In our first December blog in 2010 as we launched The Beryl Institute as a global community, I shared a quote from Maya Angelou. It read:
"There is no greater burden than carrying an untold story."
That idea has been essential to our journey at the Institute and a seed of the evolution of the experience movement itself. Every patient, family member or caregiver we serve in healthcare, every individual who wakes up each day to work in healthcare and every person who is impacted in the communities we serve in healthcare ALL have a story to share. This idea, this reality, is universal. We all have untold stories inside us to share.
I believe we have together pushed the conversation in healthcare to see people we care for not simply as a room number or a diagnosis on a chart, but as human beings with needs and wants, hopes and dreams, all rooted in their own story. At the same time, from the lenses of those that experience healthcare, we have heard loud and clear, and have seen reinforced in data from our own research, that the number one request from their healthcare experience is “listen to me”.1 When we take a moment to listen to those we serve in healthcare and those who serve in healthcare, we reveal a rich and powerful tapestry of our very humanity. When we create the space for stories to be told and ensure needs and desires are revealed, we create new and more powerful paths on which we can impact the human experience overall.
It was this realization that sparked a powerful idea at the heart of Michael Barry and Susan Edgman Levitan’s piece in The New England Journal of Medicine on shared decision making.2 In their perspective, they offered we must move from simply engaging people on “What is the matter?” to “What matters to you?” as an essential element of providing the best quality care. That very question “what matters” begins to crack open the doors hiding the untold stories people carry. It could be about the fears they personally carry, about the family they love and are worried they might leave behind, about the way a room is lit, to the name they are called. These are all driven by the stories of our lives as human beings.
And as I have long suggested, in healthcare we are simply human beings caring for human beings and therefore must acknowledge that these realities for people, whether revealed by asking or left hidden, will have an impact on how people are cared for and ultimately the outcomes they achieve. Simply stated, we cannot take the human out of healthcare, and so healthcare is ultimately built upon and must act within a patchwork of human experiences in our desire to provide safe, quality, reliable, consistent, service-focused and accessible care.
But there is also more to the story, for as “what matters to you” has grown into a global movement grounded in the clinical encounter of healthcare, the conversation on human experience in healthcare pushes us to move even farther. As the global community of practice committed to elevating the human experience in healthcare, we realized at The Beryl Institute that the idea of measuring experience itself could and must be informed by this very idea. When we look at the traditional way in which we have asked for feedback in healthcare or in most industries for that matter, we have tended to ask “How are WE doing?”. Questions we pose to our patients, our customers or our consumers are asking them to tell us about us. But where in these inquiries do we ask about them and their needs? Where do we take the step to help them reveal their untold story and better understand how we can help them in addressing those needs?
That very question had us think about the powerful opportunity to ask less about “How are WE doing?” to more about “How are YOU doing?”. Have you felt that spark in a conversation when someone asks you that question? It is an opening, an opportunity, an appreciation that you have a thought, an idea, a need, and yes, a story to tell.
When we flip the question to “How are you doing?”, we can then uncover what people need, what they want and what matters to them more broadly. And in doing so, we can also ask about our ability as healthcare organizations to meet those needs. When we ask “How are you doing?”, we invite a different perspective on how people see things, as Gerteis, Edgman-Levitan, Daley and Delblanco wrote in 1993,3 “through their eyes.” That is the opportunity we believe we have in measuring experience overall, and, yes, we believe in understanding your needs in The Beryl Institute’s global community as well.
The opportunity is now to find ways in which we ask others to rate us not only on how we did for them or if they would recommend us, to more directly what they need as our patients, customers and consumers and how well we met those needs. How will you ask those questions in your own organizations to uncover and address the needs of those you serve? What steps can and will we take to uncover the untold story?
At the Institute, we believe we can do this by flipping the question today as we engage the over 50,000 people in our community and beyond in a new type of inquiry. We will now ask “How are YOU doing?” and based on your answer, we will also inquire “What do you need from us?”. Finally, we will ask what we are doing and what we can do better to help meet those needs. It comes back to the idea that when we ask people about ourselves, it becomes about us; but when we ask others about themselves, it becomes about them. It is about their story and the insights shared, and it actually provides a more powerful window into what we can all be doing to support one another in what we do, what we offer, and how we work together.
It is not an easy switch for organizations to move from asking people ”How are WE doing?” to “How are YOU doing?”. While it is reaffirming and helpful, I think we can agree the first question is limited and may miss the biggest opportunity of all. When we ask people “How are YOU doing?” there is acknowledgement for the un-acknowledged, there is space for discovery and there is the opportunity for connection and for the ability to meeting one another where we stand as human beings in healthcare and beyond.
In a world where the concerns of human discourse have turned sour across the continents and distance has been created between people versus bridges being built, we must accept this is our current reality. Perhaps in our willingness to ask others about themselves, we can begin to tighten the seams of humanity once again. When we each in our own way try to express our interest in others, and when we change the way in how we ask about the experiences of others, we all take one step closer to the power of the human experience that we look to foster every day in healthcare. We each can help catalyze this type of connection. My ask of all of us is that we work to do so. Our hope here at the Institute is to change how we ask you, our community, about your needs and to help start this subtle but significant shift. To that effort, we invite each of you to take a few minutes in the coming days via our inquiry to tell us how YOU are doing.
There IS no greater burden than an untold story. And there is NO greater means to connect and to better serve by working to share those stories. Here is to all the stories we will both share and create together in this new year and beyond.
Jason A. Wolf, PhD, CPXP
President & CEO
The Beryl Institute
1. Wolf JA. Consumer Perspectives on Patient Experience 2018. The Beryl Institute; 2018.
2. Barry MJ, Edgman-Levitan S. Shared Decision Making — The Pinnacle of Patient-Centered Care. New England Journal of Medicine. 2012;366(9):780-781. doi:10.1056/nejmp1109283.
3. Gerteis M, Edgman-Levitan S, Daley J, Delbanco T. Through the patient’s eyes. San Francisco: Jossey-Bass, 1993.