always off the page in healthcare, right? They have extreme levels of burnout, extreme levels of feelings of low psychological safety and things like that and stress, but the mission just jumps off the page. When we go to some of our private for-profit clients, it's almost the reverse, right? All of sudden, you know, they're saying, yeah, you know, feel safe to say what I want to say, but, you know, I don't really care about the mission here. you know, okay, so we're gonna make a few more widgets a little faster, you know, that's nice, who really cares? And so, you know, I think in the healthcare environment, whether you're talking about communication training or process improvement, you bringing it back to the patient, right, that's why everyone's there. You know, by and large, you know, people are there for the right reason, you know, and they want to help. and they want to heal, and they care. And so in all of that, I think as much as you can bring this work, whether it's leadership development or communication training, back to that mission and tell those stories of the impact that it has, I think that that in healthcare is definitely a unique advantage and unique difference.

Tommy Re (19:03.322)
Yeah, know, Dan, that's been my experience as well in terms of the industries. I've done a lot of work in the life sciences industries and in life sciences people, they get that. They get that mission. They think about the patient. They think about drug discovery. It's very clear for them. But in others, it's not. And I always say that the manager's, the leader's job is to connect people to what that mission is. And even if the mission of a company is not as noble as life-saving medicine, they're serving someone in every group, in every department. They're serving someone, the element of servant, not servant communication, but the element of being at the service of other people in your organization is often a powerful way to help get people motivated to... be more engaged, et cetera. And I'm wondering if you've seen that play out in different ways in healthcare and in especially non-healthcare settings where it might be a little more difficult to connect people to the mission.

Dan Cashman (20:17.521)
Yeah, no, I think it's a good point, right? Like every process has a customer, right? Every service has a customer somewhere, even if you don't realize it. And so, yeah, absolutely. And I think, you know, if you go back to some of the...

Tommy Re (20:22.788)
Right.

Dan Cashman (20:33.543)
earlier conversation about different scrub colors, I Yaakov was describing it, the light color versus the dark color, et cetera. I mean, you see it in any industry, right? And so it's a natural human instinct, right, to say us versus them. It's a basic survival instinct. But then if you draw back to some of heavy hitters in communication and influence, just like you said, appealing to someone's better nature and getting them to help you is often one of the core tactics to get people to influence them in a way to want to pick up what you're putting down.

Tommy Re (21:11.982)
Yeah, so let's talk about that from a more of a training and learning development perspective. When you engage with a client, what are some of the types of things that you're doing to develop people's skills in addition to helping change their mindset? Yaakov?

Yaakov Klein (21:32.851)
Sure. So, I mean, if we focus on communication and we focus on leadership communication, I think that there is a, for all humans in general, but particularly when you own a business and operate a business and you have a team, there is definitely a misconception that people can read your mind. And there's this misconception that if I just say, you know, if I just describe what I want, everyone will understand what I mean. and I won't have to follow up. You know, it'll be fine. I just have to say what I need and then it'll just happen. So the first thing is that we try to break down from a skill standpoint and from a identification standpoint, simply understanding the objective versus subjective language. That from a fundamental standpoint, if I can, if you can say something to me and I can take it more than a single way, then it's possible it will happen. And certainly it's going to happen to people on your team. So we begin there of just, I get you to agree? And there's a lot of, you know, there's a lot of research around this. One of the things is a famous mental model that came out of Harvard Business School from someone, think Chris Argyris, if I'm pronouncing correctly, it's called the ladder of inference. And the ladder of inference is this, you know, you start at the bottom with your pool of data and sort of, am I, you know, and then you have neural blindness. Do I, can I see everything? Can I access, but I form opinions and... You go up this ladder until you're making decisions, but it all starts on how I interpreted that initial whatever. It could be something that I saw, something that I heard, something that I read. And so we start with trying to get agreement, and I say that very purposefully, trying to get agreement from our client that there is a difference. Let's just agree that there can be a difference between you saying that you need to quickly...

Tommy Re (23:05.242)
Right.

Yaakov Klein (23:26.058)
and you saying that you need it in five minutes. Those are not the same thing. All right? No skill involved yet, just sort of acceptance. And that acceptance is really hard because part of what we believe, part of the job is initially when we're interacting with our clients is to sell them the concept before we sell them the skill. Meaning I can't tell you that this is a model you should use until you agree that a model would be helpful. And so we start over there.

Once I could get you to agree that yes, there's a difference between fast and you know, five minutes that that exists. Now I could introduce a whole plethora of different ways of making sure that when we're communicating for performance or setting clear expectations or having challenging conversations, right? Here is what I'd like you to sort of frame it this way. Here is why, right? We'll bring in some of the neuroscience around the amygdala and amygdala overload and things like that to make sure that the defense isn't to lower defenses and active listening and all those sorts of things. But the approach is that I need you to believe that this is something that you're interested in because and I think it's very transparently to all the clients that we work with, Dan and I have said this a million times. We believe that you're never going to do anything because we said so, right? That's not going to happen. You're not going to be there and they'll often say, well, Yaakov said do this. That's not what's going to happen. You're gonna do it because you believe it's the right thing to do. And so my job is to sell you that this is the right thing to do.

Dan Cashman (24:57.213)
Yeah, and just to piggyback off that, think, know, one of the, mean, sell sounds almost like you're trying to massage someone, right? Or you're trying to, you know, manipulate in some way, but the best salesperson is themselves, right? And so, you know, I can say, you know, Yaakov by far is the best person I've ever witnessed at doing this because, you know, I think, just to shoot his own horn here for a second, but, the way he personalizes things I've always been impressed with right because you everybody knows that right that you want to try to tailor to your audience and when it comes to training, right?

Tommy Re (25:28.656)
Sure.

Dan Cashman (25:32.207)
If people are gonna buy something, they're gonna change something on themselves, they need to feel it. It's one thing, obviously, good, better, best. You need a good training to start. That's your baseline. Better, you put in some examples, maybe some role plays. Hopefully you get it closer to fidelity for them, some examples that might be more in their ballpark. And then best is how do I really personalize this to you? People like real time in training look at us and say at a case study we were about to have them role play and they say no no no I don't like this one you know and you go okay why and you tease that out right like is it just that you don't like it or it's you know

Tommy Re (26:08.954)
Ha ha ha ha! Yeah.

Dan Cashman (26:15.869)
Or is it off the mark? And then real time float it back to, okay, here's a scenario that this guy over here just had last week. I saw Yaakov one time have a team pull an email up on the screen that somebody in the room had sent. And they took the activity they had done before as a hypothetical. And obviously I wouldn't recommend this for every training environment. need to be confident there's some psychological safety in the room. But the group objectively took apart an email that had been shared between somebody in the room and someone else and looked at it now through this new lens and what better way to get somebody to pick it up than to go wow I'm the case study.

Tommy Re (26:49.114)
Yeah, yeah, yeah, it makes it I mean, it's got to be relevant, right? In order for the learning to stick, it has to be relevant. But I want to go back to something that you were referring to earlier, Yaakov, about this idea of people having to kind of buy in and and agree that this is going to be helpful, whether it's the executive that signs the check for the training as a sponsor or the people that are in the room. There's an element of persuasion.

Yaakov Klein (27:19.984)
Yeah. Yeah.

Tommy Re (27:23.588)
that we have to engage in and we have to help people shift an attitude and we have to use all the tools of persuasive communication to do that. I see the same thing and I think that's so true because sometimes people have to go to training because someone told them to go to training and when they go to training and they don't buy in, you're not going to see a lot of attitude change or

Yaakov Klein (27:43.208)
Yes. Yeah.

Tommy Re (27:52.386)
behavior change, but when we when we start a program or even do pre work that really helps people understand the case for this the why the You know, they've got a shift of belief somehow We've got to help them see how this will be more valuable for them. It works. Well so

Dan Cashman (28:13.117)
I'm curious, Tommy, do you see patterns in that? Are there certain kind of inflection points that are common with some of the decision makers that makes it spark for them? Or do you feel it's person to person?

Tommy Re (28:26.116)
Well, sometimes, maybe at the higher level, it has to do with pain. if a client's experiencing some pain in the organization, they're probably going to be more open to some persuasive communication about the value that a learning experience can bring. On a personal level, like in the classroom level, I try very hard to start all the workshops that we do with some type of activity or discussion that really gets right at the core of what the value is for the learners. And I think it's different for different people. we've been lucky. We've got great clients and it's been fun to work with their people. But it can be challenging. And I would imagine that in healthcare where it's so fast paced as well and people are really using all of their time.

Yaakov Klein (29:22.713)
Yeah.

Tommy Re (29:24.496)
focused areas of providing services, that can be a little bit more challenging. So let's wrap up, guys, because this has been a fantastic conversation. But I think I'd like to ask you about what piece of advice would you give to a leader, let's keep with health care for now, someone who is an emerging mid to senior level leader, what advice would you give them about leadership communication? and even the importance of doing this learning and training work that you do.

Dan Cashman (30:03.485)
Yeah, I'll start. So I would probably distill it down to just two bite-sized things, right? And I would, again, would try to appeal back to the clinician in everyone, particularly in the healthcare environment. So number one, from a leadership perspective, I would appeal back to just that first moment when you started your healthcare journey and they said, do no harm, right? And so, you I think that leaders, you know, one of their big aha moments in anyone's leadership journey is understanding the impact of their own behavior. And that, you know,

The way that they lead, the way that they communicate, the way that they collaborate with their peers is really setting the tone for then how the rest of their team is going to communicate what's acceptable, what's not acceptable, how they're going to collaborate with different disciplines on down the line.

So, you know, that would be number one. And the number two, again, I would bring it back to the mission, right? You know, I spent a lot of time, a lot of years doing process improvement work, you Lean Six Sigma projects. And, you know, I can tell you the amount of times that we walk into a room and we say, hey, who's excited to make this 20 % cheaper? Or who's really excited to do this with 30 % less staff? You know, I bet you can guess how many hands go up. But when we leave from the patient experience, which again is where that mission focus is for people. And we say, okay, hey, listen, let's look at the experience that this patient is having in this process. Guess what? At the end, you get the team talking, you break down those silos, and you end up with a better result than you wanted from an efficiency standpoint anyways, right? Because people will just say, all right, yeah, no, 20 steps to get through this clinic is crazy. know, having to talk to 15 people, why are we doing that, right? And once people begin to talk about that shared mission of the patient that they're all taking care of on that continuum, all of a sudden that communication really starts to open up and they begin to kind of feel a much more powerful why behind this type of work.

Tommy Re (32:12.858)
Yaakov?

Yaakov Klein (32:14.431)
Yeah, I think if I was going to talk to a mid to senior level health care leader, know, again, the business of health care has drastically changed so much in the past 30 years. And there have been so many tweaks to law and policy and reimbursement that it becomes sort of a different game. Even if you're on a lead clinical side of physician leadership or a nurse leadership, you're still now looking at more business questions and decisions than you've ever had beforehand.

And one of the things that we'll often talk about with leaders is, know, I'll usually very much again explicitly say, let's take all the emotional side out of this, right? I know, you people don't necessarily mix emotions at work or things that, know, it's not personal, it's just business, which we all know that's not true. But, but, but let's say that's the approach you take. There is just too much, too much research and just too much data that if I say, even if you don't want to be the nicest leader, right? And you want to just communicate what you need to communicate. I will show you 10 studies that will show you that when you communicate with care, you will have better patient outcomes, employee outcomes, higher clinical outcomes across the board, right? There's a couple of studies that I looked at and that I had been used as a part of when I was working at Sinai and other places. One is from the IHI, the Institute for healthcare improvement. It's about joy at work. And you're like, who needs joy at work? That seems like something like such a luxury, joy at work. But the idea was that you cannot give what you don't have, right? So if you don't have joy, if your team doesn't have anything, right? If they don't have support, they don't have respect, they don't have joy, they don't have resilience, they can't give any of that to their patients and families and residents or whoever the caregivers that come in. So that's number one.

Tommy Re (33:46.724)
Mm-hmm.

Yaakov Klein (34:11.87)
And number two, Schoenfeldt also, I think in like 2021, talks so much about physician and nurse burnout. And again, you want good care, you want good outcomes, and you want a healthy environment, you're have to make sure that you're taking care of your team, your clinical team, your non-clinical team. It doesn't make a difference. So I think if I was telling them, I'd say, listen, I know that you're leading healthcare now and you're in an important role and you're making high level decisions.

You can't do all this on your own. All the people that are looking up to you for those decisions and that you're trying to lead, they actually need to get all these things from you for them to do all the jobs that you want them to do. And so when you invest in the five minute side conversation with a doctor that's having a hard day, or when you pull aside a head nurse on a unit and the attending for that unit and say, hey guys, let's talk about how the two of you are connecting.

I know you might think that's fluffy emotional stuff, but listen, the ultimate outcome is going to work best for everyone involved. For you, for the physician, for the nurse, for the patient, for the family, for the hospital. So it's going to work across the board.

Tommy Re (35:22.768)
Yeah. You know, I think, Yaakov, in that example, that person goes home, that's what they're going to tell their partner or their family about. I was having a rough time today, and my colleague picked me up and makes a big difference, right? That's what they'll wind up saying.

Yaakov Klein (35:42.096)
You know, just similar to that for a moment is, we're always doing a lot of training on performance feedback, right? Clear expectations, accountability, that sort of thing. And we'll go through some of the good, just best practices and, you know, well-known, don't criticize people in public, right? Don't do it. And, you know, it's gonna be embarrassing. And I say again, it's not about being nice. Let's just think strategically. Regardless if they're gonna get insulted or hurt, which obviously we don't wanna do.

But if your goal is for them to hear you and learn and change behavior, they're not going to do that in that moment where they just want to be swallowed up by the ground and they're embarrassed, practically. And on the other side, we're all into public appreciation and shout outs at the meeting. And I say, that's all well and good. Fine, you want to do that, that works. But I'm telling you, nothing beats a one-on-one intimate interaction of a leader taking an employee to the side and expressing that one-to-one appreciation. So those moments of just simply, I like to joke, if you take 10 minutes of a reinforcing sort of positive feedback conversation with your employee in an office, that will buy you three months of performance. Just by simply giving that because they see that they're seen, they're heard, they're recognized. You don't have to give a bonus, you don't have to give a gift card, you don't have to throw a pizza party. Just tell the person to their face that they're doing an amazing job and explain the things that you've seen that connect to that, and it's very powerful.

Tommy Re (37:08.016)
That's fantastic, great. Guys, what a great talk. I really enjoyed talking with you, learning more about the industry that you serve in the healthcare industry and leadership there. So thanks so much. I really appreciate it, and I wish you the best of luck.

Yaakov Klein (37:23.838)
Thanks so much, Tommy.

Dan Cashman (37:25.287)
Thank you, Tommy.