If anyone is still looking for a 2024 New Year’s resolution that does not involve dieting, exercising, saving money, or spending less time on social media, we have a suggestion… commit to improving communication with your team and hospital administration.
Leadership requires team building, effecting change, and having others implement your vision. This can be accomplished through effective communication. As former presidential speech writer James Hume once said, “The art of communication is the language of leadership.” There are many ways leaders need to communicate and one tried and true method is through a daily email.
I was first exposed to the daily email concept in 2011 and honestly, was petrified. It seemed like a lot of work and had the potential to get me in trouble for putting the wrong message out there. I also didn’t think I would have enough to say and didn’t think I’d be able to commit to anything daily, particularly on days I worked clinically.
A mentor of mine embraced the challenge (it was required by his boss who wanted to be cc’d). He split the writing responsibility with his vice chair, and together they found their voice. They also used movie quotes at the end of the email and before long, people were emailing them with their favorite quote to be included.
Both of the authors have now sent daily emails for over a decade and believe that it is not a coincidence that some of the most successful chairs with whom we have worked do the same.
Part of my motivation to start was I found there were days where I was sending out multiple emails on different topics. Changes to the admission process might get an email and a separate email would be sent out about an equipment change in the trauma bay. It just made sense to me to incorporate everything into one email.
Spending 10-15 minutes each day summarizing the activities and providing updates to the team also helped each author focus on the department priorities and activities while ensuring we knew the department metrics inside and out.
No one became an ER doc because they like reading e-mail. On the other hand, e-mail is the standard communication in the professional world to communicate to teams. As a physician professional, we are not immune from having to achieve goals and frequently need an effective way to share information to get our teams to achieve them.
Getting Started
- It may take you a few weeks to get fully comfortable with writing these, but they do get easier and will make you more efficient and your department better in the long run
- Commit to your team that you will try to send emails on a regular basis, and, in exchange, they will commit to reading an email a day from you. Although a daily email is great, it may be easier to start by writing emails Monday, Wednesday, and Friday or even a weekly email, such as a “Friday Weekly Wrap Up.” This allows you the added time and space to find your management voice. The key piece is having a regular cadence that works for your group so they know what to expect
- When your team sees you sharing particular metrics every day, they also come to appreciate their significance and will increase their focus as well
- Start off by just sending the daily email just to your clinical team, and, after you have gotten more comfortable and have worked out “reply all” and other issues, incorporate your nursing leadership team
- Next up is to add your c/suite. Consider including your CEO, CMO, and/or CNO. You can include them on one and then follow up with each of them about whether they want to be included on a regular basis
- Plan on including metrics such as a dashboard or certain graphs that are easy for you to access on a regular basis
Benefits to cc’ing your leadership team
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- You control the message and get to deliver the critical points in a politically correct way- no transporters last night, two zones closed due to nurse callouts, chemistry analyzer was down, CT readings taking 4 hours to come back, etc. These are all things that would otherwise very likely go unnoticed, and it puts some responsibility on the c-suite to address these. Of course, you also have to be very cautious not to throw your nursing team under the bus or appear to be making excuses
- You demonstrate that you are working to make their ED better every single day. Even if you are not in the hospital that day, the 15 minutes it takes to put together the email each day, sends a message
- Your administration will come to better appreciate all of the challenges we face every day
- You will be surprised how often the CEOs reply all and share their appreciation for your team, which otherwise almost never happens
- You get to showcase all of the hard work happening every single day. This is a significant differentiator from every other service in the hospital
Strategies we have found successful
- Keep a list (notes/email folder/etc.) in which you store anything that you want to include. This will make it easier when you sit down to compose it, and you’ll appreciate it on days when you are light on material
- Limit the emails to Monday through Friday and non-holidays, although a “special edition” on a weekend or holiday can have an impact
- We use a rough outline so the same kinds of things get mentioned and updated on a regular basis. It also helps with creating the content when you have a script to follow
- Insert graphics into the body of the email when possible, as opposed to relying on your reader to open attachments. Feedback over the years has been that people often don’t open the attachments (“I’ll look at that later”), but they will scan through the material if it is easily visible in the email. If you have a great ED dashboard that is important to attach, call out the most important elements in the body of your email
- Things to include in a daily email
- Patient comments from patient experience surveys
- Develop a dashboard of Key Performance Indicators that can be sent out to the group with the daily email. Refer to the dashboard so your team can improve their understanding of the metrics. Highlight both great metrics and poor metrics. Provide some explanations as to what worked or didn’t work (for example, boarding was significant and can be seen by the 50% increase in our admission length of stay above average
- Metrics that are a priority to you, your group, and your hospital administration
- New medical staff members (and cc them on that particular email—always start the email to announcing that you’re cc’ing them as well to avoid the very uncomfortable reply all that might be insulting)
- Announcements- births, birthdays, weddings, marathon completions. Photos break up the monotony, add a humanizing touch and help bond the team
- Tips and strategy reminders- how to sign up for patients, not batching calls to hospitalists, using certain order sets, getting patients out of Intake quickly so you don’t slow down the triage nurse, patient experience core behaviors,
- Great saves and interesting medical cases
- Lots and lots of public praise of your team
My format
I generally start by highlighting key points from our daily dashboard. Then I give shout outs or kudos to docs for the work they did the day before. This could include great case management, and interesting case, or staying late to help someone. Metrics are a huge part of managing an ED and while I want to keep metrics in our team’s forebrain, I know they’re much more likely to read the email if there are interesting cases being highlighted.
I love when docs text me to highlight one of their colleagues for a shout out in the email. In order to keep everyone focused on some of the quality indicators, such as STEMI and thrombolytic time for stroke, I almost always comment on every individual case and highlight the care provided by the doc and the nursing team. This is the time to include reminders with documentation tips or what order set to use, etc.
On the fun side, I do the occasional email that is just for fun, such as asking people to reply all and share their holiday card photo, their kids in their Halloween costumes, or give highlights and photos from an ED event. Though I do generally leave the C-Suite off of these.
In journalism, a draft article historically signifies the end of the article by writing “-30-“or “###.” Just like my mentor used a movie quote to end his daily email, I’ve used a “quote of the day” for over a decade to mark the end of the email. You do have to keep your HR hat on when you’re thinking about what to do if you want a non-traditional end to the email. When I worked in a Catholic hospital, it might have been appropriate to end an email with a bible verse; after all, we started every meeting with a prayer.
However, that would not be appropriate in most nondenominational hospitals. I go to the same website designed for the workplace every day to use their quote of the day. This gives me tremendous diversity in who I’m quoting. Before I found this website, most of my quotes came from Jimmy Buffett, former presidents, some athletes I liked, or celebrities my kids told me to quote, so I think the change was a big improvement. Having a “fun ending” will also keep people reading until the end. On days when I forget to add in the quote, I definitely get a few responses asking me what happened.
Conclusion
Daily emails are a great way to communicate with your group and share information with your nursing hospital leadership team. Part of our job as leaders is to get everyone working towards common goals and this is one tool that can facilitate that. It can be intimidating to start this process, but once you get going, I’m sure you’ll see the benefits.
Photo Credit: cottonbro studio
