It’s a little over a year since I originally published this blog. In it, I discussed my personal story and how that became the catalyst for Laudio. Well, a lot can happen in a year. So, I’d like to take this opportunity to provide an update on what we’ve heard, experienced and, most importantly, the adoption of Laudio across health systems that has surpassed our expectations.
I had a front-row seat to nurse burnout.
I was lucky. After my near-fatal ski accident, I received excellent care during my 7-week stay that spanned three of the highest-ranked hospitals in the country. But I could not shake the dissonance between the care I received and the engagement and satisfaction of the people delivering it. My caregivers were helping me, and I was genuinely grateful. From my perspective, they were doing the most critical job in the world. However, as I got to know my team, I came to understand they did not feel the same way about their jobs that I felt about them. They were burning out.
Why were they burning out? There are many complex and multifaceted reasons. Overwork. The invasion of technologies like EHR. Higher acuity patients with less time. Lack of appreciation. Inability to see a future career path. Crazy schedules. And the list goes on.
The consequences of burnout add negative fuel to a healthcare system that already struggles with the quality and cost of care. Burnout causes mental distress, disengagement, loss of focus, leaving a job or a career (known in the industry as “turnover”), and at its worst end-state, impaired quality of care and safety for patients. All of these downstream effects of burnout are impediments to the teamwork, communication, and training that are key to achieving results.
Given that healthcare is now the largest sector in our economy, there are innumerable healthcare workers at risk. Burnout is not just about nurses. It’s pervasive across the healthcare workforce, including; doctors, lab techs, therapists, cafeteria workers, housekeepers, and many more. And, since everyone eventually needs healthcare, the impact of healthcare workforce burnout affects us all.
Motivated to Action.
I was motivated. After my recovery, I assembled a team of the smartest people I know, and we set out to identify whether we could determine the causes of burnout and develop a solution to reduce it dramatically.
Why were the caregivers — who were engaging in what should or could be the most fulfilling work, human caregiving — burning out with increasing frequency and intensity? Who were most at risk? Was there a way to predict and take action early enough to make a difference?
We studied this issue for over a year. We talked to more than 150 healthcare leaders and staff members in over 100 institutions across both the US and UK. Initially, we focused on nurses but quickly expanded our inquiries and discussions to all healthcare staff.
We partnered to “create a first of its kind dataset,” looking at healthcare staff activities and behavior and scrutinized it for signals, patterns, and insights. We talked to published academics and subject matter experts. We kept asking questions and testing hypotheses. We did our best to leave no stone unturned.
Findings that Lead to a Breakthrough.
Finally, we started to hone in on the role of front-line staff managers. Front-line staff managers exist in health systems across almost all domains from nursing (about 70% of front-line managers are nurse managers) to the laboratory, to housekeeping. Multiple avenues of investigation signaled to us that a team’s manager had the most significant opportunity to impact all of the key drivers that lead to burnout. So, we dug deeper.
We discovered that managers of healthcare staff have large spans of control — most average around 50:1, but some have as many as 200:1, and they operate in a 24 x 7 environment. There is also a high variation between managers. Most are promoted into the role with little training, and the opportunity to share best practices between managers is limited. In our data, which was an extensive cross-institution data set, we identified a correlation between a manager’s span of control, and the rate of turnover and engagement of that manager’s team, when comparing like areas (such as Emergency Departments).
In general, the larger the team, the higher the rate of turnover was among staff members. We hypothesized that as managers were increasingly spread thinner due to administrative work and increasing spans of control, they were missing the opportunity for critical staff engagement.
These findings ultimately directed us toward a solution. What if we could make a “large team” feel like a “small team”? What if we used “gentle AI” to automate and simplify much of the administrative work of managing so that interpersonal connections could shine? Could we then accelerate and amplify interpersonal connections by making them easier? Would this make a difference in burnout? In engagement? In retention? In care?
The Laudio front-line team, 15 engineers, two designers, and two data scientists accepted the challenge, with humility but gusto.
We built a system that would work within managers’ existing workflows to make these workflows better, faster, and more productive. We were guided by a panel of executive leaders and front-line managers that could support us on a day-to-day basis. These managers came from a wide array of institutions and care settings so that we could focus initially on the common pain points. Together, we identified almost one-hundred administrative management workflows to automate.
In addition to administrative streamlining, we scoured the literature for best practices to prevent burnout. Through published academic experts, we created a scalable best practices framework that any manager could apply to enhance relationships with their teams and improve the impact they could have. We then automated as much of the workflow as possible using this framework. After a few months of arduous work, we built a system that could both automate administrative duties and turbo-charge interpersonal actions for the manager. Our goal was to operationalize these best practices, make them sustainable, and drive results that positively impacted patient satisfaction, quality of care, and safety
We created an Intelligent Human Engagement platform, and we’ve been enhancing it ever since, releasing improvements and refinements in sprints, every two weeks. Nothing like it exists – at least that we have found! We’ve named the platform Laudio after the Latin word laudare, which means “to praise.” Praise is one of the critical levers of interpersonal relationships that the platform seeks to optimize.
Early Laudio Results.
We began deploying this platform a few months ago at an academic medical center (AMC) who wants to be an innovation leader in the area of engagement, leadership, labor expense, and turnover. And guess what? It works like a charm.
At our AMC partner, our platform saved managers hundreds of hours while supporting thousands of new interactions with their staff, aided by Laudio’s smart recommendation engine, which teed up opportunities with the staff that needed it most. The turnover trends of the teams using our platform were 5% lower than the teams not using the platform, which is worth millions of dollars a year in savings for the health system.
But the best part was hearing managers talk about the positive difference the platform was making for them and their staff. “It saved me over ten hours last week,” said one manager. “My staff thinks I am very smart,” said another. “It helps me do what I was already doing, but to do it more consistently,” said a third.
We’re now introducing this solution to the broader health system market, including; ambulatory settings, post-acute, and senior communities. There is an enormous market opportunity to impact the environment of care, and our initial response is strong. The early pilots have demonstrated ROI potential as high as 40:1, based on retention impact alone. We’re expecting to see new results in quality and safety as we continue to expand the Laudio platform and measure our progress.
Laudio One Year Later
So, what have we learned and accomplished over the past 12 months? The response from hospital managers and front-line managers continues to be overwhelmingly positive. The managers use the platform more each month as they save time and get reinforcing feedback from their teams. Seeing this user growth has been exhilarating and rewarding. The senior leadership at these hospitals are using the platform to provide coaching and feedback to their front-line managers. And engagement is up by up to 25%, and turnover is down 5% at our longest-running site!
Here are just a few additional highlights:
- More than 150 front-line managers use Laudio daily to manage anywhere from 50-250 staff members each.
- The Laudio platform has generated more than 15,000 real human engagements.
- Daily recommendations for nurse managers have facilitated meaningful interactions that are making a positive cultural shift.
- Month over month, front-line managers using Laudio have dramatically increased the number of interactions with their teams.
- Staff engagement scores have increased by up to 20%.
- Nurse managers are reporting that “Laudio makes me a better manager.”
We know we’re onto something important, and we hope we to make a difference in burnout. How big a difference? Time will tell. But our team is super excited. We thrive on the instant feedback we get from showing this new type of platform to health system leaders. A movement has started, and it’s growing. We are grateful to be part of it and would love to show it to you. If you’re interested or would like to learn more, you can watch our progress at www.laudio.com.