When it comes to building a culture of patient-centered care, there’s a lot of talk of empathy, kindness, compassion, and human connection and yet the L-word is rarely uttered.
Barb Bobula, vice president of Patient Experience for Allegheny Health Network, thinks it’s time that changed.
“The word ‘love’ is not often used in conversations at work, except perhaps to say we ‘love our job,’ or maybe we ‘don’t love our job,’” Bobula says. “Yet we don’t talk about loving people at work, or about how we infuse love into the work that we do.”
For health care team members people who dedicate their lives to caring for others she says that love should be part of the daily discussion, an integral element of the workplace culture that helps leaders and staff build resiliency, engage peers, and express empathy for patients.
“We want it to become more acceptable to use that term at AHN, we are bringing love back into the conversation,” Bobula explains. “In health care, love is a healing super-power not only for ourselves, but for everyone around us.”
Why is “love” so important? Don’t empathy and compassion cover all the bases?
Not precisely. Empathy is about respecting the humanity in others, and listening with intent to develop an emotional understanding. Compassion goes a step further, taking measures to act on that understanding.
But love is rooted in genuine affection, a stage of caring in which a person derives happiness and satisfaction from increasing the emotional and physical well-being of others.
Of course, not all stages of love are created equal. In this case, we’re talking about what’s known in psychology circles as “companionate love” which is based on warmth, affection, and connection as opposed to romantic love, which is based on passion. And people who feel that companionate love at work those who perceive genuine affection from their colleagues, and caring from their bosses are likely to perform better, and like their jobs more.
That’s true in most industries, health care included, and there’s abundant research supporting that conclusion, much of it conducted by Sigal Barsade, a Wharton School of Business professor and love-in-the-workplace advocate who died in 2022. A 2014 study from Barsade and a colleague, which surveyed employees and patients at a large U.S. hospital and long-term care facility, found that:
“Employees who felt they worked in a loving, caring culture reported higher levels of satisfaction… They showed up to work more often. Research also demonstrated that this type of culture related directly to client outcomes, including improved patient mood, quality of life, satisfaction, and fewer trips to the ER.”
That may seem like common sense a culture of love and appreciation leads to happier, more productive employees. But how do you build that culture in the first place?
Southwest Airlines 2022 scheduling difficulties notwithstanding might be the most obvious example, with its heart logo and its LUV stock ticker, but many other companies have figured out that putting “love” at the center of their culture is good for employee morale and customer perceptions.
In health care, though, love is about more than brand loyalty and customer perceptions. It can contribute to better outcomes and healthier patients. Conversely, lack of caregiver connection can lead to lower attentiveness, and has been associated with lower patient satisfaction and longer post-discharge recovery time. As one study in the Journal of Patient Experience put it, “Without compassion, care may be technically excellent but depersonalized, and will fail to address the uniquely human aspects of the health care experience.”
Employers, including AHN and its parent company, often try to measure that sense of connection through workplace surveys do you feel supported at work? Do you feel that your efforts are appreciated? Do you have a best friend at the office? Those questions, though important, often nibble at the real heart of the issue: Do you feel love at your job, and loved by your peers?
According to Bobula, a loving workplace starts with compassionate leaders.
“Leaders who embrace love in the workplace motivate others by example, and signal to other team members the benefits of a loving, compassionate workplace environment,” she says.
Love also plays a key role in keeping team members engaged, and helping to avoid employee burnout.
“Burnout isn’t solely about being overworked,” Bobula points out. “It’s about the absence of meaningful human connection. We can combat that by reconnecting with the reason behind why we do what we do.”
Actions have to meet the words, though. It’s one thing to talk the talk but organizations also have to build impactful, measurable caregiver wellness programs, putting money and institutional resources behind the effort, nurturing peer-to-peer engagement and emotional wellness. Organizations must also work to mitigate systemic pain points and non-meaningful tasks that cause burnout in the first place.
“AHN has been investing in caregiver wellness for years, and it’s one of the reasons that our caregivers are feeling less burnout, and more empathy,” Bobula says.
Wellness programs have been supplemented by AHN’s “Share the Love” campaign, which began in 2021 and continued through 2022. Squishy hearts were distributed, a “feel the love” AHN playlist was created, and managers were tasked with setting the tone and allowing loving relationships to flourish.
When most organizations go about establishing culture, it’s what’s known as a “cognitive culture” the way employees are supposed to act with integrity, and work toward collective goals (think core behaviors). Embedding love in the workplace is less about an organization’s cognitive culture and more about its emotional culture. The values are less descriptive, and more aspirational.
In other words, emotional culture is not about what employees should think and do when the boss is not around it’s about the emotions that employees should express, or evoke, whether the boss is around or not. Importantly, it’s a frame of mind that must be woven into the system, rather than based in a short-term awareness campaign.
“Love means we are not hesitant to acknowledge our vulnerabilities. Love means we are prepared to have crucial conversations, because love leads to inclusivity and trust,” says Eugene Scioscia, Jr., MD, AHN’s chief experience officer. “By bringing ‘love’ into the health care environment along with empathy and compassion, we can bridge the gap between the caregiver experience and the patient experience and make it about the complete human experience.”
Adrienne Boissy, MD, a staff neurologist at Cleveland Clinic and the chief medical officer for Qualtrics, a Seattle-based experience management vendor, has spent years trying to bridge that gap and build that culture. She discovered a lot of pitfalls along the way, and she acknowledges there may be more of them to be found in health care than in other professional fields.
“Suffering in health care is everywhere not only in the diseases themselves, but in the pain we create when systems and operations are redundant, difficult, and friction-filled,” Dr. Boissy says.
There’s also the emotional cost of loving a colleague or a patient. After all, that’s the whole point of “clinical detachment” emotional distance supposedly allows a caregiver to maintain objectivity, which is meant to ensure professionalism and optimal care.
“It hurts sometimes to love our patients, and it is natural to want to protect ourselves,” Dr. Boissy acknowledges. “I also suspect many left brains in the business of health care find ‘love’ hard to measure, and that’s why we avoid the word. But as a physician, I love my patients, and these relationships provide more than I ever imagined. They are a part of my fabric.”
So, in a health care setting, what does love look like in practice? Well, it looks a lot like it does outside of the hospital gestures of caring which get baked into how we think, feel and operate. Handwritten notes. Flowers for the cancer patient who is returning for her first post-chemo checkup. One of Bobula’s favorite examples of workplace love happened at AHN Allegheny Valley Hospital in 2021 when staff took heroic measures to ensure that a husband and wife, both ill with COVID in the same hospital, were able to spend time at each other’s side before the husband died.
The long-term goal is that these expressions are cultivated in such a way that they suffuse the entire workplace, outside of the exam rooms and emergency departments. What does a loving billing process look like, for example? A loving hiring process? A loving health care navigation system?
We’re a long way from there. But it’s a place Dr. Boissy believes the industry needs to get to.
“Clinicians, and everyone else in health care whom I’ve met, want to bring their heart as much as their head to their daily work,” she says. “And over the years, I’ve found that love is the one thing that fills our collective cup the most.”