Volunteers: Partners in Care

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, and I'm very pleased to have Alicia Pitre with me today. Alicia, welcome to Studies in Empathy.

Alicia Pitre: Thank you.

Steph Bayer: Alicia's, the Director of Volunteer Services here at the Cleveland Clinic. We're excited to have you here and to learn more, so ready to jump in?

Alicia Pitre: Yeah, absolutely. Let's go.

Steph Bayer: Well, let's start with the easy one. How long have you been at the clinic?

Alicia Pitre: I am coming up on my 10th year of working for Cleveland Clinic.

Steph Bayer: Oh my gosh. Talk us through your journey. Have you always been with volunteers?

Alicia Pitre: I haven't, but I have always built volunteer service into my professional career. So I started at the Stephanie Tubbs Jones Health Center, which is one of our health centers here on the east side of Cleveland. It's in a lower socioeconomic status community, and so my job there was to be a patient navigator and in that role, I was to help remove barriers to healthcare. So find out why people were not coming to the hospital and help them to overcome that.

Steph Bayer: That's so important.

Alicia Pitre: It really is, and I think that sometimes we guess what people want, but we never really go and ask. So in my role, I went out to libraries, I went to town halls all over the community and just asked people, "What's keeping you from coming to get care?" And overwhelmingly the answer was, "I have more important things to do." You look at Maslow's hierarchy of needs and you have those physical needs at the bottom. So we need to make sure that we are attending to people's food, clothing, their safety, before they can move up that and start thinking about their healthcare. So I heard from a lot of people that they were busy trying to find food and I said, "Well, how can we overcome that?" And I started a food pantry at the Stephanie Tubbs Jones Health Center. I actually had a patient tell me once they weren't taking their medication because he didn't have food at home and the medication said, "Take with food," and such an easy solution to be able to provide food to people.

Steph Bayer: How did you start a food pantry though? That sounds like a daunting task to me.

Alicia Pitre: At first it is, but I had great partners over at the Greater Cleveland Food Bank. They have a great program. It's called the Mobile Food Pantry. You sign up and you provide the volunteers and the space and they will drop off 12,000 pounds of fresh produce. And so this isn't the shelf stable type foods that are full of preservatives and can sometimes make the problem a little worse. This is fresh foods and we see that in communities when they have easy access to fresh fruits and vegetables, we see a lot of those healthcare issues declining like diabetes and high blood pressure, obesity.

So in addition to giving people what they wanted, we were also looking at it as food as medicine. So we're giving them the food that they needed every month for totally for free. And then I also built in some navigation into that as well. So I'd ask people while they were on site, "What else do you need help with? Can I help you get a primary care doctor? Do you need any tests done? Do you need help filling out a resume so you can get work or so that you can do childcare?" So I was able to build it into the whole role and go full circle and use the time in between the pantries in order to address those needs that people had.

Steph Bayer: That's so amazing. And because I know you and I had an opportunity a few years ago when you were out doing that to join you, I have to say I was so impressed at the number of people that you were getting to attend. When did you start this and how many people would join on a given pantry day?

Alicia Pitre: Sure. So I think that we started it seven years ago. It's still going strong there. Even though I have left the role, they've continued to carry the torch. We needed about 20 to 30 volunteers every month, and this was on a Saturday morning that people were coming out and helping us to distribute food and we easily got those 30. We'd often have to tell people, "I'm sorry, we have enough," because sometimes too many hands makes it a little more complicated. But we had many of our volunteers that would come month after month and they just became basically the trainers and they were fantastic, and we served about 300 families every month as well in handing out this produce.

Steph Bayer: That's amazing. And I know that story's a model now for other areas for us in the Cleveland Clinic as we're trying to create a more robust food is medicine program.

Alicia Pitre: Absolutely. We took that food pantry model and we actually created an emergency pantry within the health system. That way, when a patient was telling a doctor or a nurse or a social worker that they didn't have food, we were able to immediately go to our pantry, get them a bag of food and then connect them with some community resources so they had some ongoing support. I know other hospitals have looked at the model along with the Greater Cleveland Food Bank and they are also utilizing this and being able to reach their community in ways that we didn't before.

Steph Bayer: So volunteering is just in your DNA. It's who you are.

Alicia Pitre: It really is. I was raised a Girl Scout. I was active in my church growing up and it's just always been part of me. I was a young mother and I have received a lot of help when I was young from my community and from my family. I feel like now that I have the ability to give back, that that's my calling.

Steph Bayer: I love it. When you were done with patient navigation, and that's where your volunteering really honed those great skills, you actually joined us in patient experience. Am I right? That was next?

Alicia Pitre: Absolutely. I moved on. I worked in the ombudsman office for a few years. For those who aren't familiar with an ombudsman office, we act sometimes as a patient advocate, sometimes a caregiver advocate. We are the liaison between the patient and the hospital when they have concerns regarding care or they just need help. It was really the perfect transition from navigator to ombudsman. So a lot of times, I found it was just education that was needed, that trying to provide the empathetic listening skills, finding out what they needed and helping them to get to that.

Steph Bayer: So taking your patient experience background, your patient navigation and touchpoints with patients and your volunteering background, you seem to be a natural fit for Volunteer Services.

Alicia Pitre: When I saw the posting, I really did a little happy dance and I said, "This job was made for me." It brings that professional abilities that I've had in the past, the empathy as well is my passion for volunteering, all together and now I'm able to help other people get connected to the system to volunteer and give back in areas that they're interested in.

Steph Bayer: So I have you doing a happy dance in springtime when you came into this role. What surprised you though? What would stop your dancing now? Anything?

Alicia Pitre: I don't think anything would stop my dancing.

Steph Bayer: Good.

Alicia Pitre: I have seen it can be a little difficult with the bureaucracy to get into volunteering at the Cleveland Clinic, so I've been working to try to make that a little bit easier for people, both our volunteers and our volunteer coordinators. But I think what surprised me most was really how robust the program is. We have the volunteers that you normally think of that are helping on nursing units, but a lot of people think of volunteers as like, "Oh, they're making coffee. They're giving blankets." Our volunteers do a lot here at the Cleveland Clinic.

Steph Bayer: That's a great point. Let's transition there because I think initially, when I heard Volunteer Services as a part of patient experience, I immediately go to the candy striper role. Remember the old candy stripers?

Alicia Pitre: Yeah.

Steph Bayer: But it's much more robust. Can you talk about what types of roles in little more detail that their volunteers are doing right now?

Alicia Pitre: Sure. So as I mentioned, our volunteer services, they work on nursing units. They provide that comforting support and care to our patients while they're admitted to the hospital. They can help with some lower level activities that are non-clinical things to help our nurses. But even in that role, they go beyond just providing those comfort items. They help with education. So they try to engage the patient and get them to talk to their nurses, talk to their doctors. We have a great thing called Plan of Care visits here at Cleveland Clinic where our team's round every day on our patients and our volunteers encourage the patients to participate in that.

Steph Bayer: That's such an important part and I want to just flesh this out a little bit. So a Plan of Care visit at the Cleveland Clinic, it's when the doctor, the nurse and the patient, it's like a three-legged stool, all have a part to play, have a conversation each day about the patient's plan for that day. This is your plan of care for today.

Alicia Pitre: Yes. And a lot of our patients, especially older patients, feel like they're just being talked to and they're just there to nod and say, "Okay," so our role is really to encourage them to speak up. "Tell us what's important to you," and I know your team has been working on trying to get our caregivers as well to ask the patient, "What's most important to you today?"

Steph Bayer: Absolutely. And I don't know if you've seen in the latest data, but I did see some early data this month that we have volunteers currently that are working in this role in both neurology and our heart and vascular areas and in the areas that they're working to encourage patients to speak up, we've seen our helpfulness, we ask patients, "Was this a helpful endeavor for you?", our helpfulness and our likelihood to recommend go up by up to eight percentage points.

Alicia Pitre: Wow.

Steph Bayer: Right?

Alicia Pitre: That is incredible. I'll have to share that with those volunteers. They'll be so impressed.

Steph Bayer: This is a really effective program that's changing healthcare because we want our patients to be participants in our plans, so that's great.

Alicia Pitre: Yeah. So in addition to being on the nursing floors, we have volunteers that are helping with some of our operational type activities too. They help with restocking shelves through supply chain and our surgical services areas. They are greeting patients along with our awesome red coats here at the Cleveland Clinic, been helping with some wayfinding.

Steph Bayer: What about canines?

Alicia Pitre: So our four-legged volunteers, they help out to really just spread some happiness. How can you not look at a dog, pet a dog and not smile and maybe forget about what burden you're carrying for a few minutes? They're just one of my most favorite volunteers.

Steph Bayer: Oh, I love the four-legged volunteers. What about training though? We're coming out of a pandemic. We know infection prevention is important. We know healthcare in general has a lot of training. What kind of special training do our volunteers complete to help us out? What qualities and skills do they need to have?

Alicia Pitre: Sure. So first I want to start out by saying there's no special training needed to apply. We have really something for everyone here at the Cleveland Clinic. If you're looking to volunteer, either a patient facing role, a behind-the-scenes role, anything. So please don't let having some sort of special skills dissuade you from applying.

Steph Bayer: No special training needed. Got it.

Alicia Pitre: Right. So after people do apply, we make sure that you do have the skills that are needed in order to do the role that you're assigned to. We have a volunteer orientation that'll talk about just being in a hospital and how we keep you safe and keep our patients safe both physically and informationally too. Then we'll do some role specific training where you'll do orientation with your work leader in your area, and sometimes we even do some one-on-one mentorship.

Steph Bayer: That's great. As you mentioned, volunteers are actually interacting directly with our patients in many cases. Can we talk about things that you've noticed are valuable to our patient when volunteers help them?

Alicia Pitre: Absolutely. So I think the value is they're just constantly improving the patient experience. They provide just a listening ear. Our volunteers have the gift of time that they don't have to get to the next patient to pass pills. As much time as they need to spend with a patient, that's how much time they spend with them. I tell people, "If you come in and you're in your role and you only see two patients for an hour and a half, they must have got a really great visit from you," and I think this really helps to build empathy for our patients and our caregivers and our volunteers. So volunteering, sometimes you're exposed to people, places, things that you may not have experienced in just your regular bubble. I think it's really important to mention that our caregivers need empathy as well.

Steph Bayer: Absolutely.

Alicia Pitre: They're just so busy. For the past couple of years, I think we've really shined a light on what caregivers are doing here in the hospital, and it's not just doctors and nurses. Doctors and nurses do a lot, but all the support staff too, and our volunteers get an opportunity to see how many people it takes to care for one patient. I think that that's so important and they can take that to their community and help to be our advocates. But just talking to somebody who's in the hospital and walked a different path than them, it will help to expose that volunteer to a different perspective and allow them to maybe put themselves in their shoes and be thankful for what they have, but also more willing to help and it makes the conversations a little easier the next time.

Steph Bayer: That's a great perspective to add to this, that it does allow you to see things differently and to be the community voice and help. And I love that our volunteers do all of those things every day. So we talked about patients. With our caregivers, you hit on it a little bit that our volunteers can give a little bit of the burden that our caregivers are caring and take some of that load and support them. I'm also hoping though, that we can talk a little bit about some of our special volunteers that are healthcare partners. Can you tell me how they help our caregivers and what that healthcare partnership program is?

Alicia Pitre: Sure. Our healthcare partners are a special volunteer. So they are volunteers who are also patients of the Cleveland Clinic, or they could be the community that cares for that patient, a spouse, a family, a friend, a church member that comes to their appointments with them. And they help with our design and our delivery of care. So we go to these healthcare partners and say, "Hey, we have this great idea on how we can improve patient care, how we can make access easier, how we can build a nicer building. What do you guys think about that?" And I can tell you they're opinionated and it's just great. They have helped us in so many ways. Even during the pandemic, they helped to advise us on some of the communications that we were putting out in regard to how we're trying to make the hospital safe, some of the precautions regarding visitation. They really walked this path with us in a way that we weren't ready to experience and they weren't either. So we were able to do it together and make sure that we had the patient included in all of these decisions.

Steph Bayer: I think those are really important volunteers as all our volunteers are. But I think it's a really unique opportunity here where you're co-designing, you're co-creating along with our teams. You're not sitting in a committee room, separate, but we're asking you to walk with us and to see things. And a great example you gave me actually was our new neurology building. Do you recall?

Alicia Pitre: Yes.

Steph Bayer: Go ahead.

Alicia Pitre: Oh my gosh. So first I just have to set the stage. So we have these healthcare partners and they told us that we're going to do a walkthrough of the new neurology building.

Steph Bayer: A construction site, basically.

Alicia Pitre: Right. It's being torn down, the old building, right now as we speak, and it's just a nice kind of sandbox. So I wasn't sure what to expect. I walk into this room and it is the greatest fort that I have ever seen made out of cardboard boxes. These architects are just incredible. So they did a full mock-up of what different ICU rooms would look like, what the exam rooms would look like, where the buttons would be, where the TV was, where the caregiver would sit, where the patient would sit. And as we were looking at one of the exam rooms, one of the healthcare partners spoke up and had said, "Could you show me one more time. Where's the patient and where is the caregiver in this scenario?"

And they had shown him, and the way that the layout was is they had the caregiver close to the window, then the patient and then the door and the healthcare partner had said, "This just won't do. We need to think about safety for our caregivers, and what happens if this patient were to become unruly or aggressive towards our caregiver. They're stuck in the room. You need to make sure that when you're designing a room, you have the caregiver in mind too and make sure that the patient is never between the caregiver and the door." And I was just blown away. We asked them for opinions as patients and what we can do for them, but there's that empathy right there that they're thinking about us too.

Steph Bayer: Yeah, it's amazing. And we welcome all of our different institutes and our different hospitals to reach out, and if they don't already have healthcare partners, to connect and we can get them folks that will help co-create and stand with them. And it's amazing. It's not just for patients, but also for our caregivers. I love this group.

Alicia Pitre: Yeah, absolutely. And we just created a special focus team too. So if you just have a couple questions that you want to ask, we have a healthcare partner group that can help you with that.

Steph Bayer: Perfect. I love stories and you just gave me a great story, so I want more. Can you tell me a volunteer story that captures the value volunteers bring to healthcare?

Alicia Pitre: Absolutely. So this is just one of many. One of our volunteers was rounding on the nursing floor and they always stop at the nursing station to find out, "Who's a new admission?" "Who might need some extra attention?" "Is there anybody that maybe I should avoid?" And they had said, "Well, the patient in the room over there has been here for a little while. He's pretty upset about everything. I don't know that you really want to visit him." He said, "Actually, I think I will." So he went to them first and was talking to the gentleman, and from talking to him, he said, "Yes." He was absolutely an angry person. He had a lot of anger in him, and he said, "Tell me about what's going on?" And after talking to him, it was like the onion where you just start to peel layer by layer. So first he just is telling him, "I'm a young man. I have a life altering diagnosis. I'm mad." And that's out of his control.

Steph Bayer: Sure.

Alicia Pitre: And then from there he said, "I understand. I actually am a patient here at Cleveland Clinic too, and I was in that bed just two doors down when I had my life-changing diagnosis. I understand how you're feeling." And he said, "Tell me a little bit more. Why are you so mad? What can we talk about?" And so he started talking about all the things that were out of his control. He can't sleep when he wants to when he's in the hospital. Everybody comes in and they want to know about his bowel movements. They want to get more blood. They're poking. They're prodding. He's sleep deprived. He's not eating the food that he wants. They want him to change his diet. Everything is out of his control, and that's really the heart of why the patient's upset.

And he said, "Hey, let's talk about what do you have control over today?" And the patient said, "You know what I'd really love? Is a shower." And he's like, "I've been cleaning up here in bed with washcloths." He's like, "But I think I would feel like a totally different person if I could just have a shower." And the volunteer said, "You know, that sounds easy enough, but let me talk to your nurse and your doctors and see if that's something we can do." He goes back to the nurse's station and he finds the nurse manager standing there. And she said, "So how did it go in there?" And he said, "Actually, it was incredible. Let me give you a little debrief on what we talked about."

He's like, "But is it possible that he could take a shower today?" And she's like, "Yeah, we could do that." And so within an hour, the gentleman was in the shower, cleaned up, back in bed and actually apologizing to some of our caregivers saying, "I acknowledge I'm not bringing my best self here today, and thank you for still putting up with me and providing care and for the shower and for listening." And a total 180 in just his attitude, and he was really just a pleasant patient going forward. It just needed that time that a volunteer could give.

Steph Bayer: What a beautiful story. And that's the power that our volunteers bring. And in a time in healthcare where unfortunately, and the Cleveland Clinic's not unique, everyone is feeling the same stresses, we're just so busy. There are so many people that need to be cared for and about. It's wonderful when we can ask friends to help us care about people, and what a great way to do that. So for those listening that have not yet volunteered, what would you say to encourage them to offer their time to serving others?

Alicia Pitre: I say, "Just do it."

Steph Bayer: Just do it.

Alicia Pitre: Just do it. We're at the time of resolutions right now. Maybe you made a resolution that you want to get more steps in this year. We have a volunteer role for you. You can help with way finding here at the hospital. Maybe you wanted to make some new friends. We can put you on a nursing unit and you can start talking to tons of people every day, or maybe you just wanted to get out of the house a little bit. We have roles for you. And if not here at the hospital, look to your community. What inspires you? Did you receive help from somebody in your past or are there things that you're passionate about? Look for the opportunities and do it today, because we always put things off until tomorrow and we always say, "Tomorrow never comes."

Steph Bayer: So you're right. It's January. We need to just do it. If they wanted to volunteer at the Cleveland Clinic, what's the best way to take that first step?

Alicia Pitre: First step is you want to fill out our volunteer application. So just go to clevelandclinic.org\volunteer and we'll be able to get you started from there. Follow the links that'll say, "Apply now," and fill out that application and one of our coordinators will get in touch with you to talk about what might be the best fit.

Steph Bayer: Love it. What did I not ask you about today that you were hoping we would have time to talk about?

Alicia Pitre: Gosh, Steph, there's just so many things about volunteering that I love. I want to actually ask you.

Steph Bayer: Uh-oh.

Alicia Pitre: Where have you volunteered the last couple of years?

Steph Bayer: I love that. Thanks for asking that. Volunteering is core to me too. It's part of how I make my way in the world, and I will own that COVID has slowed it down a bit.

Alicia Pitre: Sure.

Steph Bayer: In getting to do things in person. But I'm back, so I volunteer. There's a West Side Catholic Center near my home that does dinners, so I've volunteered there. I've done the pantry with you at Stephanie Tubbs Jones, which I love, and then my biggest one that I love to do is the Stand Down to Homelessness in January. So it's January. They do this downtown and it's where we provide all kinds of services, from clothes to medical to food. It's a one-stop shop for our unhoused community.

Alicia Pitre: Yeah, I've heard about that event.

Steph Bayer: It's a great event.

Alicia Pitre: Incredible.

Steph Bayer: Yeah. Thanks for asking that.

Alicia Pitre: Thanks for volunteering.

Steph Bayer: This concludes the Studies in Empathy podcast. You can find additional podcast episodes on our website, my.clevelandclinic.org/podcasts. Subscribe to the Studies in Empathy podcast on iTunes, Google Play, SoundCloud, Stitcher, or wherever you get your podcast. Thank you for listening. Join us again soon.