This week on IRH we break down The New York Times podcast, The Retrievals, a five part series that provides an in-depth look at the Yale Fertility fentanyl scandal.
Lisa Duran, who’s consulted dozens of fertility clinics across the US and Canada and was the Chief Experience Officer at Inception Fertility, leverages her experience to offer up methods you can integrate to drastically reduce the likelihood of a terrible scandal at your own clinic.
She provides four big takeaways:
A Closed Loop Feedback System (Lisa gives some examples and how they work for patients and staff)
Recruitment and Retention (And the risk management necessities involved)
Leadership (How to engage your team to create consistent accountability)
Service Recovery (Validating feelings, getting more information, and taking ownership)
Lisa Duran:
Website, Lisa Duran Consulting
LinkedIn
Transcript
Lisa Duran 00:00
What happens is, of course, the patients were feeling like, how did nobody believe me? And I was telling my nurse, I was telling my doctor, and why didn't nobody believe me? Whoever was in that procedure room, how was I not believed after that? And and I found myself really thinking about that, going oh my gosh, how do you not believe hundreds of women?
Griffin Jones 00:26
Excruciating pain and public scandal. Those are the topics of a podcast that is much better known and will reach far more people than this one ever will. Well, you might be familiar with the incidence of fentanyl theft by a fertility nurse at the Yale Fertility Clinic that occurred in 2020. You might be familiar with the lawsuits that happened after it. And now there is a podcast that is currently ranked number one in all podcasts, a mini series from the New York Times and Serial called The Retrievals. By the time this episode comes out all five episodes of The Retrievals will be out at time of recording. They're not all out yet. The first episode is about the patients. The second about the nurse, the third is about the court case, the criminal court case that is not the civil one that came later, and the fourth is about the clinic. My guest is Lisa Duran. Lisa's been an in house marketing director for fertility clinics before she was the chief experience officer at Inception Fertility for some years, and she's consulted dozens of fertility clinics big and small throughout the US and Canada on patient experience management tools and leadership capabilities. Lisa listened to all four episodes that are currently out I think more than once she has four big takeaways that you and other fertility clinics can employ to drastically reduce the likelihood of a terrible scandal like this ever happening to your clinic. The first is a closed loop feedback system. She gives examples of those systems, how they work, how they escalate how patients use them, how staff use them. The second is recruitment and retention as risk management necessities and I share a couple of things I learned about recruitment and retention, reducing some administrative time to fill responsibilities that currently fall on your staff. Lisa's third takeaway is about leadership, how to engage your team's hearts, so there's always accountability. And in the fourth, she has three points about service recovery, how to validate feelings, get more information and take ownership the follow through. This is not a bright chapter for the fertility field. Hundreds of women suffered in excruciating physical pain. It's an embarrassing scandal and the cat is out of the bag. These media outlets are huge. And now the topic is very much in the public square. This episode isn't about Yale Fertility Clinic. Lisa argues that this could have happened at a lot of different fertility clinics. She shares why and she shares her takeaway of how you can prevent it. Enjoy today's conversation with Lisa Duran, Ms. Duran Lisa, welcome back to the inside reproductive health podcast for what I think is the fourth time.
Lisa Duran 02:41
Yes, I'm so happy to be in one. Thanks for having me back.
Griffin Jones 02:44
We're on to talk about a current topic to have one that has just started to wrap up but it's still very popular that more people in our field are starting to find out about it. And it's from an incident that happened back at Yale Fertility three years ago. And the New York Times along with their subordinate companies, Serial, made a podcast that is the most popular podcast right now, a mini series, five different episodes about this incident that happened back in 2020. As it was released, you texted me like did you see this? I said, Yes, I saw this. I want to talk to you about it. I want to have you come on and tell us about how this can be prevented in the future. And we can go through it. Why don't you set it up? Explain to the audience what the podcast is about.
Lisa Duran 03:37
Sure. Okay. Thank you. I'm so excited to talk about this because I was getting texts from friends and emails saying, have you listened, have you listened. And so of course, I jumped right on. It's called The Retrievals. And there have been four episodes. The fifth episode of the last episode is dropping this Thursday. And I just I found just ranges of emotion throughout the, you know, the series of the of this podcast and I wanted to share them with you because I think they're really important. And this is not going to be about how Yale failed. This is not going to be anything about processes necessarily. Or you know, I don't have a clinical background in terms of I'm not a nurse, I'm really going to talk about the experience today. So the lens that I was listening to a podcast with was from the experience standpoint, and so the first episode was about the patients and about their horrible experience and hundreds of patients went through a retrieval with no payment because there was a nurse that was stealing the fentanyl and in replacing the fentanyl was saline. So the nurses or whoever was administering the what they thought were pain meds, and these patients weren't getting them and so hundreds of patients were complaining about pain, you know, going through an excruciating ordeal without any pain management. And so of course, the first episode just tears rolling down my cheeks for these patients and just, you know, what they what they went through. And it was not just the physical, but it was the emotional of, you know, the, what we do as women is we talk ourselves in and out of things, right. And so many women said that what they did is they found themselves telling themselves stories about why this was happening, well, maybe I'm just not sensitive to, you know, this is just what I have to go through, because my body is not operating the way it should. This is just what I have to endure for this process. And it was just so sad, because we often do that as women is we just, you know, we try to explain it away. And we try to blame ourselves and just say, you know, what, just suck it up and deal with it. And it's going to be okay. And and I think one of the most difficult parts is hearing how after it all came out how they thought, you know, how did no one believed me? You know, how did the nurse not believe me? How did the doctors not believe me how to, you know, if whoever was in that procedure room? How was I not believed after that? And, and I find myself really thinking about that, oh, my gosh, how do you not believe hundreds of women, right? And so we're going to talk about that in just a little bit. So episode two was all about the nurses story. And I found myself tears rolling down my cheeks about her story and thinking, gosh, you know, what could have been done to help her alone? That third episode is about the court case. And of course, you know, you're saying, gosh, she should you know, she should get what's coming to her. But on the other hand, you know, after episode two and hearing her story, empathize with her as well. No excuse for her decision. But and then this last one was so good. It was about the clinic, of course, where was the clinic in all this and what was what was the patient's experience, and as well as the the employee experience, throughout this deal. So those are the four podcasts that I dropped, that you're able to listen to, and what I'm going to unpack during the scene of this talk, as we unpack.
Griffin Jones 07:08
Do you know what the fifth episode is going to be about? Do we know what it will be about before it drops?
Lisa Duran 07:15
You know, that's a great question. And I've been researching and trying to find out and I believe it's going to be more about the clinic and just really summarizing everything, but I didn't know to high. Thursday, Thursday is on my calendar.
Griffin Jones 07:29
And by the time this episode comes out, that episode will be out. But at least we've got four episodes thus far. First about the patient second about the nurse, third about the court case, and fourth about the clinic. And you talked about the patient's feeling like well, I guess I just have to suck it up. I guess this is just the way it is for me. Did they have any kind of recourse where they could have found out if other people were going through this? Is there something that could have been done for to do at least know, for them that this isn't an isolated incident?
Lisa Duran 08:05
Actually, I'm so glad you asked that question, it actually tees up its solution, but I feel would be would have been a great way to catch it early on, you know, what happens is, of course, the patients were feeling like, how did nobody believe me? And I was telling my nurse, I was telling my doctor and why did nobody believed me, I don't believe that that was the case, I don't believe that the women weren't believed. Or that that or that the nurse of the doctor didn't care. What I believe happens is that, you know, there's so many different people, so many different nurses and so many different doctors that are working with patients that they're not necessarily talking to each other. And so they're not seeing a common thread. And so your question, Griffin, about, you know, what, is there something that could have been done? And yes, there should be a formalized process for patients to give feedback, one that doesn't depend on one, two or 10 people to communicate, you know, and then finally, you know, how do you communicate that who documents that you with technology today, there are some amazing systems, you know, Qualtrics Medallia, they have an SMS real time surveying that can by touch point, you know, after retrieval within, you know, 24 hours or after the patient's recovered, can send them a text and say, you know, Lisa, how was your experience, or tell us, you know, how could we have improved this experience? And and if they would have something like that in place, they would have seen a common thread, Text Analytics would have picked it up and they would have seen a very common defect going on, they would have caught it earlier, because they would have seen this, this feedback being woven through a lot of the patient's feedback.
Griffin Jones 09:57
Okay, so there's the opportunity for patients to report using text they get they get how tell us about your visit. It was terrible. I felt like I was going through excruciating pain. It was a 10 out of 10 pain if they had seen this from a number of different people, ostensibly they would have been able to connect a pattern now, is there something in the technology that connects the pattern for them? Would they have to would have to connect the pattern themselves? Would somebody have to be monitoring it actively? In other words, so if they have this, and you get 10 patients in a week that all say I had excruciating pain in my, during my retrieval, that should send up a red flag. But what if nobody's at the helm? Reading it? How does? How does the other end of it work?
Lisa Duran 10:48
Another great question. The beauty of these platforms is that there are two things, there's text analytics, that will compile common themes, and will push them out to leadership. And when you're when you were building the system with whatever company you choose, you create the governance, right, you create the who it goes out to. And and the other thing is, there's a closed loop system that is absolutely beautiful, that if there's a you know, you set whatever the rating is, and if the patient gives it a rating, you know, you talked about, you know, the rating of 10. And let's say they gave it a five and a detractor would be a five. And there's a closed loop system that that does a real time right away alert to the practice administrator. And then the practice administrator can give that patient a call and find out what happened and close that loop. And there are actually systems in place to where, if that doesn't happen, an alert goes to the next person. And if that doesn't happen, then alert can go to the next person. So the idea is that no patient left behind no patient unsatisfied, or no patient that had a less than optimum experience is not followed through with a phone call right away to try and preserve that relationship and fix it. And you better believe that if somebody if a leader is getting no constant detractors on the same issue, that there is going to be some awareness there. And we are going to talk about leadership and in one of these conversations, and we'll dig a little bit deeper into what happens then. But the system is good. And it takes the subjectivity out of things. And it really creates data and, and helps you see, you know how much of a problem it really is. And I believe that this would have been caught a lot sooner had they had a system in place.
Griffin Jones 12:38
So that escalation would help to catch it and not for it just to be another normal issue, because you could have one patient that is keeps dinging you for I didn't get a call back about my lab results yet. I didn't get a call back about you could have that. But if you started, if you really started to get pinged from multiple people about the same issue, it seems like you would pick that up a lot faster, that you wouldn't have to be worried about the boy who cried wolf with this type of solution, because you're talking about a critical mass of people and critical frequency about a critical problem.
Lisa Duran 13:18
Yes, yes, exactly. And depending on how you set it up, as well, as it's not going to just one leader, it should be going to multiple and if an administrative leader doesn't think it's important, it doesn't happen or doesn't get paid attention to. So right, it becomes subjective and one person makes the decision and whether it's initially or not, this takes all of that away, because there are multiple people looking at it. And you see you've got leaders that are really looking at the big picture. You know, if one doesn't seem as it doesn't think it's important, there are many other eyes on it that may may believe that yeah, this is something very important that we need to be addressing.
Griffin Jones 13:58
Tell me if I'm jumping ahead too far, and if I am then un-jump, me back. But how did the patient, while we're on the topic of the first episode of the patients, how did they come to find out about each other? Was it not until charges were pressed on the nurse? Was it, did they find a way to connect with each other in a support group or elsewhere? How did they find out a bit about each other?
Lisa Duran 14:21
You know, that actually in the service recovery piece, that was my fourth, you know, I have four points of my four big takeaways from this and the first one was that having a system in place so that was the first one, the fourth one was on that service recovery piece and how it was handled with the patients and with the team. And so you have they you know, they found out via letter, they got a letter in the mail, the patient's got a letter, not a phone call, but they got a letter and and that service recovery piece, you know, I believe that that we all can be better at service recovery. And so as far as the patients they found out about each other and much later when when it became public when it became when it was on the news and and people started to talk about it, they did not feel comfortable talking about it in the clinic as they continue their treatments, some continued to treatment, some didn't. And nor could they talk to their nurses or their the team about it. And that that was difficult on the team. Because the team was instructed not to talk about it and completely understand that the company has to protect and make sure that you know, nobody says something that is going to damage the company or throw someone unnecessarily under the bus. But there's a way to equip teams to be able to have healthy dialogue about it. And when you tell them just don't talk about it, then it's
Griffin Jones 15:46
One, it doesn't work. Yeah, so I want to come back to that when we talked about service recovery. And, and so in your four takeaways we have the first one was closed loop feedback system, what was the second main takeaway? And what was the third? And then we'll go into them each individually?
Lisa Duran 16:05
Yeah, that sounds great. So the first one was on the patient experience, and you know, what could we do, and it's having that system in place? Where are they they can give feedback from real time, not not the feedback just once you get the pregnant, but each touch point at or at the very important touch points. The second one was, you know, like the second episode, Donna's story, it was the nurses story, and it was the employee experience, you know, I'm in clinics all the time. And I have such a hurt for the teams. And, and I see, you know, firsthand of places where they are equipped and more than where they are unable to give great patient care. And I also see where they suffer, you know, and in this particular case, what happened was, they had two nurses that had quit, and they had a new nurse manager that they were frustrated with. And so they were spread very thin. And that is no excuse for making the decision to autonomy, I want to make sure that that's very clear. What I will tell you is that, I think at times, you know, we think about employee retention, as something very important. And it is, you know, when you look at how much it costs the organization, it's 100% of their salary, you know, to, to recruit, train, or get them up to speed. That's not just about, you know, retaining great talent, it's also about managing risk. And so when you've got a team that spreads so thin, and it's, it's ripe for abuse, and again, very good intentions, with leadership, very good intentions, everybody doing the best they can, but it made me realize that employee retention and talent retention is not a nice to have it to have to have on so many levels. It's not only taking care of the organization, it's taking care of the people that are there, the ones that stay, and a lot of you know, the the nurses that they talked to, they said, you know, we didn't, we don't feel like we could give patient good good patient care, we became a nurse, because we wanted to care for patients. And when we're spread so thin, we couldn't care for the patient the way we wanted to. And one of the nurses said, I just find that I was constantly apologizing, and it wears on you when you're constantly apologizing when your heart is to give good patient care. And I just feel like there's a lot out there. And so that's why this is not about Yale, this is really about, really about in health care, how are we taking care of our people? And how are we ensuring that that when there are openings, you know, we can't always control? And we can do everything you can to be proactive, but when there are openings, and you've got two nurses down in an organization, what are you doing for the people that are there that are picking up? You know, the extra, the extra patients and how are we caring for them? And so that that was my second takeaway on as it relates to this series, but it's the employee experience.
Griffin Jones 19:04
I want to come back to that employee experience to talk about retention and recruitment more, especially as it relates to risk management. What was the third major takeaway for you? And did that also core, seems like each of your takeaways, like you had one major takeaway, per episode topic was the third did the third topic was was that also, did that also correspond with the third episode? Did that come from the court case? Or, or was that a different takeaway?
Lisa Duran 19:28
Actually, this was the only one on the court case. That was more of an emotional takeaway for me, because, you know, if I would have just listened to episode one, I would have been like, you know, throw her in the slammer. That's terrible to say, but after hearing her story, it reminded me that every life has a story. Right? And, and what could we have done? Or what could you know, what were the signs that we could have taken better care of her again, that's no excuse. There's lots of people that have the stress that she has, that doesn't that don't make the decision she makes okay, so there's no excuse. But the court case I just found myself, like the judge, actually, you'll hear the judge talking about not quite knowing how to navigate this, because you see both sides of it. And so so there really wasn't a huge takeaway, other than just my personal emotions on it, just the roller coaster of it.
Griffin Jones 20:20
So what was your third takeaway?
Lisa Duran 20:22
the third takeaway was on leadership, you know, and it's so funny, because what I'm doing now is, it's called an integrated experience, because I don't believe that you can just create a patient experience program, and scale it across the company and expect it to be fabulous, right? You've got to have great leadership a place to catch, you know, catch those wins, and celebrate those wins. And then coach for behavior change. And then, and then there's the employee experience, you know, people don't do what organizations expect they do, it's paid attention to, and they and you know, you want their hearts, you know, In leadership, we don't just want people's compliance and health care, you absolutely compliance is critical, we have to want their hearts because if we have their hearts, then they're going to take great care of the patients. And so what I found, my third takeaway was with leadership, you know, one of the, actually, the hostess, the host of the podcast said, who was managing Donna, you know? And I see this so often in clinics, you know, there's been a nurse that's been there 15 years, and she hands the nurse manager or the senior nurse or, or she, and there's a lot of trust put in that person. And I'm not saying it's not rightfully put there. But there needs to be accountability, not just systematic accountability, you know, for the meds and, and all, but there also needs to be personnel accountability at every level. And so where was, who was managing Donna? And who was the leader that was looking at the big picture. And so often we find that the in health care that there are managers that are managing tasks, but not leading people. And so it just, you know, it made me think of this new manager that they were very frustrated with, what was her experience or his experience? You know, what, what was that person's onboarding experience like? Is somebody coming alongside them and helping them to build trust with the team so that they can have healthy dialogue? You know, what was that manager's experience like? And so without good leadership, without strong leadership with people leading and servant leadership, then again, it's right for abuse. So that was my third takeaway.
Griffin Jones 22:32
You're a very efficient thinker. I know your your points don't perfectly correspond with the episodes, but they almost do and it makes it very easy to follow. So episodes go patient, nurse, court case clinic, your major takeaways go closed loop feedback system, a retention and recruitment as a means of, of risk management, leadership and accountability, and then service and recovery. We talked about the closed loop feedback system. Before we get into your second major takeaway. I am curious about what you found to, to what tugged at your heartstrings with the nurse because I think of you as somebody that actually probably wouldn't be a good person to have on a jury. Like in a liberal democracy. I feel like Lisa Duran is the type of person that you want on a jury to give to give fair jurisprudence to people and I think of somebody like my dad who has been selected for, not called on Lisa, selected for jury three times because he's so even keeled. My dad's the type of guy that you want on a jury. And I feel like they sit around somebody that you want on a jury. But what swayed you about the nurse?
Lisa Duran 23:04
Well, there were so many things, you know, she's a mama herself. She has kids. I think what drove her to the decision, you know, when you hear her life, and you hear about her, her marriage, that was a very unhealthy relationship. And you know, there were some some verbal abuse, emotional abuse, and how it was a very unhealthy situation. And you know, that it's my very favorite video is that Chick fil A video that's every life has a story. And it just really reminded me that, you know, what drives somebody to do something like that. Is this a bad person? No, I don't believe this is a bad person. I believe that this was a very, very hurt person who needed some intervention who needed some help. And so, you know, my heart went out to her, but then you get back to listen to episode, one and you hear these patients? And you're like, oh, it just I don't think I would be a good pitcher because I think I'd have a hard time making that decision.
Griffin Jones 23:45
You lean too much towards mercy and not not enough towards justice in that scenario.
Lisa Duran 24:15
You said that very well.
Griffin Jones 24:25
Well, then talk to me about how retention and recruitment are a means of risk management, and you alluded to it as you were covering the you're giving the synopsis of the point, but I want to hear more about how it's not just for to have butts in the seats. It's not just for productivity. It's not just for the the cost impact of having to retain and recruit somebody new and train them and that being 100% of their salary. But there also is risk when seats aren't filled. Tell us about that.
Lisa Duran 25:31
Yes, well, you know, my entire career, I've been doing patient experience, patient experience as a differentiator patient experience as it's the right thing to do, right and patient experience, as you know, it's it's a good thing for the team member, as well as the patient and their and championing for the patient experience, as as a good thing as a differentiator. And this made me realize it is all of that. And it is also risk management. Because it really highlighted the fact that when teams are spread very thin, what could happen in that, and this happens to be, unfortunately, a scenario that that's exactly what happened, a very skeleton crew, and now a new leader. And, and a decision was made without accountability and, and people that are spread too thin to pay attention to some of the cues that would have alerted them to something's not quite right. And they did in, in the podcast, I think it was, yeah, I think it was episode two, they and episode four, they did some of the team members did talk about some things that just didn't seem quite right, there were a few things that were off, but they're so busy, right, they were just going from one patient to another that they really didn't have time to process that or communicate that, you know, to each other or up to a leader who had the big picture in mind to, you know, to get that off of the pass or to, you know, address it or at least ask the right questions. And so when you have when people are spread, then it really becomes a risk management, not just a good thing to have for patient experience. It's also and it's also retaining the good people that you have, because, you know, as a few of the nurses said, Well, if we don't feel like we could give good patient care, you know, we come somewhere where we are equipped to give good patient care. And if there is an urgency in filling the positions with the right people, and please know my heart and that I think HR, HR leaders have the hardest job ever, just trying to find the right people. And they're working really hard to do that. And so hats off to the to the HR community right now. And this is really hard with a with a with a short list of people or with a shortness of of talent, of good talent there. So I know it's hard, and it's hard. But it really highlighted that this was, you know about patient experience, it was really about risk management as well.
Griffin Jones 28:03
Do you have any solutions for service because on the feedback from patients point you, you get a closed loop system, whether it's a self checks, whether it's a Medallia, whether it's another software, and you walked us through a little bit about how that can work, other than just posting more trying to raise salaries, trying to to maybe give people more benefits, or whatever it might be, do have more suggested solutions for how these managers might retain staff and recruit them for longer so that they don't make themselves liable to risk with a shortage like this?
Lisa Duran 28:41
Well, there are two things in your question. One was in how do you retain staff? And the other one was, you know, what can we do in the recruitment process? Or is there anything you know, that you can do? So I'm going to first address the retaining piece, and you know, how you retain people, if you care about them? Right. And so often we think the employee experiences, you know, is a pity party, or, you know, and those are good things, please, I'm not minimizing that, but you know, professional development pouring into them personally and professionally. And there's a way to do that, really caring about them, you know, building trust with with their direct, that's what the leadership piece is so important. And I've been probably doing 90% Leadership Development nowadays, because, you know, health care leaders are so often promoted into these positions, because they were good nurses and they weren't good, you know, in patient services, or they were good in financial concepts and they are not given the tools to really to lead people, they can manage the tasks but not lead the people. And so, you know, the, in my personal opinion, I would say that the biggest retention strategy is leadership development and how to lead people and how to care for them and how to be servant leaders. And that is going to make people want to stay you know, not go across the street for another dollar an hour, when you really win, and you know, we've all worked for people that really care about us, and we will, we will stay, despite her times, we will stay, you know, you know, just despite all the hardships because we know that we're cared for. So that's on the retention piece now on the, when it does happen, and you can't always control that, right when it does happen, and you've kept openings, this is going to sound a little cheesy, but you know, me, I'm cheesy, but giving oxygen to hope. And I know what I mean by that, is that so often the clinics feel that it is a secondary priority, to fill their open positions. And I know and I know, for a fact, with a few organizations, that is not the case, it is their number one priority. They you know, people don't often see the back end of all the people they're screening, you know, they're trying to find the right candidate, not just any candidate, but where the breakdown is, is in the communication. And it's, it's HR, being able to communicate or communicating the right message and giving oxygen to hope. And speaking to the fear of the clinic of the people in the clinic, and I know you're spread thin, and I know you're working hard, and it doesn't have to be HR is lucrative, I know you're working hard. And know that this is our first priority, and I am I'm screening 60 people this week, and I want to find you the right candidate. And those messages aren't always happening. And you know, when when people feel that, that their sense of urgency is your, your sense of urgency is their sense of urgency. It's amazing how much that could just kind of that how much better they can feel about, okay, I know, and give them confidence in the organization, they're working hard, because they know they're doing the best they can. And they know that it's a priority. They know that there's a sense of urgency there. So you know, speaking to the fear, giving oxygen to help, and communicating that this is absolutely there.
Griffin Jones 32:03
Let's use that as a segue into leadership then and talking about how to engage their hearts to lead them to instill that accountability, because that is partly also a retention tool. I gotta tell you this, I've probably you said, we've all worked for that type of people that really has engaged their their people like that. I've both been that person and both not been that person. And I've not been that person at times where you're crazy busy. And clients have a lot of needs, and your recruitment or retention pipeline is slow. And and then managers can end up taking on a lot of have that responsibility. And then they can become resentful at one time or another. And you know that that servant leadership can be difficult at a time, it is really difficult in a time where you're like, I am working my tail off, and I can't hardly sleep. I'm working from seven to 7am to 10pm at night. And I am totally focused on this. And I'm trying to keep my team from feeling that burnout. But yeah, eventually it's like, yeah, get the damn thing done like and and then you turn into a manager that you might not have been previously. And, and so I'm wondering if you can talk to that a little bit about from the leadership coaching of how you can be that leader at a time when everything is under water, where so many fertility clinics are right now?
Lisa Duran 33:41
Yes, yes. And I have to tell you, the organizations that I've been working with are amazing, and the hearts for their people are there. And you know, we can't always control our circumstances, we can't always control what happens in terms of people leaving, you know, or things that happen processes, protocols that need to be changed. But one thing I was put when I'm working with leaders who say my response is my responsibility. You know, I can't control what's coming at me all the time. My response is my responsibility. And I know for me, when you said you've been that lead, you've you've you've been that leader, and you haven't been that leader, I say very much the same. And I have an executive coach who has just been amazing and she talks me into the ledge all the time, and like help me get me out of my emotion, you know, help me to help me to formulate a response that's caring and and that validates the feelings of the teams as well as holding them accountable. And one of the things that I'm finding in clinics is that leaders are so afraid of losing someone that and I spoke to this on the last podcast, I believe, are so afraid of losing someone that they're not coaching for behavior change. They're not redirecting that, that toxic or that negative behavior, especially the leader, right and, and so equipping them for two things, equipping leaders to be intentional to celebrate those wins to be on the floor to, to put the task stay on, and it to be on the floor with their people and intentionally catching them doing something right. As well as addressing those, you know, those negative behaviors or those toxic behaviors, the gossiping, the negativity, the complaining, you know, it was complaining is like vomit, you feel better afterwards, but everyone else around you feel sick. And so. So as leaders really working with them, I'm getting very comfortable at that skill, and teaching people how to have a voice, but how to do it productively, and how to do it in a way that inspires change. Rather than just feed and plant seeds of negativity. You know, those are the things I think that that are bringing the most change in, in my experience, what I'm doing. And certainly just understanding my response is my responsibility. And as a leader, we have a responsibility that the words that come out of our mouth are optimistic, they don't have to be positive and lying, we can say, you know, we can say things are tough, you know, the definition of optimism is not the denial of the current state, the definition of optimism is saying, you know, this really sucks, or this is really hard right now, but it's gonna get better. And this is going to help, you know, streamline things for us so we can give better, you know, patient care. And so that that attitude of optimism and holding people accountable, catching them doing something great. And then realizing and teaching and just cultivating the call for the culture of my response is my responsibility. Those are the things that I that I'm seeing are really helping.
Lisa Duran 36:47
That axiom that you talk about of complaining, it's like vomiting, you feel better afterwards, but everyone around you feel sick, I really tried to take that into other areas of my life to lease and I think I hear your voice saying it to me, in my own head, like I want to, I want to complain to my wife, when she gets home about how the tech didn't show up, you know, to fix our Wi Fi or whatever, and try to like, who's that going to make feel better? Me for 10 seconds, and then you know, I'm just going to dump all over her day. So I try to I try to carry that into to other areas. You've mentioned, you've mentioned several times during this interview with this isn't about Yale, but let's take a similar situation where we have a clinic that is down at least a couple nurses, and and you've got managers running around probably doing a whole bunch of things out of the normal scope of their seat, how would you coach them from a leadership perspective to where they can still hold people accountable,
Lisa Duran 37:54
I'm not gonna claim that that's an easy thing to navigate, it is very challenging, especially because, you know, the rollout of new software, or the or the changes that doesn't stop regardless of how many openings you have. And so that could definitely present lots of challenges for a leader. But by showing them and coming alongside them, and really, really coming alongside them, arm in arm, and saying, you know, you can do this. And you can do this by identifying those that can do it with you, you know, who's going to come alongside you in the clinic and champion for that optimistic attitude. And, and prioritizing things in again, going back to caring for people. What happens so often in these situations is they're managing the tasks, and they're trying to fill their positions. And I was in a clinic once when the practice administrator had to be in an office screening, you know, resumes for, you know, six hours, and I thought that's, you know, and it was so hard for her because she wanted to be on the floor with her people. And so, you know, really just carving out time and putting those, you know, putting the tasks down where you can and investing in people and making sure that you're talking to people on the service recovery part. One of the things that hit in that episode for was that the patient is well as the teams were saying, we didn't get any genuinely caring communication. Nobody addressed our feelings about this. It was always the legality, the legal language, and anytime in service recovering I think that your question of how you know when there's a situation in clinic where you're short staffed and in and all those things, it's a little bit like surface recovery, where you have to speak to the fear. And you know, fear is a liar. Fear is a liar, but we listen to it. And so when patients are fearful because they're continuing their treatment in a situation like this, and they're walking into a clinic and they can't talk to their nurse about it because our nurse has been, you know, told you cannot say anything, you know, how can that nurse help alleviate those fears? You know, we need to equip people to speak to the fears. And equipping them means teaching them, you know, the verbiage. You know, what kind of verbiage you would say what would you say to a patient? And it's similar for a leader with a team? What do you say to your team? When you know they're working their tail off? Do you just tell them? Like do with it? I'm working on it? Or do you say, Look, I know this is hard, and I appreciate your hard work and just know that this is my number one priority. And I'm working hard to fill this and you know, is there something that we can do together? Yeah, what ideas do you have, you know, really partnering with your teams in the solution. And so often, leaders feel like they have to fix everything, when when you know, the teams sometimes have the best solutions. And so really partnering and not feeling like you have to fix everything. But caring for people is, would be my best advice.
Griffin Jones 40:59
I want to give something to the listeners that you made me think of when you talked about that practice admin that was going through 60 resumes, or however many you said, two hundred resumes, or whatever you said it was. And there's plenty of people listening that have to do that. And it's dozens or hundreds of resumes. And one thing that leaders can do that I did that completely changed my business was hire someone else to do that to go through the resume. So by the time my hiring manager gets a resume, it's a short stack. And the recruiting specialist, the HR person is going through those interviews, before going through those resumes, doing the screening interviews, like the 20 minute screening interviews, that are only a few questions, and then bring those to the hiring manager so that you are going through this process faster one, and two, you're not asking the hiring manager to do all of that. That was a life changer for me. And a lot of people are listening and think, well, I can't hire that person, because they were a small practice, you can hire that person as an independent contractor, you can hire that person part time. And for all the economic reasons that Lisa talked about, as well as the risk mitigation liability that she's talking about, it is a much cheaper solution. And I strongly recommend people do that I get more into that topic with Dr. Eric Widra, that episode will come out after this one does, but I am telling everybody listening, it totally changed my business. I was in a position where you when you're trying to do all the things that Lisa is talking about and and you do that for a while, and then you do it for a little while longer. And you're and you're still at this problem where, you know, maybe when you are trying to involve your team for solutions, you're involving them in areas where they shouldn't be involved, because they're supposed to be accountable for other things, I was doing all of that. And, and now having the system has made things better, I was key, I was not rewarding people quickly enough, I was not dancing, growing some people. And then because of that, I was also letting other people that should have been fired in two seconds, stay on and, and and, and not contribute to the solution. So that's a huge, huge thing that I think leaders can do. Get a couple of recruiters have some redundancy in HR, it's okay to have some redundancy in HR, you can do it at a part time, hourly independent contractor level, if you have to as long as it's scoped properly. And that can can really to help with some of those odd things. So you've talked about some that leadership coaching of how they can approach their teams about being prepared for the responses being prepared for the conversations, then how does that lead into service recovery? In, in your view? What what happened in this situation? And what should it look like?
Lisa Duran 43:58
Yes, service recovery is more than just when a patient is upset. I mean, that is that is worse teaching me how we talk about service recovery. Very, very important. But the concept, I've got three steps that I teach. And the concept is very relevant internally for leaders with their teams, as well as externally, with teams with our patients. And the step that we always forget to do is validate the feelings. And when I talk about, you know, speaking to the fear, when you're talking to a patient who was fearful that you know, what if this doesn't work, or what if i What if, what if I didn't pick the right doctor, or what if my body's just not going to respond? You know, when you can speak to that fear. When you can say, gosh, I could understand why you're feeling anxious. Even, there were so many emotions to this. Like, you know, I would feel that way too. And just now we're here for you. Right that venue foof then you kind of did, I wouldn't say diffuse But you communicate to the patient, or the person that I'm on your side, I'm on your team. It is not, I'm just trying to fix something for you. It's, I'm on your team, and I get it. And it's very normal for you to feel the way you're feeling. And it's the same. So in this situation, patients didn't get that. Right. So they relied on each other. And, you know, so there they were all in one camp. And then same with the organization that the teams did not. I'm not claiming that they didn't, it didn't sound like they did. Because they were told don't talk about it amongst yourselves, don't you know, share. And and firstly, they said, How can we not? You know, right, we're very affected by this too. We were very, we were betrayed by Donna as well. And so how can we not talk about this. And so speaking to their fear, and just saying, just, you know, if the organization were to fear, the leader, were to say, Listen, I know that you're fearful of the press of what's going to come out, and that people are going to think that you're working for an organization that's not desperate, that doesn't have their act together, or doesn't care about patients. Let me tell you, that is so far from the truth. And this is what we're doing to prevent that from going moving forward or from ever happening again, right, you're speaking to that fear, that's really important. You're validating those feelings, so that when you go to the fix that place, they're ready to receive that, fix it. And so and so the first step is validating those feelings. The second step is getting more information, tell me more about that. Invite the patient, invite the team member to talk to you about how they're feeling or about the situation or giving you facts, so that you can, you know, fix it in the proper way. And then the last one is to take ownership, right, and it may not be my fault, but it's my problem. And, and taking ownership of the follow through and not just, you know, sending it off to another department that you cross your fingers that someone's going to call you. So you personally following through. So it's a very simple three step recovery process. That really, and I think I realized that during this podcast, in that episode number four, that the service recovery that I've been teaching all these years for patient experience is very relevant here and the team member experiences as well.
Griffin Jones 47:17
so you validate the feelings, you get more information, and then you take ownership of that follow through, is this something that people can do even if there's a legal liability, because if I've done something wrong, I want to admit it, I want to share what I've, what we what we're doing to change it. I've also never been in a situation, this public profile, this high level of stakes, and it's all the lawyers that are involved. And I could only if my lawyers are telling me shut up and just keep your mouth shut, then I would feel it that would be really conflicting for me because it's like we did something wrong, I want to take ownership of it. But I also don't want to maybe accidentally take ownership of some legal liability that we really aren't responsible for. How it can they use this in this? Like, maybe that's what you were saying about not? It's not my fault, but it's my responsibility. They still, here's what we're doing to change it. Do you have any thoughts on what that would look like in a really litigious environment like this?
Lisa Duran 48:22
You know, Griffin, I will tell you, I feel very equipped, ill equipped to answer that question because I don't have any legal background. And I understand the risk of somebody saying the wrong thing. And I appreciate them trying to control that I really do. And so, so I think my service recovery in this situation was really more about leadership. And, you know, following the guidance from their legal counsel, absolutely. Follow that. And you know, that, does that mean that you also can't, you know, get your team together and have a very honest conversation about, you know, I understand how you're or tell me how you're feeling, you know, you just just tell us how you're feeling. Tell me how you're feeling, right? And, and to have some of those conversations, of course, within the boundaries I mean, you know, managing the risk there. And so, you know, that would be something that I would hope, though, that a leader of an organization, or a high level leader, would have that conversation with our legal counsel, and how do we take care of our people? What can we say, what can we do? What can we do with patients? Or can we say to patients, and it felt like and I'm just gonna say it felt like because I don't have any proof on this patient is perceived that that the organization was just trying to to care about the organization. And so I think that the question to your legal counsel, is, how can we maintain the boundaries and what we need to be doing legally as well as take care as well as care for our patients and our teams during this time
Griffin Jones 50:01
People can check out this mini series. It's called The Retrievals, The New York Times Serial podcast, by the time this episode comes out, all five of the episodes of that mini series will come out, it's called The Retrievals. First episode about the patient, second about the nurse, third about the court case, fourth about the clinic. Fifth, to be determined, but you've walked us through how we can prevent these incidents in the future by first having a closed loop feedback system. Second, by having by equipping the team to for retention and recruitment of personnel and viewing, recruitment, retention and recruitment as not just economic nice to have, but it truly is a risk mitigation factor. I talked about enabling leadership to engage the hearts of their team and to employ accountability. And then you also talked about three points for service recovery when something like this happens, and you need to make it right. What did I ask you? And, and or how would you, how do you think we should conclude this topic?
Lisa Duran 51:16
Thank you for asking that. Actually, you asked everything. And so thank you very much for that very engaging conversation. And thank you for putting in your your experience with HR and what you did. I think that's really helpful. I think that I, you know, when I first listened to this podcast, I wanted to hide it from everyone, because I thought, I didn't want any future patients hearing this, because they're going to be so afraid of fertility treatment. And so, so I strongly recommend everybody listen to this podcast, and I recommend that you listen to it with a heart of not looking at how the system failed, necessarily, but looking at what we can learn from this. And I'm realizing that although one person made a really bad decision, there are hundreds of thousands of people, there are hundreds and thousands of amazing nurses, amazing doctors, amazing leaders, amazing patient care specialists out there that are taking great care of patients every single day, and helping them achieve their dream of a baby or family. And so, so you just to go into it with that thought and that idea and putting things into perspective. And that, you know, this was one person's decision out of so many people that make great decisions every day, to really care for people, and just really going into it and what you can personally and learn from it. I highly recommend this podcast.
Griffin Jones 52:44
We'll include your contact info in the show notes and pages, but for those clinics that could use some leadership help they could use some team help with with some of the things that you've talked about today. How can they get a hold of you?
Lisa Duran 52:58
Yeah, they can call or email me, they can go onto my website, which is lisaduranconsulting.com. I have all my contact information there. But yeah, I would love to come alongside you. And it's that integrated experience. It's not just one. It's all of it. It's leadership, development and patient experience and internal culture. That's the secret sauce. Thank you, Griffin. Thanks for having me.
Griffin Jones 53:20
Lisa the pleasure's always mine. Thank you very much for coming back on the inside reproductive health podcast. Thank you.
Sponsor 53:27
You've been listening to the Inside Reproductive Health podcast with Griffin Jones. If you are ready to take action to make sure that your practice thrives beyond the revolutionary changes that are happening in our field and in society. Visit fertilitybridge.com to begin the first piece of the fertility marketing system, the goal and competitive diagnostic. Thank you for listening to Inside Reproductive Health.