Audrey Cortez, Senior Advisor and Resident Resiliency Expert and Beth Guyton, President and Founder of Interactive Quality

Raising the Resilience of Your Organization with Audrey Cortez, Senior Advisor and Resident Resiliency Expert and Beth Guyton, President and Founder of Interactive Quality transcript powered by Sonix—easily convert your audio to text with Sonix.

Raising the Resilience of Your Organization with Audrey Cortez, Senior Advisor and Resident Resiliency Expert and Beth Guyton, President and Founder of Interactive Quality was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.

Saul Marquez:
Hey, everyone, Saul Marquez here. Have you launched your podcast already and discovered what a pain it could be to keep up with editing, production, show notes, transcripts, and operations? What if you could turn over the keys to your podcast busywork while you do the fun stuff like expanding your network and taking the industry stage? Let us edit your first episode for free so you can experience the freedom. Visit smoothpodcasting.com to learn more. That’s smoothpodcasting.com to learn more.

Saul Marquez:
Welcome back to the Outcomes Rocket, Saul Marquez is here and today I have the privilege of having two wonderful guests. First, I’ve got Audrey Cortez, Senior Adviser and Resident Resiliency Expert. She is doing some outstanding work at Interactive Quality. She’s a proven nurse leader and sought-after speaker who’s passionate about patient experience and caregiver well-being through years of clinical experience, nurse leadership, and a deep understanding of challenges at the bedside. Audrey has developed Steady and Raise, an evidence-based resiliency model that is easy to learn and apply in daily practice. Audrey’s experience spans nurse executive roles in the hospital and health care industry, skilled nursing, nurse education, and patient experience. She’s a highly effective leader, adept at motivating through engagement, developing trusting relationships, clearly communicating purpose, promoting accountability, and leading teams to targeted goal achievement. Audrey earned her BSN and Master’s in nursing administration from Texas Tech University Health Sciences Center.

Saul Marquez:
We also have the outstanding Beth Guyton with us. She is the founder and president of Interactive Quality, a consulting firm dedicated to helping health care organizations improve performance. She is passionate about leadership development and creating cultures that foster trust, value caregiver well-being, and deliver exceptional patient care. Beth is a certified executive coach, certified professional in health care, quality trained mediator, and Six Sigma Green Belt with extensive experience developing health care leaders. She is a graduate student of industrial and organizational psychology at George Mason University and holds a Bachelor of Arts in Advertising from LSU Manship School of Mass Media. So we’re going to be diving into, as you’ve probably guessed, resiliency and how we could best do that in today’s health care environment. So I want to thank both of you, Beth and Audrey, for taking the time to be on our podcast today.

Beth Guyton:
It’s my pleasure.

Audrey Cortez:
Yeah, it’s our pleasure. Thanks.

Saul Marquez:
Absolutely. And so before we dive into Interactive Quality and the work and resiliency that you and the team are up to over there, I’d love to hear what inspires your work in health care.

Audrey Cortez:
This is Audrey. And I know for me, I love people and I have a deep belief that people are good and to recognize them. And I think that’s what inspired my work both as a nurse leader, but also my passion for resiliency.

Beth Guyton:
I think Audrey and I have so much in common. We’re both definitely people, people, and I totally agree with what she said. And for me, I just really want to secure the best and safest experience for the patient, but also for the caregiver. And that was something when I first started working with health care as a consultant. It’s like there’s a lot of focus on that outcome from the patient perspective, which is vitally important. But the caregiver is so important too. And so how can we also create some metrics and put them as a top priority in organizations to care for the caregiver?

Audrey Cortez:
And Saul I have to share that Beth and I ran across each other a couple of years ago and it was just like an instant connection. I really felt that our sense of values were very similar, our focus on people, our belief in people, our drive to do the right thing, to help health care organizations grow and with leadership, with resiliency. And it has just been an amazing collaboration.

Saul Marquez:
That’s awesome. The connection is palpable. And I could certainly understand the passion behind all of the things that you guys do around resiliency. And I’m excited to dive into it with both of you today and the perspectives of a clinician and also a certified coach just, I think, meld quite well in the need of what we have today in health care. So talk to us a little bit about how Interactive Quality is adding value to the health care ecosystem.

Beth Guyton:
I’ll go first, if you don’t mind, Audrey.

Audrey Cortez:
Go for it.

Beth Guyton:
So what I would say is we’re here to talk about the solutions. And Audrey has put together an awesome solution that is genius because it takes a really complex idea concept and something difficult to operationalize. It puts it in a very simplistic form, but the problem is worth mentioning, which is burnout. And before COVID hit, burnout was a huge crisis in the US with health care and some estimates were even as high as 17 billion dollars as being the problem. When you look at the cost of lost engagement, turnover, trying to rehire, retrain people, and then any time you’ve got turnover, when you’re trying to deliver a service such as health care that relies on consistency and quality and best practice, you’re going to skip a beat and you’re going to have missteps that are going to cause your product or your service not to be on. The highest quality, so burnout is a huge problem when we look at it from a financial standpoint, but you think about everything that it affects. It affects the caregiver first. And that’s where we see the symptoms. That’s where they show up, although we know there are all the systemic problems. But the caregivers effectively see higher suicide rates, broken relationships, alcohol and drug abuse, et cetera. And then patient safety is impacted. You have more caregivers leaving the profession. And even though there is not solid data out yet, I would imagine when we emerge from this pandemic, we will see more health care givers looking for other professions and leaving. And then that throws us in a situation where we have less access to care. And even with the pandemic, disparities in care and access for different groups have kind of come to light. And so you can see how this problem at first glance seems like an individual clinician problem. But it really is a problem that affects us throughout our community and as a nation when we think about access to care ultimately being impacted. So I think that making a difference is so important because the problem is so vast. And then I’ll let Audrey speak to the resiliency model that she’s put together and why it’s a little bit different than other things you may see on the market.

Saul Marquez:
Sounds great to us all.

Audrey Cortez:
Just a little background before it hit us. Stress and burnout were identified as top challenges in health care. And so I’m one of those nerds. I sit up and read research and books on health care, and my passion is resiliency. And I’ll be honest that this passion came about from a personal loss. I lost my only son in an accident in 2009, and as horrible as that was, I realized that life goes on and you have to make something good come from every experience, even the worst experiences imaginable. And what came out of it for me was just an intent to help other people go through loss, through chaos, through times of uncertainty, not even knowing that COVID would come and hit everyone as a nation. So fast forward and I have implemented a resiliency training program at my hospital where I work, which is Peterson Health in Texas. And we were noticing a lot of clinicians and nurses really becoming burnt out and probably around twenty seventeen developed a preliminary program for them. And I was asked to speak at a national conference regarding our efforts which improve our employee engagement and our patient experience scores. And so I’m speaking about that to a small group. One hundred twenty-five people. And I go across the hall and there’s an author that I just really respect. And I have read her research and found it very valuable in my work. And there were hundreds of people in this room, probably a thousand people. It was a huge room and there was just such a sense of anger in the crowd. Frustration. We know the research. We’ve read the research. What is the solution? And the speaker was very gracious and she offered all the tips and all the what research was showing. But it bothered me. And I went back to my hotel room and spoke with my fiancee, who’s a physician, and he’s experienced some of the stressors in health care. Absolutely. He’s been a physician for 30 years. And I said, what is the solution? And he said I don’t know what I don’t know. And so we went to sleep. Now, this is part of how my brain works. I couldn’t go to sleep. Finally, I did. And then I woke up at two o’clock in the morning and I woke Tom up and I said, Tom, wake up. I’ve got it. I got. And he said, Audrey, can we talk about this over coffee?

Audrey Cortez:
But I couldn’t. I just couldn’t. I said, No, get up. We have to do this right now. And so I said, I’ve got it. What’s going to help is you have a tool, a set of tools, a toolbox for staff, for physicians, for clinicians, for anyone in health care. And you teach them these tools. And then on top of that, you have to have a set of tools for leaders to be able to support and guide their staff. So it’s two prompts, a set of a toolbox for staff and a toolbox for leaders. So Steady is a set of tools for staff and for everyone, for physicians. We roll it out to everyone here at Peterson Health and Raise is how leaders can elevate and support their staff through times of stress and uncertainty and through change.

Saul Marquez:
That’s so cool. Well, I think it’s great that you have a program that focuses on both stakeholders. And this is primarily within the four walls of the hospital, correct?

Audrey Cortez:
It’s in the four walls of the hospital. But then Beth and I also offer consulting across the United States. So this is for anyone. We want to make sure that people have access to these tools.

Saul Marquez:
Because I’m thinking as well about the caregiver, the unpaid caregiver, and there’s so many in this country. You guys are focused on and more so the paid provider.

Audrey Cortez:
With our program, we’re focused on the paid provider, but we also have at Pieterson Health, we do a lot of coaching for the family as well on how they deal with stressors as well. So honestly, the tools and steady can be used and applied in different ways. And we use the two not only on resiliency but on the annual evaluations, on difficult coaching conversations. So we found that it’s really scalable to be able to adapt the model to what the need is. We recently at Peterson have started an interactive two-hour class on COVID in the time of resiliency and we’ve woven in Steady for the staff. But we’ve also empowered the leaders to help support their staff to be more resilient through using Raise of it.

Saul Marquez:
So great. So as you embark on distributing this content and training people on it, what have you noticed makes the approach different or more effective than what’s available today?

Beth Guyton:
Well, I think in, a lot of approaches, so kind of look at this, we see the symptoms of the problem on an individual level. So it’s easy to fall into the trap of thinking that, oh, well, we’ll give the individual a tool and it’ll be kind of, in essence, a clinician go heal thyself situation, which we want to give into the individual skills because people can build resiliency on an individual level. But you also build it through the community that you create at work, and that can be on a team level or even organizational culture. And then there are organizational or system factors that can drive that. And the leader is in a unique position to address those types of things. So there’s been in the past a lot of could be something like mindfulness training, which is great. And I’m actually in the process right now becoming a certified trainer on mindfulness. So it’s a great tool, but that alone won’t solve the problem. So what’s really different about this is it creates a kind of like a common language within a culture, gives people anchors for behavior and almost best practices for interacting with one another and creating and giving leadership tools to create that cultural dynamic that gives support beyond just saying, hey, as an individual, you know, you should go take care of this problem. We’ll give you some tools, we’ll give you one training class and you go take care of it. So it’s really you begin the process with the training and having people understand the model that Audrey has created. And again, what’s genius about it is that it’s simple, even though resiliency is really a complex topic. So it allows for the organization, but more systemic support in place versus just giving an individual caregiver, a physician, or a nurse some tools and expecting them to solve the problem.

Saul Marquez:
Yeah, I appreciate that. And yeah, I think you nailed it with making it systemic because you leave it to an individual. How do you make it so that it’s scalable and therein lies the systemic solution that you guys offer. So talk to us a little bit about maybe how it’s worked and a success story or two.

Beth Guyton:
Audrey can speak to that.

Audrey Cortez:
Yes. Saul what I will tell you is that we focus on resiliency from a couple of different aspects. So we have this individual resiliency, then we have organizational resiliency, and then now we’re tying it into community resiliency. So, for example, we take Steady and Raise to our firefighters here in the community because they have stressors. We do a lot of training but is also we do a lot of activities that are about self-reflection and how each person looking at how they deal with stressors in their life. And we talk about fears and we talk about what happened in the past that we’re dealing with, whether it’s COVID, how we deal with what’s going on in the present. And then always we look to the future. What future do we want and how do we create that, whether it’s as an individual, whether it’s as an organization or whether it’s has a community. Now, I will tell you a success story that just happened today. Today, we received our results from our employee engagement survey. I will tell you that my organization, Peterson Health, they have in the last four years of this journey, they’ve been in the top 10 percent for patient experience nationally. They’ve been recognized by health great. But today we got our results back from our employee engagement survey. And we were at the eighty-nine percentile two years ago. We were at the eighty-seven percentile last year. And this year in the midst of COVID, I just learned today we’re at the 92nd percentile nationally.

Saul Marquez:
Nice.

Audrey Cortez:
On the resiliency aspect of the survey, ninety-six percent of all of our employees, and we had 90 percent of our employees take the survey, which is unheard of. It’s an engaged group. We had ninety-six percent on rate highly on the resiliency aspects of the survey, so that to me just made me incredibly proud and just made me feel, OK, we’re making a difference. We’re helping these people get through this disaster, this pandemic in a way that is healthy, where they can engage and realize they have some control in how they handle these stressors.

Saul Marquez:
Yeah, that is awesome. Congratulations on that. By the way.

Audrey Cortez:
I’m very proud. We also won the governor’s award, which is the Texas equivalent of the Baldrige. And so a lot of good stuff that I’m really, really, really proud of.

Saul Marquez:
Well, you know what? You woke up at 2:00 a.m. You had some answers. I’m glad you wrote them down.

Audrey Cortez:
And my fiance Tom, we’ve been together a long time, but he helped me a lot as well. He’s a physician, so he has that aspect,

Saul Marquez:
That’s awesome.

Audrey Cortez:
But there are probably awesome in our 15 years of knowing each other, there have probably been five times when I’ve woken him up at 2:00 and said, OK, we’ve got to hammer this out. And he always rolls his eyes, but then he’s always he’s just real calm and laid back. But he said he has a.

Saul Marquez:
Let’s go for it.

Audrey Cortez:
Just do it. By six we had three pots of coffee. Of course, we did have to take a nap later on. But over about four hours we went through the concept and from a, I’m a nurse by background. He’s a physician. We both love people. And we hammered out Stadion Race that night. We brought back to my organization. I said, look, this is what we came up with while we were away. And they were like, we want to do a leadership development institute. We want to implement this. We want to embrace this. And they did. And that was back in the end of twenty eighteen,

Saul Marquez:
That’s brilliant.

Beth Guyton:
Audrey’s hospital in Kerrville, Texas, really got a jump start on resiliency. Many organizations are finding now in the midst of COVID, some of them have had to furlough staff and then the staff. Yeah, I mean it has been so challenging and resources are very tight on all levels. Like it’s not just money, it’s time, because you may not have enough staff to allow people to go to training classes and whatnot. And so what we’ve done is create almost like just little mini video sessions and then that can be parsed out instead of having to pull staff in for an hour class or our leaders for a three-hour session to be able to get them the content more in bite size chunks if you will, and then also offer guided discussions with people from our team to drive the concepts, especially with the leaders, so that they can see how they can take that forward and start to pull it through into the daily activities.

Audrey Cortez:
And I would just add Saul that with COVID, it’s not only a psychological safety and physical safety. There are those mental stressors just eat at providers and nurses and staff at the front line. The stressors that I get to see, the stressors I put up with every day and you see about them on the news. But I see what they face. People who come in, the ET who have COVID and people don’t realize that even though they screen through. The nurses going home, having to decide whether to leave their children with their elderly parents who are susceptible to COVID or to take them to daycare and expose them to COVID. The stressors are just immense. And if we can do anything to help these providers deal with this day to day and we’re still going through it and there’s really not an end in sight.

Saul Marquez:
I agree.

Audrey Cortez:
The need is out there and the stressors are immense.

Saul Marquez:
Well, I think it’s wonderful. And so folks are listening to this and they’re like, OK, how do I get in touch? I learn more and we’re not even done yet here. But if you want folks, if you if you’re meaning to know right now where to go, it’s interactivequality.net. Type in www.interactivequality.net. You’ll find out more there, ways to get in touch. Certainly, the time is now for this, you know, and how can you make it systemic. I think that right there is a takeaway. How can you make resiliency systemic for both the leadership team and also the caregivers individually? And so we all know that these types of programs and initiatives don’t come without challenges. So I’d love to learn from both of you Beth and Audrey, one of the biggest setbacks has been and what you learn from it to make you guys and the program stronger as a result.

Audrey Cortez:
Well, I can go with that. One thing I will say is that traditionally, nurse-led initiatives are not widely accepted by physicians. Physician burnout is huge nationally, and it is, even more, an issue with COVID. I mean, the physicians, especially emergency room physicians, and hospitalists are taking care of COVID patients. And so in the Raise model, the R stands for relationship. So one of the hurdles when I first started the work was really the physicians needed to be able to use this tool. But how to get them to do it because you can’t mandate all physicians must attend this training of physicians. And so that that didn’t work and it wouldn’t work. So what I did instead is I created relationships with the physician groups, specifically the hospitalist group and the ED group, and the specialists. And then I went to and took it to the nurses and the nurses in the hot areas took the information back to the physicians and they said, oh, wow, we went to this resiliency training. So I actually had the head of the ED physicians come to me and say, hey, we hear you’re offering this for nurses. Are you not offering this for physicians? And I was like, oh, thank goodness. I said, Absolutely. I would love to bring that to physicians. So since that day, I do monthly sessions with the ED hospital physicians and I do quarterly sessions with our hospitalist group. I’ve also been asked to speak regionally to the sound hospital as a group and present to their whole Gulf region district in Texas. And so and they said, oh, we want you to come back. So the lesson I learned is, is that with physicians, you have to show them and then have them invite you in. And that has been very effective.

Saul Marquez:
I love it. That’s such a great call out. It is tough. And, you know, at the end of the day, I think there’s certainly a big need for them. And it’s great that you have figured out an approach that works.

Beth Guyton:
And I would also say Saul like right now, everybody’s struggling, especially in health care and different organizations for different places with different resources and different capacity. And I mean, to be honest, COVID has created a lot of challenges and to deliver this type of program that so badly needed. But what I would say is one of the things I think that we are really good at is meeting clients exactly where they are. So if somebody feels like, well, we just can’t do anything, but, oh, my gosh, our turnover is crazy or no one’s engaged anymore, and they feel like this would be helpful in that arena. And of course, that wouldn’t solve all problems, but definitely, a piece of the puzzle, reach out to us because we will brainstorm with you. And, you know, it may be that you need a really big comprehensive solution. And that’s not going to happen right now because of the constraints. But we can certainly help you map that out and at least get started with some simple things that are doable with the time and resources that are available for your organization now. That to me, I think that’s the biggest challenge. It’s almost like COVID through a monkey wrench in everything and has created so many more demands on the health care system. And then there’s more that needs to be done to take care of health care workers, yet there’s less ability to do that. So how can we get really creative and see how we can at least provide them some support and begin to lay the groundwork for bigger things that can be done maybe a year or 18 months from now, but at least get started with something.

Saul Marquez:
Now, that’s a really, really great point, Beth, and it’s a gracious offer. And so if people want to reach out to take you up on that, where would they reach out?

Beth Guyton:
So I’m easy to connect with on LinkedIn, but then reach out to me directly. It’s beth@interactivequality.net. And I’m always happy to schedule a call and we can brainstorm for as much as 90 minutes if you’ve got the capacity to do that. And of course, it’s all complimentary and I love doing it. That’s what fills my cup up, is to solve problems for people. So it would be a pleasure to do that and see how I can help you in some way.

Saul Marquez:
There you have it, folks. Take advantage of that. And so, you know, even if now’s not the time and if you want to get some ideas, totally take that up on it. We do this podcast for the sake of action so you can take action, not just get ideas and sit on them. So what are you both most excited about today?

Audrey Cortez:
Saul, for me, in the steady model, the Y stands for you and that means, how we translate that is, what you do matters. You make a difference. Peterson health, interactive quality. We care about you. And one thing I’m excited about is just seeing the employee engagement results. When I see that employees are in a time of COVID are excited about the work they do, they feel supported by their organization and they feel that with their team they can make it through this pandemic, that excites me beyond anything.

Beth Guyton:
And yeah, and I would piggyback on that, Audrey. And I would just say, you know, I’m just excited about the opportunity to help. It’s heartbreaking to see all the hardship that our country has gone through and it’s not limited to caregivers. There are people hurting everywhere. Maybe they’ve lost a loved one. Maybe they’ve lost their job, et cetera. I mean, there’s a lot of hardship, but part of what we learn from resiliency is we are all capable of bouncing back. It’s a kind of ordinary magic because we’re all capable of it, even though it’s incredibly extraordinary when we’re able to do it or we hear the stories of others who have bounced back from unimaginable things. And as a nation, we will bounce back from COVID. And I hate that this is kind of what it’s taken to put the caregiver, the physician, the nurse burnout on the forefront, on the front burner, so to speak. But I’m excited that we’re having the conversation. And I think as things start to settle down, even now, we’re going to see more people, more health care organizations than ever saying, hey, this is a priority. We cannot ignore this anymore. And I think in the end, really great things are going to come from this hardship that we’re all enduring.

Saul Marquez:
And this is great. Thank you for that, Beth and Audrey. Certainly, a lot to be excited about with the promise of a program like this in light of how big the problem is. And so I certainly appreciate both of you and the passion that you’ve brought to today’s discussion and also the experience that you and the organization you have behind you supporting this program to deliver it is doing so. Why don’t we just leave our listeners with a closing thought and then the best place for them to get in touch, to learn more, and continue the conversation?

Audrey Cortez:
One of the things that I believe in doing to be effective and to make it scalable is to create a language that takes fire in your culture. And so one of the languages that we’ve woven in at Peterson Health is you only grow outside of your comfort zone. We use that language and I hear the staff echo it, but you only grow outside your comfort zone. What this means is as human beings, we don’t have to stay stuck in the mud of fear, of uncertainty, of feeling loss. We have the choice to grow and to become better. And I believe that’s what we’re doing as an organization, as a community. And ultimately, as Beth said, as a world.

Saul Marquez:
That’s beautifully said, Audrey.

Beth Guyton:
Audrey is so awesome in pulling together very visual and memorable ways of understanding complex things. One of the things I absolutely love about her, and I would take that to build on her thoughts. If you are a health care leader within your organization and you have a concern about engagement and turnover and caregiver well-being, please reach out to us because there are so many possibilities and the most difficult problems in life really are not meant to be handled in isolation. And so the human connection, the sharing of ideas, and us all working together is really what’s going to bring about the best solution. And so many things are possible. And I would just my parting words, or even though things are hard now, to stay positive and look for the opportunities and lean on others that can help.

Saul Marquez:
Wonderful. Thank you, folks. Just a reminder, it’s interactivequality.net and we will provide Audrey and Beth’s LinkedIn information in the show notes so you could get in touch with them. Should you have any questions or want to explore that that conversation about how they could help your staff and the culture at your hospital build that resiliency to improve caregiver well-being? I want to thank both of you for spending time with us and sincerely appreciate the insights you’ve shared today.

Beth Guyton:
Thank you.

Audrey Cortez:
Thank you. So being a pleasure.

Saul Marquez:
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