Hospital Uses and Inner-to-Outer Approach to Solve Massive Post-COVID Challenges

Table of Contents

The hospital had already risen from the ashes five years back

This hospital leadership team used our B STATE Systems before COVID to remove the hospital from needing to sell it, go out of business, or create a culture that could save it. As a result, they broke down silos, shared accountability, and built a strong leadership and middle management teams that resulted in becoming profitable again, getting magnet hospital status, and being recognized as 12^th of the top hospital cultures in the country.

Then COVID hit, and everything changed.

They weren’t allowed to meet physically
Nurses were traumatized by constant deaths and were the only support system for patients dying alone because family members weren’t allowed into the hospital.
They went into a mode of let’s just get through this

But coming out of COVID, things started falling apart

Nurses, completely burnt out, were leaving nursing for just 10 cents more per hour somewhere else
Those who stayed nurses became traveling nurses, leaving the hospital but still working in the area for 5x the hospital rate
Other entry-level people could get more money at McDonalds than at the hospital, so people left, and positions were harder to fill
Leaders had to fill in, extending their hours and stress, which resulted in them losing more leaders that then needed to be replaced
Now people are coming in that weren’t integrated into the culture because they still couldn’t meet yet in person.
The culture was starting to fall apart and returning to silo, isolation, and survival approaches.

Why IMPAQ was called

We were called in because we helped in the first crisis using our B STATE (B = Breakthrough) systems.

They wanted someone who could help relieve the stress, rejuvenate the group, and restore some sense of work-life balance for the team.

We weren’t even sure we were the right solution until we came up with a radical strategy for addressing the massive challenges they continued to face.

A radical solution for the hospital’s post-COVID dilemma

It became clear that the only way to address a severe crisis like this one, where they didn’t have control of the environment, was to address it from an inner-to-outer approach that created support without adding anything to people’s plates.

We needed to shift the inner experience of the situation to one in which people could support themselves and each other through the change. The top leaders immediately accepted the approach, and it was so important to them they created two days for leadership to meet to make this shift.

We divided the time into two parts: one and a half days for inner transformation work and a half-day for commitments and action planning to sustain the support system for 60 leaders. We only agreed to do it if they agreed that anything they chose to do didn’t add to their plate of work.

What happened in the session was miraculous

We started by having them brainstorm their hopes and fears about meeting and then having them transform their fear statements into what they wanted instead of the fear. When they looked at the two statements they came up with, each leader instantly understood a key to the inner-to-outer transformation they needed to make.

When they faced a massive problem, dealing with it from a place of fear and isolation only worsened it. Instead, they focused on what they wanted and shared that with others on the team. When they did, they instantly transformed their sense of the problem into a positive inner experience, providing immediate internal and group support and opening the door for new and creative solutions.

Everything had changed by the first break, and the group of 60 leaders said they were entirely “in and ready work the inner-outer approach.” Now we could take them deeper into the inner game of supporting themselves and others in ways that almost instantly reduce unnecessary stress, isolation, hopelessness, and fear.

They had learned the power of making decisions based on intention, which gives direction, focus, positive energy, freedom, and hope, rather than deciding based on fear, which locks you up, creates stress, isolates you, and leaves you frustrated and hopeless. It was a choice they could make independent of the external pressure or conditions.

How an inner-to-outer approach differs from a typical outer-to-inner approach

We often create individual and team support, safety, accountability, and work-life balance by setting external transformation and improvement goals (that add to one’s plate of things to do) to create the balance and support people need inside.

In this case, we needed to do the opposite. We needed to create support from the inside out because taking control of the outer environment was a long way off. Anything they did on the goal level would not relieve the pressure or give them the ability to take care of themselves or each other, let alone experience peace or joy in their challenging environment.

Anchoring a transformation without adding work to people’s plates

Once they anchored the inside-out approach, had the skills and techniques to do this, and felt rejuvenated, they formed into groups to come up with the answer to “What are we going to do with each other to create a system of support?” They came up with five areas of focus:

More facetime – less isolation
Less kneejerk reactions
Fewer, clearer priorities
More trust
Less negativity

They then broke into small groups that, on the spot, came up with how they would improve these areas without adding more work to anyone’s plate.

The initial review of the results was impressive

For weeks later, we did a one-hour follow-up virtually:

Almost all the nurses reported that not only did it help them; it was a life-changing experience
When asked if they thought it was better, the same, or worse than coming into the session, most said the same, but over 1/3 said it was better – and that was with nothing changing in the outer environment. The ah-ha was that they had shifted back to thinking the external situation needed to change before their inner experience changed.
We assessed the five areas, and three of them had already made significant improvements with nothing on the outside changing:
- More facetime – less isolation
- More trust
- Less negativity
This awareness pointed out the next thing they needed to do was to address priorities differently (which would also create fewer kneejerk reactions) – so now they had a clear direction for their next step, and it was still one that would take work off their plates.

Every hospital across the US seems to be experiencing the same type of things

We have been checking with our other healthcare clients and have found they are facing many of the same challenges:

Short staffed
Highly stressed
Nurses leaving because they can get better jobs working for insurance and other companies
Leaders are overly stressed
The degree of ongoing change is continuing
Medicare reimbursement hasn’t gone up enough to keep up with the higher costs of every role – primarily nurses – so continuous cost reductions are required just to survive
For more entry-level positions, you can get more pay at other jobs than the hospital