Latest / Here to Serve - A United Regional Podcast / Toya Gorley, Improvement Advisor at National Research Corporation (NRC) Health
Transcript
- United Regional: Welcome to Here to Serve, a UNITA Regional podcast. I'm your host, Ryan Graves. My favorite part of being the director of patient experience at UNITA Regional is the incredible people that I meet and work with on a daily basis. And I want you to meet them too. Join us to meet the people behind the badge and to highlight those who are here to serve. Toya, welcome to the Here to Serve podcast. It is an absolute honor to have you today. I've been looking forward to this one. thank you, Ryan. I've been looking forward to it also, and it's the honor is all mine. Awesome. Well, you are genuinely one of my favorite people in this healthcare and patient experience space. And I've known you for I don't know how many years now. It's been at least I would say four-ish years. Yeah. And just immediately felt a connection to your authenticity and to your your wiz I've gleaned a lot of wisdom from you. and so I was excited to get you on here for many reasons, some of them just very selfish because I want to get some more wisdom out of you today. I'm gonna I'm gonna get some more. But before we get into any of that, please tell us who you are and and what you do. Absolutely. So my name is Toya Gorley. I'm a strategic advisor with NRC Health. NRC Health is our is your partner at United Regional Healthcare. We work with you all to help you understand what matters most to the patients that you serve. And in my role, I support partners like you with strategies to improve the experience for patients and employees and healthcare consumers. Tell me, I I know a little bit about your background. I I d at least the one thing I do remember, and it's been a minute, is that your part of your career was at the Cleveland Clinic. Yeah, that's right. Tell me about your path into healthcare. Did you sure did you always know you wanted to be in healthcare? I I did. so the the story that I often share, Ryan, is you know, I'm from Cleveland, Ohio. I was raised by my grandparents, and my grandparents were very ill for a lot of my upbringing. And so we spent a ton of time in doctors' offices and in hospitals. And as a child, a teenager mostly, I was able to see how interacting with the healthcare system not only impacted the patient, but the entire family. And I'll share a specific story. I remember this like it was yesterday. So my grandmother was a patient at Cleveland Clinic, and she was there. She was going to receive heart surgery. And let me tell you a little bit about my grandmother. She was the matriarch of our family. She was a wonderful cook. Every morning she would make biscuits from scratch for my grandpa. I know, right? I can smell that. Yeah, that's amazing. She was a church-going woman. She was a deaconess in our church, which meant she was one of the female leaders in the church. And her appearance was very important to her. So she was always very. You know, polished, buttoned up, a hat on. And the one thing about her that was super important was her hair. And I don't know if you've ever heard the phrase, a woman's hair is their crown and glory. yes. Right? And so that's important to my story. So she was in the hospital at Cleveland Clinic, and I would take the bus from high school to the clinic after school to visit her. And one day I visited her. And she was sitting in the chair next to the bed, and someone had styled her hair. And I'm assuming this person thought that this was a really kind and empathic thing to do. What they did, Ryan, was they parted her hair down the middle and made two big ponytails and put two big pink bowls in her hair. And my grandmother was sitting. Head down, slumped over, shoulders lowered, and I could tell by entering the room that she was humiliated. And again, I don't believe that whoever did that meant any harm. But they didn't know her. And if they knew her, if they knew what a leader she was in our family and in our church, in our community, and if they knew how important her crown. And glory was to her, they would have never put those childish bows in her hair. And so I immediately took them down and styled her hair the way that she preferred. And as I was doing that, I could see her posture shift and see her come back to her full self. And You know, this sounds maybe a little dramatic, but in that moment I knew that I had to make a difference in healthcare. And so that was the starting point of my dream of doing something to make a difference in healthcare. So I am not an older w what how old were you at this point? I think I was probably fourteen or fifteen. So very young. Fourteen or fifteen years old. And so that again, that sort of kicked off my journey to make a difference in healthcare. Now, back then there wasn't a such thing as patient experience, right? Like that's very new. Relatively new. Very new. And so I started my career in healthcare as a marketer. So doing very traditional healthcare marketing, I wrote business plans that were designed to increase awareness of healthcare service lines. And essentially to drive business to healthcare service lines. So I often say that that was my job, but my motive was to make sure that the healthcare experience was welcoming and safe and respectful. So even though patient experience wasn't a thing yet, I was always drawn to that part of the work. We didn't have the title. We didn't have the title yet. But the the departments didn't exist, but it was the spirit of it was was always there. Yes. Absolutely. What a powerful story, Toya. and that that the story doesn't necessarily surprise me, but it makes me understand you a little bit better of where your passion for this comes from and authenticity. It's very personal. Yeah. Yeah. That's I I talk about that often on on this podcast with many of the guests that come on or you know work at United Regional. And that's a theme that comes up all the time is this is personal for us. It's especially if I'm here at United Regional, because this is where this is where my mom, my daughter, my my family, this is where they come. You know and so it's very personal. it's incredible. I you know, I want to get into this a little bit later, but it just already makes me think one of the things that I have I've been on a journey about understanding compassion and empathy and what those things actually mean everybody loves those words, right? But what do they actually mean in in practicality and in the real world? And one of the things that I have been just thinking about and talking about and and just chewing on lately is I think everyone, if you ask them if they're compassionate, they go, of course, especially in healthcare. Of course I am. Right. But compassion looks so different, the giver versus the receiver of it. It's not always the same thing. And so I, you know, being able to show compassion in a way That can be received by the person across from you is a really interesting thing. Yeah. And I that's where my brain goes when you're talking about that this person thought they were being they were trying to do something nice. That's you know. But this was not something that could be received by and and so compassion is not what I think it is. Yeah, that's right. It's what they think it is. And so and how could I possibly know that if I don't know them? Exactly. You know, I it so I I want to come back to that a little bit more, but I don't want to forget because that's just too powerful. So before we get into anything too healthcare heavy, tell me what do you do outside of healthcare? Right? What's Toya doing on a on an off day? On an off day. So again, I I live in Cleveland, Ohio. I live with my husband. we've we'll be married for twenty-five years in June. Congrats. And thank you. And we have a sixteen-year-old daughter. So a lot of my free time is spent with family. my daughter is getting ready to go to college, so we're doing all the visits and those things and and I'm really enjoying that. I love outdoors, so when the weather's nice in Cleveland, you can find me walking through my neighborhood or riding my bike. I just got a new electric bike. I'm so excited about that. Yes. I'm an avid reader, so you know, a perfect day for me is being curled up on the couch with a book. I love music. So I'm a kid of the eighties and so I love hip hop music and R and B music and gospel music and so you know I can break out in a song or a dance at like with no reason. So that those are some of the things that I love. I love it. We should have had some BB C C wine inside. that would be great. If I'd known I've got I've I grew up in that world. So incredible. okay. I wanna ask you. You said something to me probably two years ago. I always love how life is funny. You can have somebody can say one little thing that can have a profound impact, right? It doesn't have to be a long conversation. And you and I were having a conversation, I believe, if I'm not mistaken, we were having a conversation about I was working on improving care and experience for our non English speaking patients. And I was putting a group together to help me with that. bringing our our non English speaking patients, giving them a seat at the table and going, hey, help us, help, you know, I know this is this we got problems, help us, right? And I asked you if you had any input or I think I might even have asked you have the answers, any other organizations that are doing this, well, that kind of thing. And you said to me, Ryan, I think one of the best things you can do is just be curious. Yeah. And man, that just when you as soon as you said it, I went, You know, that is that is so simple and so true. I took that to heart and for that particular endeavor and we we made great progress there and are still still making great progress. But I just said, man, I gotta apply that to everything I do. To the point where now, not only do I incorporate it into like new leader training, when I anytime I'm training new leaders or when I'm doing new nurse training, I actually have a slide that's just Curious George. Uh-and I put it up and I say being One of my phrases has become being curious is a superpower. I love that. It is a superpower to connection. Yep. Tal talk to me more about where that came for you to give me that advice, be curious. You've clearly had some insight yourself. Talk to me about curiosity. Wow. So I do remember us having that conversation. but I don't remember sort of the basis for why I would recommend that. I will tell you though, that you know, curiosity. I believe it is the basis for a few of the things that we've talked about already. It's the basis for empathy. So if you don't know how a person is feeling or what they are going through, or you know what they're bringing into this space, if you don't know, then can you really be empathic? Meaning, can you Communicate your understanding of that person? Can you take action to alleviate their suffering or pain, which I believe is what compassion is? Can you really do that in an authentic way if you're if you don't know? Right. And in order to know, we have to be curious. You know, one of my favorite phrases is tell me more about that. Right. And then to sit and be present and really hear and take it in, I think is so incredible. in my line of work, I get asked the question that you ask me probably daily. And sometimes I joke, like if I had a dollar for every time someone asked me, What's a best practice for? Or tell me what other organizations are doing. And I'm happy to do that. And I believe that the power of this work is in our curiosity because what works at Hospital B may not work at your hospital. What works in this community may not work in your community. And so being curious and seeking to understand and apply those understandings to what you do every day, I think is the only way to approach this work. Yeah. I couldn't agree more. It's such a life changing thing to When when you look at another human humans are fascinating. Fascinating, right? And you d and no two are alike. That's right. You so there are very few people that that don't like to talk about themselves. Right. Like people will tell you if you ask. I agree. If you are open, people will tell you. I agree. If you're if you're a genuine like cause it and I find it's there are pockets of people that do this, but by and large, because of just the the nature of our society. social media, phones, you know, you're we're seeing people be more and more disconnected, more connected through other ways, but disconnected sitting across and talking to people. So I find it's becoming when I say superpower, I mean I genuinely mean that. When you sit across from someone and go, man, tell me about that. Why do you do this? Tell me about why do why do you think this way and what's going on? And they they're they're like, did another human just take interest in that? That's right. You know? And then they start sharing. And then when they start sharing, you start understanding them and and one of my favorite phrases, There's a lot of hate in the world and unfortunately there's a lot of love. There's also a lot of hate out there. And one of my favorite phrases, one of an a a physician told me this long ago, he said it's hard to hate up close. Yes. And so when when you sit across from somebody and ask them questions and are curious about them, my goodness, it just opens up a relationship between those two people and understanding. And if I and if I have the desire to show you compassion, I now know how to do it or at least have a better idea of how to show you compassion. On the other side of of curiosity. That's right. But it's personal. You know, again, going back to that, you know, compassion is personal. So this ties into another topic that I wanted to kind of visit with you about. And I I think they're almost kind of one in the same, but y you have an authenticity about you, right? And again there's another I'm I'm kind of overusing the word superpower, but I feel like in in twenty twenty six, authenticity is kind of a superpower too, because it's and I hate to generalize, but I feel like It is becoming more and more rare with AI. and I'm not against AI. I'm a I know you know, we can joke about AI, I always joke because it might kill us all, but you know, in the meantime, we're I'm gonna use it. it's just everywhere, you know. And but with AI and social media and and influencers and all the different things, I feel like authenticity is what people genuinely crave. People have always wanted authenticity, but I almost feel like there's a more of a premium on it at this point. and when I first met you, I remember thinking like immediately, and that sometimes you just know or you feel, and then you can you kind of test the waters over time. But there's an also there's always that immediate, like, you know, I was like, Man, this this, this, this toy lady, she's authentic. She's real. I can tell you'd set in the seat that I had sat in, first of all. You knew what you were talking about. But there was also a humanness to you. Where do you think that where do you think that comes from? Where do you think if somebody goes, I am I authentic? Do I want to be authentic? Where where does that come from? What do you think? Wow, wow, that's a great question. you know, I I would have to say it comes from my upbringing. you know, I I lived grew up in a very real home situation. you know, there was no room for heirs, my grandma would say that, you know, no heirs, right? Like we're just real humble, spiritual, hard working people. Yeah. And so I don't know any other way to be. I love that. Yeah. Yeah. Well, I can tell I've I've not met your family, but I know a lot about them because I've met you. and so there's you can learn a lot right there. I'm a I'm a big fan. It's one of the reasons I wanted to do the podcast is I feel like a podcast, not always, but they can, you know, help bring an authenticity 'cause there's no script. It's just two people talking, you know, and and so there's an authenticity there that I think the people people tend to Tend to create. I want to make sure we have time to talk about compassion. We've mentioned compassion quite a few times already today. I am a huge fan. When I when I first moved into nursing, I came from a from a ministry background. I don't know, do you know that about me? Have we talked about that? I can't know if we're talking about that. That was another thing that we connected on. Yeah, I came from a minute, minute, and I still am. I'm still a associate pastor at my church in Iowa Park, but I was raised in a pastor's home and And so human human connection, a soul connection with other people was always very important to me, not just looking at the medical care, but but but the soul of a human, right? And when I moved into nursing, I was very excited to be a new nurse, but I s I felt like I I saw very quickly, man, there's a gap here from the clinical care to the actual human connection. I felt like there was there was definitely a gap in healthcare. And I don't And there are people out there, let me be very clear, there are nurses and doctors and people all over healthcare out that are amazing at this, far better than I could ever be, right? But I also saw there was a big gap and I got very interested in that gap of I never rarely have I met folks that work in healthcare that don't care about patients. Yeah. Almost never, right? And if I do meet them, they don't work for us anymore. They're gone. they care, you know, but the patients. many times can't see that they care, right? There's a gap there of how much the the provider or the nurse or whoever it may be cares versus what the patient actually sees and feels. and I that drew me and I was interested and and partly drew me into the patient advocacy work that I that I did after I moved from the bedside. I was in a patient advocate office and thousands of reps of visiting with people and talking and trying to be curious and understand. You know, I started to see that, man, there's there's this very real gap here. And one of the first places I saw that helped it make sense to me was Compassionomics, the book Compassionomics. I read that book and I went, my goodness, there this is the data, the science of what I'm seeing and feeling. That's right. and it just clicked for me. I'm like, my goodness, this makes so much sense. By the way, I'm super excited. Dr. Treziak, one of the co-authors, is gonna be a guest in a couple I'm limited month or so. I'm so excited about that. That is so exciting. That's dream for me. Because I'm a total fan of the book. But what do you think? You fan of compassionomics, like it, challenges? What do you think? I am a fan. I I yes. I will say that I have not read the entire book, but the I understand the concept and I'm on board. Okay. What so what they say in the their definition in the book. And I don't know if this is their definition. I've seen this definition in other places. So I don't know who originated it. But their their definition is empathy is a feeling. Yeah. So empathy is I I can see this other person what they're going through and I can I can tr try to at least resonate with something in myself that knows that feeling. Right. Mm-hmm. and that so empathy feeling and then compassion is taking action on that feeling. That's how they def so empathy plus action is compassion. and I love that definition. It separated it out for me that compassion is not a feeling. Compassion is an action. Empathy is the precursor. Is that all track with you? Do you agree with that? I yes, for sure. I often think of compassion as a verb. Right? It's like you said, it's action. I often describe compassion as empathy in action. Empathy in action, I like that too. So yes, I am definitely on board with that definition. I think what I love about that so much is if 'cause I think so many people hear the word compassion and they think of a feeling. Yeah. It's a nice compassion is a nice feel. It's it's me, it's I had a provider not too long ago actually tell me, just tell me whose hand to hold and I'll do it. Yeah. I was like that's that's not that's not the point of this conversation. I mean you may need to hold someone's hand at some point, but that's not what I'm recommending. But I think that's kind of sometimes what people see like rainbows and unicorns and butterflies and this is compassion and The idea that compassion is a skill set, which means it can be learned and it can be trained. Yep. And I've become so passionate about helping all people. it's it's it's a it's a universal skill that everyone needs, you know, but healthcare, the stakes are so high. Is how to I I my and again, my theory is I think most people, other than sociopaths, feel empathy, right? Most people see somebody suffering and go, man, that stinks for them. Yeah. Right. but then They don't know what to do about that. That's right. Right. and so they do nothing. And so then they just got that feeling. Yeah. And there was no action with it. The patient didn't receive it. They didn't get the there's pleasure in actually doing something for them as well. do you have any advice? Have you seen anything that helps teach, coach, you know, anything that you would add to that? I promised to answer your question and I wanna tell you a personal story about when I felt Compassion. Please. And I love what you said that compassion isn't always like rainbows and butterflies, and because that's typically what we think. And I and I I do believe that those what I think of as those, you know, grand gestures, they are important and meaningful. And I also believe that compassion doesn't have to look that way. Yeah. So here's my story. A family member who was in the hospital recently, and this person was very, very ill. And I would come to visit this person, and I would see, you know, the doctors and the nurses come in and out of room and, you know, take the vitals and administer the medicine. And there was a lot of experimental treatments, and so lots of big equipment. And my assumption as a second party to this was like they knew what they were doing, right? I trusted that the clinical skill and expertise was there. And yet my family member didn't seem to get any better. And and I believe, now I've been thinking about this. I no one ever said that she would, but just the way that people were acting, like if we do this thing, this will fix that. And if we do this test, then that will get rid of that. And so maybe not long knowingly, the medical team was giving hope that things would get better. But I didn't see it knowing this person very well. And honestly, in my heart, I didn't feel it. And so one day I was there and same things. Lots of people, lots of medicine, lots of tests coming in and out of the room. For procedures. And I happened to have time alone with the nurse. And I said to the nurse, Can you please tell me what's going on? And the nurse looked at me straight on and said to me, Your family member is dying. And I will tell you, Ryan, that that was the most compassionate thing that she could have said to me. Because In that moment, I could reframe. Yeah. I could change my prayers from prayers of healing to prayers of peace and forgiveness. And I could show up differently, right? Because I was thinking, when we get home, yeah, I'll do blah blah blah. And I showed up with the mindset of right now. I will do blah blah blah. And so again, there was no flowers, no butterflies, no balloons. Some people might even say that was too direct and straightforward. But in the spirit of compassion being personal, it was what I needed: the act of honesty, the act of authenticity. Yeah. Again, that was what I needed in that moment. So your question is, how can you teach that or can you? Or I I think I would go back to being curious. So curious doesn't always mean conversational, but it's like maybe it's about being observant. So looking around, seeing who's there with that patient. Not being nosy, but like listening to the conversations that are being had. pay attention to the interactions of the people in the room, their body language and their tone, and if there's laughter or sadness, if there's bickering between family members. Cause I will tell you that my family members would not have been open to that statement. I mean, that would have been awful for them to hear. Right. So that would not have been compassion for them. So I will add again to compassion, observation, again, authenticity, being present. Yeah. I think those are all things that you can build as muscles. Yeah. And in turn you can deliver compassionate experiences. When they are relevance and applicable to that particular situation and to the people involved. Wow. Well thank you, Toya, for sharing that story. What a what a There's no answer that could explain better than that story. I think stories make things real and that is as real as it gets. And I'm thinking, you know, I'm a nurse by trade, and so I'm I'm I'm thinking through this nurse's eyes for a moment here. I am I'm thinking she probably had been thinking that. Yep. But didn't know when or how to say it. Yep. And she recognized in you this person is asking me for the truth right now. Yes. Right? They're asking me for the truth. I need to tell them and and she Had clearly gleaned enough information about you that she knew you wanted her to be direct. And that was compassion in that moment. I love that example. I'm sorry for that situation that you were in, genuinely. But I mean if I can add, I'm just gonna sort of replay what you just said to my explanation. You're right. I believe that that nurse was observant. She saw me come lots of days. And so There was something there. she was curious, right? We've had conversations. She asked how I knew this person and what our relationship was. I believe because she was present in that particular moment, she could sense my pain and my desire for truth. And her compassion was demonstrated in her statement. So yeah, so just connecting those things, Ryan. I love it. that that's such a great example. I because and and the reason I I love that so much is I think there is such a misunderstanding when people think of compassion, and even myself in the past sometimes before I really got into I really want to understand this down in my bones because I want to I wanna help with it. I can't help with it if I don't like really understand it. because sometimes you can know something to be true, but if you can't explain it or teach it Yeah. It that's not very helpful, you know? And so I'm just kind of bent that way, right? I just do those things. They're natural to me because of my upbringing. But how do I how do I help others with this? Because it's it's so important to me. I think it's a travesty on both sides of the bed. Right. If it's it's a travesty for the patient or the family, if if there's not compassion that they can receive because they don't they don't get the outcome that they could have gotten whether whether and and there's not always a a positive outcome in healthcare as far as not everybody gets better. Right. But they but there could have been more peace and love and and all those things. So the patient misses that if there's compassion they can't receive, but the provider, the care team also misses it because they never got it feels good. It feels good to connect with other people. And so if you miss those skill sets, it's just a travesty on both sides. Right. And I I will add to that, just going back to authenticity, like imagine that nurse carrying around with She might feel was a lie. Yeah. Like everyone's right. It's like every day I come here and I have to pretend that this situation is gonna get better when I know in my heart that it's not. Yeah. And so I imagine that that was a release for her as well. I can tell you from a nursing standpoint, it's a huge, it's a huge issue for for nurses and providers of looking at someone and going, This is not going well. Yeah. But I can I can tell or I'm afraid this family isn't ready to receive it. Right. And so, but the the answer to that is is connection. That family or that patient or whoever it is, if they are connected with you, yeah, are much more likely to be open and honest both ways. You know, so it's just one of those things that I think is so important. I I have lately been taking kind of almost an extreme stance of saying compassion is an a skill, it's the skill. Yeah. of like it is the skill. And and I just wanna Maybe we wrap up here, then we're getting close to time. But I think many people think of compassion as an as nice. Yeah. Right. And compassion and nice are not the same thing. Sometimes sometimes compassion is the nice thing to do. Yeah. But saying to a loved one, you know, it's not a nice thing to say that, hey, I don't think your family member is is gonna get better. That doesn't feel like a nice thing to say, but I would say it's kind. Yeah. It was definitely kind. It was so I make my kids repeat this sometimes and I'll say nice is not the same as kind. Yeah. They're not the same thing. I that. And so compassion without integrity or compassion without truth is just enablement. That's right. Right. And so compassion isn't isn't always a the nice fluffy word. It's a in my opinion, it's a hard word. Like it's it's a it's a hard skill. One of my friends recently said something about. soft skills, you teach soft skills, and I'm like, I'm not offended at you. But but, you know, it I don't think they're soft skills. I think they're very, very like these are these are tough. They are yeah. So I I push back on that as well. They're not soft skills. It's not customer service. Right. Right. Like it's it's just it's not that at all. You know, in the context of our work, Ryan, I describe them as evidence based behaviors that are positively linked to compliance, outcomes, safety and experience. Yeah. The clinical it it affects us what compassionomics was just blew my mind when I read it of and I already knew it in my heart, but I hadn't seen all the data and how much the patient's perception of their team and their compassion toward them affects the clinical outcome. Yeah just blew me away. You know, th th there was one study where they showed over a lifetime a patient who thought that they had a p compassionate provider had a forty percent Lower rate of admitted being admitted to the ICU. I mean, it just was in it was an incredible number. And like I think one of their quotes from the book was if we had a pill that did that, you know, it would be mandatory. We everybody would have to take it. So it's crazy. So Choya, let me ask this before we go. Anything you're excited about that you wanted to talk about before we wrap up today? Yeah. So I am leaving here to speak at your organization's leadership development meeting. I'm super excited about that. You know, whenever I have the opportunity to evangelize about the importance of this work and particularly how leaders, you know, we we talk a lot about our clinical team and certainly some of our leaders are clinicians as well. But I have seen in this work that leaders make the difference in terms of creating an environment where compassion can thrive. Right. And we can, you know, talk about that forever, right? Because sometimes there is desire to act on our empathy and barriers, right? I might get in trouble, I don't have time, I have another patient to see, I gotta check out or clock out because I you know, I can't have overtime, right? So those are the things that can get in the way of a person who is authentically. Willing. Right. And and leaders have to really set the tone and pave the way for authenticity and compassion to live. And so sharing that message with your leadership team is something that I am immediately excited about. Awesome. Well I can't wait. I always enjoy listening to you. And so I got a little bonus that I could listen to even more. But we're fixing to get you over to the event and and I'm excited to get you up there. well this has been so wonderful. Will you have me back? absolutely. You say the word. You say the word anytime. We can even do it I always want to be in person, but we can always always do it via webinar as well. So many topics that we can talk about. All day I could do this all day. Ryan, thank you so much. Yep, same to you. you so