Tomorrow's Leaders Take on Healthcare
What do future healthcare leaders think of the current state of our industry and where it is heading? In this episode, graduate students and Cleveland Clinic interns, Yamileth Gonzalez and Ermonela Muhameti, talk with host Steph Bayer to share their unique perspectives as immigrants who came to the United States at a young age. These experiences helped shape their passions for improving healthcare and access for underserved populations with empathy as a guiding principle.
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Tomorrow's Leaders Take on Healthcare
Podcast Transcript
Steph Bayer: Welcome to another episode of Studies in Empathy, a Cleveland Clinic podcast exploring empathy and patient experience. I'm your host, Steph Bayer, senior director of the Office of Patient Experience here at the Cleveland Clinic in Cleveland, Ohio.
I'm very pleased to have with me today, Yamileth Gonzalez and Ermonela Muhameti. Yami, Nela, welcome to Studies in Empathy.
Nela Muhameti: Thank you. Thank you so much.
Yami Gonzalez: Thank you so much for having us.
Steph Bayer: Yami is our Cleveland Clinic Clinical Transformation intern. She's a graduate student at the University of Florida, and has a passion for improving patient access and the quality of healthcare.
Nela's an intern with our Strategic Workforce Planning team. She's a graduate student at the Ohio State University and is motivated to develop her knowledge of healthcare management and address health disparities within underrepresented communities. How are you guys?
Nela Muhameti: Good, thank you. How are you doing today?
Steph Bayer: Good. Thanks for sticking with us throughout the entire internship, let alone being dragged into a podcast.
Yami Gonzalez: No, it's our privilege to be here.
Steph Bayer: Well, this is very exciting to talk to you. When we think about a place like the Cleveland Clinic and how we're an academic medical center, and teaching and learning is part of who we are.
I think it's so important that we also ask our students in all realms, not just our residents or our nursing students, but in all realms, how are we doing? What you've learned from us and what we can do better, so this is going to be a great conversation for me.
Nela Muhameti: Thank you. Thank you so much again.
Yami Gonzalez: Thank you.
Steph Bayer: Yeah. I want to start off right away, by getting to know you better in your healthcare capacity. We'll take it one by one and we'll go with Yami. What drove you to healthcare?
Yami Gonzalez: Yeah. Nela and I both have very similar stories. We both came from immigrant families and I migrated here at the age of two, and Nela came at the age of six. I was born in Mexico and my parents didn't really know English very well growing up. I stepped into that role of being their translator and their guide, so I really navigated them through a lot of aspects of life. But I was there often in healthcare visits, so not even just primary care, but those emergency situations that do come up in life. From a young age, I saw the opportunity for healthcare to improve.
My family and I saw a lot of barriers to access. It wasn't just a language barrier too, it was also cultural health literacy. Knowing that I was going into grad school for my master's in health administration, I'm always out here looking for ways to remove those barriers, to better give care to underserved populations. I think later in life too, I will probably work for an organization to help promote health literacy in our young adults and our kids in public schools. I think that's really important and I see a need for that.
Steph Bayer: I love your story and that you shared it with me so early on, so thank you for sharing it again today. One of the things I learned from you this summer was to think differently about reaching all populations. In fact, even on this very podcast in the last few months, we've talked to folks that are outside of our traditional realm.
We talked to, for instance, Monica Ramirez, who is an advocate for migrant workers. I want to credit you with pushing me to think differently and to engage in different conversations, so this is where our interns are just so important in so many ways.
Yami Gonzalez: Yeah. No, and I think the clinic has done a great job too, with being an advocate for patients, who otherwise wouldn't have a voice or feel confident in sharing their voice. I've seen that a lot during this internship.
Steph Bayer: Well, that's nice to hear. Nela, what drove you to healthcare?
Nela Muhameti: Yeah, of course. As Yami mentioned, very similarly, we both come from immigrant backgrounds. I moved to the United States at the age of six with my family from Albania and been in Cleveland ever since. Specifically, what it was for me, was being a patient here at the Cleveland Clinic at the age of 11, going through a life-threatening surgery, really gave me a different aspect of healthcare. From that, I thought I wanted to be a nurse originally. Realized I can't stand blood, so that was not the route for me, but I still loved the field of healthcare and helping patients, and being an advocate for them just like they were for me.
My parents still don't know English, so I'm always there being an advocate for them. For me, still sticking around in the healthcare field and the business end of things, I want to make it available to underserved communities, that the resources that they have that are there for them, and getting them access. Sometimes the access is there, but they don't know that it's there. Similarly, to my family, they didn't have insurance at the time that I was hospitalized. In addition to the fear of losing a child, they had the fear of this huge hospital bill.
Having the advocates here at the clinic, ensuring us that there was something for us and they would help us was immaculate. I see my future in trying to minimize these hardships that communities of the underserved have experienced, and trying to prevent this from happening in the future.
Steph Bayer: It's impressive that you have similar stories as children that had to be advocates for your parents. But it's so impressive to me that you came out of that background wanting to help others, so thank you both for entering healthcare.
I'm excited to see what the future brings, if this is what's coming. I want to start with what you learned from the Cleveland Clinic. What exposure did you get that you wouldn't get in a traditional classroom? What did you learn while you were here? Let's start with Nela.
Nela Muhameti: Yeah, sure. I've had the privilege to be here a few summers ago as well, so this is my third time coming back. Each time I learn something new and experience something that I wouldn't have experienced, if it wasn't being for this specific position. In terms of what I did this summer, I did so many amazing things. Having one-on-one chats with leaders all across the organization and for them to be so open to wanting to talk to me, just an intern, is amazing.
In addition to great shadowing experiences, I got to go and visit the Mentor site hospital building. It was so cool getting to see a hospital being built from zero to one day, everything being there. But the most outstanding for me, would be getting to witness a heart surgery and shadowing, and standing in on one of the world's greatest hospitals within the Vascular Institute.
Steph Bayer: Hold on. You just said to me, you can't handle blood and you watched a heart surgery?
Nela Muhameti: Yes.
Steph Bayer: Did you pass out?
Nela Muhameti: No. Surprisingly, I was really worried of that, but it was at an angle where I saw a little bit, but not everything.
Steph Bayer: Okay.
Nela Muhameti: It was the perfect balance of seeing something but not everything where I would have to pass out.
Steph Bayer: That's a really cool experience, and real wide breath of things you got to see.
Ermonela Muhameti: Yeah.
Steph Bayer: That's great.
Nela Muhameti: Yeah, thank you. It was truly something that I wouldn't have been able to do if I wasn't in this internship, truly. I've been here two summers as well, like I mentioned.
This summer I got more autonomy and more exposure to these things that one day, I hope to be involved in some different realms.
Steph Bayer: Very cool. Yami, did you see anything you wouldn't see in a classroom?
Yami Gonzalez: Oh my gosh, so many things. With Clinical Transformation, it's a wide institute and it's enterprise-wide.
Steph Bayer: What's Clinical Transformation, because it's such a weird name, right?
Yami Gonzalez: Yeah, right. There's a lot of departments underneath it and that's Patient Experience, the Ombudsman's under there, Continuous Improvement, we even have Access to Care under Clinical Transformation. We have Strategy. There was a lot. I got exposure to almost every single department doing a project or two in each one. I think what I learned that I couldn't have learned in the classroom, is the magnitude of the work that we do and how impactful it is.
Even down to just making sure that our objectives and key results are aligned across all teams, is really important because if we're not all on the same page, then our mission isn't going forward. Getting to see the background works of how our senior directors, our directors, our program managers are all working for common objectives and common goals, was really impactful. Being part of quantifying those qualitative measures was a great experience.
Steph Bayer: That's so cool. It's so true in healthcare there's such a difference of specialty, that you can get very siloed and you can get very buried in your own work and not be able to look at the whole.
Yami Gonzalez: Right.
Steph Bayer: Those objectives, those key results, that North Star that our organization uses to say this is what matters most. If we all focus on these things, the rest will follow.
I'm so pleased to hear that you saw that in our culture because we hope that's how we make decisions. That's really neat to have it reflected back.
Yami Gonzalez: It really is. I think one of the most fascinating ones that I got to see that was a real enterprise initiative, was the Plan of Care visits and how Dr. Mihaljevic has pushed that to be on all of our objective and key results.
I got to even see how the patients are responding. I followed one of our program managers, Gretchen, around. We spoke to patients and asking them if these plan of care visits are occurring.
Steph Bayer: The plan of care or when the nurse, the doctor, the patient or the patient's family engage together, in what's the plan for today.
Yami Gonzalez: Yeah. It's really important too because they discuss discharge.
Steph Bayer: Yeah.
Yami Gonzalez: Making sure everyone's on the same page and making sure that we reduce their length of stay. That's also going to lead to reduction in their medical bills. I think that was something really encouraging to see how the teams of teams really work.
Steph Bayer: That's great. I love that we didn't just say this is our goal for the organization, but we threw you out there and let you see it in action and then talk to patients. That's so cool.
Yami Gonzalez: Yeah, that was the best part. I got to speak to a lot of patients. I didn't think with the 30,000 foot view that I would, and I got to speak to patients about every week in one form or another.
Steph Bayer: We can build on that for a second. You got a chance to talk to patients and I know that we had a chance to work together a lot, which I've really enjoyed. One of the things, one of the hallmarks of our organization, one of our values is empathy.
Yami Gonzalez: Right.
Steph Bayer: When you talk to patients, when you talk to our caregivers, when you see us in action, how does empathy come into play? What have you discovered about empathy, about how the Cleveland Clinic approaches it? Is it present? What's your observation?
Yami Gonzalez: It's most definitely present. Even with people that I walk by in the elevator or we're in the elevator together, I ask them how their day has been and ask them how their care has been. All the time, I get reviews back, "Oh, everyone's so nice. Everyone here is so empathetic, everyone cares." That is seen. Even when I talk to the bedside caregivers, they too had such a gentle grace when approaching patients.
They were there, even though they are understaffed because of the current conditions, they were present. Getting to be part of also the Studies in Empathy podcast as being one of my projects, hearing other caregivers outside of this organization really pushing empathy is amazing. It gives me hope that's a culture that we're all striving for in healthcare.
Steph Bayer: I love that you see it, that it's present. You mentioned how globally we're just understaffed right now in healthcare. I think empathy is such an important thing to not lose sight of, because empathy reminds you of your why.
Yami Gonzalez: Yeah.
Steph Bayer: It can be a panacea to burnout. It can be what you can protect yourself with if you can remember the why when you have hard days, because we're all going to have hard days. I'm very happy that you saw caring in action.
Yami Gonzalez: I did. I was really excited just to speak to the caregivers too, and learning their whys and what makes them get out of bed, and come to work. That was a great part.
Steph Bayer: Now in Strategic Workforce, first of all, maybe you can tell me a little bit more about what that even is. Then did empathy come up? Did you see empathy in action?
Nela Muhameti: Yeah, of course. Strategic Workforce is a brand-new department that has been around only for one month. Or not one month, I'm sorry, one year.
Steph Bayer: One year though is definitely not long either.
Nela Muhameti: We had our one-year anniversary a few months back. And it was created, like you mentioned, for the staffing issues that are going on. There's so many challenging forces out there, we don't have enough staffing or the capacity. Strategic Workforce is there to create the capacity and capabilities, and to forecast the staffing needs of the future. Instead of reacting to a problem, we are handling it right now in the know for the future.
How I witnessed empathy is since we're still on the preliminary engagements of trying to bring this department up, I didn't get to see any face-to-face empathy but I got to go to Leadership Rounding, another experience because of this internship. Went to Leadership Rounding at Hillcrest Hospital with a few other leaders, where we went to the patient's bedside, talked to two to three patients within an hour or so.
It was great to be able to ask them, "How are you doing? How has your care been? What can we do to alleviate any of your pain?" I think empathy can be different, whether we're feeling the joy of others or the pain. The fact that the clinic, their leaders take the time and block their calendars to go and talk to these patients, just goes to show their dedication to empathize with the patient.
Steph Bayer: That's awesome. Thank you for participating in Leadership Rounds.
Nela Muhameti: Yeah.
Steph Bayer: It's such an important program where our leaders talk to our caregivers and our patients about how their days are, so we know what we can do to make things better.
I'd argue that even the existence of your department in the last year, is empathy in action because it is saying we don't want to have to react on the backs of people. We want to get ahead of it. Empathy to caregivers is so important right now.
Nela Muhameti: For sure. I've seen within my team and how they work together in trying to always think about the patient. During our day-to-day work, you might not think about the patient as much, but we always try to relate it back to the patient. If we take a certain action, how will this affect the patient at the end of the day?
I think that's so important in showing our empathy through that, as you can get lost in this big organization and about your mission, and how it aligns with your personal goals. Personally, I always try to relate it back as what does the patient want at the end of the day, and how is this going to affect them?
Steph Bayer: Yeah. We like to say patients first, caregivers always.
Nela Muhameti: Exactly.
Steph Bayer: If we can think of what patients need first and always think about how our caregivers can be supported to make that happen, it really is how we can get through it.
Nela Muhameti: For sure.
Steph Bayer: That's awesome.
Nela Muhameti: I completely resonate with that.
Steph Bayer: Yay. Now I have to say when I talk to both of you, I'm feeling my age. I'm feeling like I'm this old lady. So uncool.
Nela Muhameti: No.
Steph Bayer: I'm just giddy by your enthusiasm. This is exciting and I want to steal a little bit more of that.
Can you tell me what your hopes are for healthcare? What do you see as someone entering the field that you're hopeful about?
Nela Muhameti: Yeah. For me personally, like I mentioned earlier, I want to educate underserved communities and making them aware of the resources available for them. As an up and coming administrator or early careerist in this great field, I want to dedicate my knowledge and develop the proper training so that one day, minimizing these hardships and lessening the burden of these underrepresented communities.
Making them feel seen and bringing them in the loop, whether they speak English or they don't, removing those barriers and making it possible for them is my biggest goal within my career.
Steph Bayer: It gives me hope too. I love this.
Yami Gonzalez: I think I've seen a lot of technological improvements and that gives me hope. I see this technology being formed to help patients with these barriers. For example, the iPads, having interpreters come in through the iPad. Because we have, again, a shortage and having interpreters there in the room through a screen, is better than not having anything at all. I am really hopeful for that, for those technological advances.
But also being with these leaders every day at the clinic, has made me hopeful because I see how much they care and I see how much the patient is put at the center of their whys. I think not just for us coming into this field, but the people who have been in it for a long time, who have seen what happens during a pandemic. Seeing that they're not losing sight of not just the patients, but also the caregivers.
That they care about those at the front lines who are doing the work, and how we can support each other during these really difficult times gives me a lot of hope.
Steph Bayer: Me too. There's an old adage, never waste a crisis. We certainly have learned in the technology realm, how we can actually leverage technology, like the iPads, in good ways.
Yami Gonzalez: Yes.
Steph Bayer: That I think we may have missed, had there not been this absolute need to respond differently. I think that's a really hopeful perspective of what's been a tough time.
Yami Gonzalez: Yeah.
Steph Bayer: I will always agree with you that the ability of people to care, that humanity is always keeping me going. It's amazing.
Yami Gonzalez: I agree.
Steph Bayer: We're not perfect, no one is. What surprised you though? You thought, "Oh, a big hospital. I'm surprised a little bit by this."
Yami Gonzalez: What surprised me was how long it takes to get some things done.
Steph Bayer: Yeah, right?
Yami Gonzalez: Because there are so many different levels of an organization that you have to get through to get things approved, it deters someone sometimes where, "Oh, I want this project to be done now. I think it's going to be really impactful right now."
But you have to wait months, several weeks to hear back and get that approval. That was just really surprising to me.
Steph Bayer: It is. There's a lot of stakeholders. Especially as organizations get bigger, it's harder to be nimble. I think in COVID we learned ways to be more nimble than we ever were before, but certainly, it takes time to get things done. That is a great observation.
Nela Muhameti: For me, I would say it was more so in my line of work. My previous internships were very operations heavy. Now, I had to shift my brain to more so of a strategic end of things. That was definitely an adjustment for me. I was used to, "Here's the problem statement. You have two weeks to do it. Here are some guidelines, go ahead."
Whereas now, "We're looking at emerging technologies in the healthcare field to improve our patient care. What can we implement within the next five to 10 years or even 15 years? Go ahead. No deadlines, no nothing." To me, it was a different way to handle things. I had to find ways to narrow my scope, and within my research and just shift that mindset of in the future and not now.
Steph Bayer: That's great. I love that you have both sides of the coin too in your surprises, where in one hand it's how do we get tactics executed now?
The other hand, why we need to think about it and how we won't see it for a bit. That's fascinating, guys. Thanks for sharing that.
Nela Muhameti: Of course.
Yami Gonzalez: Of course.
Steph Bayer: I want to ask though from your perspectives, what can we all do to show more support for people like you that are just entering the field?
Yami Gonzalez: Mentorship is amazing. We have been privileged and it was a formal system, formal way of setting up mentors. That has been a real, real relief because we have that safe space that we can go to and ask those questions, that you might be nervous asking a senior director or an executive director.
We have those safe spaces for us to grow. Being patient with us, I think, is something huge. We don't know everything and we'll get back to you with the information that we need. And just having that patience for us to learn and be able to execute it in a timely manner is important.
Steph Bayer: In other words, I can show support for people?
Nela Muhameti: Yeah. I would have to agree with the mentorship. I wish there was something better than that but there's not. For me, the mentorship that I have received has structured my work and life in so many different areas. You truly feel appreciated by your mentor.
Steph Bayer: What does a mentor look like? What do they do?
Nela Muhameti: When I envision a mentor, it's someone as a director or a preceptor. Someone that is in a little bit of a higher position, has had more work experience under their belt. They've experienced the good, the bad, and everything in between, so they could offer you advice on the current state of what you're going through. For me, I always reach out to my mentor for little project things or how to deal with the politics in this fun world. Or just anything that I may be struggling with and need that advice, they're there for you.
It's such an honor to be given a mentor. I know sometimes you don't have the ability to be given a formal mentor. How I approach this is just to network as much as possible. Once you see that connection with the different leaders, you have the ability to further continue that relationship that will last into a great mentorship. For me, without my mentors in my life, I would not be where I am right now, and that's 100 percent.
Steph Bayer: That speaks to the power of mentoring and it makes me want to make sure that I'm showing up for others too, because I also had some really strong mentors that helped me early on as well.
Yami Gonzalez: Yeah. It's so important when someone pours into you and I think you can see the good side effects of it.
Steph Bayer: A great phrase, "It pours into you." I love that. Before we end, what did I not ask you? What do you want to make sure that we take away from your time at the Cleveland Clinic? Any last observations or any things that you will be taking away?
Yami Gonzalez: I think realizing the title of someone, the position of someone shouldn't make you intimidated or fearful of approaching them. I think you need to realize that these are people too and that they care. They're not their positions, they're not their title. There's people behind that position and behind that title. Taking that away, I think I feel more confident when approaching leadership about some concerns I might see safety concerns, patient concerns, and knowing that they're going to listen to me, that they're going to hear. Even though they might not be able to do something immediately, they will consider it the next time something happens, or there's an issue like that, that comes up in the future.
Nela Muhameti: Yeah. I think Yami put it in such a great way. For me, one of my most impact impactful, key takeaways from the summer have been to be comfortable with being uncomfortable. You are in this big organization where there's going to be times where you're not going to be comfortable. In order to continue your development, you have to be placed in those intense situations and that's where you grow. I've seen that when I'm placed in meetings where I don't know everything that's going on, that's how I continue my development even further.
I tend to pay more attention and my critical thinking skills are put in right away. I think it's really crucial. I know we all want to be in a nice, safe environment and not have to worry about problems or anything where it challenges us. But I think once you're challenged, that is where you're growing and learning to the best of your abilities.
Steph Bayer: Well put. You guys are wise beyond your years. This is awesome.
Nela Muhameti: Thank you.
Steph Bayer: I'll tell you, this conversation where you talked about caring and the importance of showing up and listening, those are empathetic qualities. That's what empathy is.
If you are what's coming and how our future looks, and who's going to lead us next, I feel really, really happy that empathy will be part of that too. Thank you both for joining us today. Great, great conversation.
Yami Gonzalez: Thank you, Steph.
Nela Muhameti: Thank you so much for having us.
Steph Bayer: This concludes the Studies in Empathy podcast. You can find additional podcast episodes on our website, my.clevelandclinic.org/podcast.
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