Taking Healthcare by Storm: Industry Insights with Richie Redding

In this episode of Taking Healthcare by Storm, Quality Insights Medical Director Dr. Jean Storm speaks with Richie Redding, a performing comedian, keynote speaker, leadership consultant, and healthcare communication expert. 

Richie explains how outstanding nurse and physician communication during the COVID-19 ventilator crisis involving his in-laws inspired his work teaching evidence-based listening and levity to build trust under pressure. He describes how active listening improves outcomes and patient satisfaction while reducing errors, and he addresses burnout and nursing culture by urging leadership frameworks and communication training starting in medical education.

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website.

The views and opinions expressed by the host and guests are their own and do not necessarily reflect the views, positions, or policies of Quality Insights. Publication number QI-071026-GK

Transcript

Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

 Hi, everyone. Welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the medical director here at Quality Insights. And we all know that healthcare is built on science, skill, and technology, but at its core, obviously it's human. It's a human endeavor. And humanity is under strain in healthcare. I'm gonna say I've experienced it. I've seen many of my colleagues experience it and continue to experience it. Burnout is rising. Nurses continue to leave the profession. Patients, as a patient myself, I know patients don't often feel heard. And in the middle of all of that, communication can either be the problem or it can be the solution The individual I'm talking to today believes one powerful overlooked tool can radically change how healthcare teams connect with patients and with each other, and that tool is levity. Our guest is Richie Reading, a performing comedian, keynote speaker, leadership consultant, and healthcare communication expert. He has over 20 years of stage experience and specialized training in healthcare communication. Richie works with nurses, physicians, and leaders across the country to help them rediscover what happens when work becomes human again, because obviously we're all human. Richie's mission is personal. During the COVID pandemic, both of his in-laws were on ventilators at the same time. That experience reshaped his work and sparked his focus on equipping healthcare workers with practical, evidence-based communication tools that actually work under pressure, because when the rubber meets the road, that's when things need to work. And the results speak for themselves: improved patient communication, improved patient satisfaction, higher nurse engagement, and cultures that move from burnout and isolation to trust and connection. So we're gonna be talking about why active listening is one of the most powerful clinical skills, how levity can improve communication even when in the hardest moments, why nurses eat their young, and I'm gonna say physicians- similar, and what Richie would change first if he were in charge of healthcare in the United States. Richie, I'm really excited to jump into this conversation. Thank you for joining me today. Thank you so much. I feel very researched by that, that intro. That's impressive- Yes ... doctor. Yeah, I know how to do my research, indeed. Yes. So y- as I said in the intro, you have found a deep calling in healthcare communication, especially as what I mentioned, what your family went through during the pandemic. So- Absolutely ... can you explain that moment and how phenomenal communication changed the course of your family's story, and then ultimately- Absolutely Yeah my, both of, my, my then girlfriend, now wife's parents were put on the ventilator at the very beginning of the pandemic. It was like March 15th. And they, her dad was one of the first people put on the ventilator in Florida, which actually in West Palm Beach, which became the epicenter of it at one point. But we just kind of luck of the draw of where they were. We wound up with incredible communication from both the nurses and doctors. So my wife is a veterinarian, so h- she has obviously a great understanding of what was happening medically. So she was able to communicate, but also she just received so much communication. And they all went above and beyond, and she was able to advocate, but als- also connect with them as people. They were really empathetic, and it was, there was things such as I'm treating him as if he's my own family. Like I can only imagine how hard this is. Just know that we're all treating him the same way we would treat our own parents." And the flip side of that was that- We had other friends who their parents basically just got put into a black box and never came out, and the nurses that were in communication with us, a- and the doctors to a lesser extent just because there's so much more contact with nurses but Lisa is still in touch with some of them six years later. One of them did actually unfortunately leave the profession as well. But I just realized... I'll back up a little bit, that I had started a business during the pandemic, and at first it was helping brands to connect with marketing, and then eventually people started coming back and saying, "Can you teach us how to be funny?" And you know, first of all, it was a very dark time professionally for every comedian, right? My entire year got destroyed. I didn't know if I was ever gonna be on stage again. And when people started coming back and saying, "Can you help us be funny?" It kinda made me wanna jump out the window at the idea of teaching stand-up to suits. but I, I started a leadership program which was all about vulnerability and, like, how to be... h- how to use humor to build trust. And in the course of doing that, I wound up with Tanner Health. Their CEO and COO was, like, all about the program, and we did a ton of work with them to really improve the non-patient-facing part of it. And in that time they were pumped about and w- and wanted to find more ways to work together. And a, just very strangely a family friend had published a research book a- about... He's a research PhD that focuses in medical communication. And he found that the single biggest factor in positive health outcomes is when people trust their nurse, and the- Key indicator of a five-star hospital review is how people answer the question, "Did your nurse listen to you carefully?" And furthermore from that, that it's a the difference between a five-star hospital and a four-star hospital or A tier, B tier, depending on the state, is 10% of Medicare/Medicaid funding, and the average hospital gets $220 million in funding. So I kind of went back to the good folks at Tanner w- with this information in hand, and it was like, "Do you do anything? Does any of your training include building trust through listening and demonstrating listening?" And they were kind of like, "I mean, we do communication stuff, but not that in particular." Like, never heard of it. So it was like, all right. So I basically set out to build... Like, what I did was reverse engineered a five-star review and in the process of doing that, I obviously learned a whole bunch about nurses because I was very much a blank slate. and just found yeah, like I, I was basically able to approach it as what are the sticky points and what are the different ways in which you interact with patients, right? From the first interaction to, ongoing interactions, and then family interactions, and all these different ways and that they that they interact with them. Instead of just creating... So there's a ton of improv for business, improv for medicine stuff, and they are 100% the same, right? It's ju- they're just teaching yes, and they're just playing games that... A- and they're effective, but they're not really pointed. So by, coming in dumb and not knowing anything about it and like really just... I talked to every nurse and every doctor that would, that was willing to talk to me. So I was able to create programming that specifically practices real-life interactions in a way to show patients that you're listening to them and the goal is just to build inside jokes. Awesome. I feel like, I feel like I just talked for a really long time. No, you're good. And I, I think that's what you need. Like, People... I know, and I use a lot of case studies based in real life when I teach when I speak at conferences. You and I spoke at the same conference recently. Yeah. They used a lot of case reviews, so I think that's important. and you're, you talk about active listening. You talked a lot- about active listening that it's an underrated clinical skill in healthcare and, and I would agree. But why is being heard so powerful for patients and why does it change outcomes not just emotionally, but clinically and financially for hospitals- and health systems? Yeah, so that's a really good question. So the way that it changes- Outcomes is because people generally want to be good patients, we can assume, right? And when they feel-- when they, when there's trust and when they feel heard, they're willing to ask questions, right? So when patients ask questions of their nurse because they know they're not just gonna get bowled over, then they have fewer medication errors, fewer preventable readmissions, and lower recidivism. All because and it's it's just basically creating that comfortable environment where if they don't understand something, they're gonna raise their hand, right? it's also interesting when you really look at, At least for HCAHPS and I know it's the same for HHCAHPS for home health, all of the questions are around how you make somebody feel, right? When it pertains to the physician and the nurse. There's not a single question that I've ever seen you know, and I've, I've looked it over plenty, there's not a single question that's, "Did they give you the right diagnosis? Did they give you the right medicine? Did you get better?" It's, "Did they treat you gently? Did they treat you with respect? Did they listen to you carefully? And did they explain things in a way that you understand?" So you kinda have treating gently is, of course, about human touch, I would think. But but the other three of treating with respect, listening carefully and explaining things in a way that you unders- understand, that comes down to active listening, right? And the programming that I do is You've probably heard "yes, and," right? We've all kind of hear- If you know anything about improv it's all "yes, and." But what I try to focus on and train is, "Yes, repeat, and," so that we're showing people that we heard what they said. And a- and then, and down to little things. And so it's like the goal is not to make somebody laugh. And I think when the more serious people in very important roles hear the idea of levity in healthcare the pushback is, " "Well, what we do is really serious." Yes, absolutely. But the goal isn't to make somebody laugh. The goal is to make them comfortable enough that they're joking around with you. And then you never need to take any kind of risks whatsoever in terms of trying to make somebody laugh. All you're really doing is reflecting their humor back to them, right? And then you wind up in mirroring situations that are what cause human or, create a feeling of human connection. And it's really interesting that I run these, drills with thousands of people at this point. And the progression as we go through the different drills is at first people at first I get them to, to not listen to each other at all. And it's so uncomfortable talking over and being talked over that you wind up looking away. But then when you start cooperating with a yes, and you start nodding as the other person's talking, right? And they're both nodding at each other. And then when I add a small element of fun there's nodding and smiling. And what you start to see is people's actual body language changes and that mirroring happens, right? And then when you add a little bit of silliness and repeating things, then 100% of the time it goes from just nodding and smiling and mirroring to nod, smile, mirror, laugh, right? So like, it is a trainable thing. And there's, like a thing that I think we kind of need to dispel is that likability is something you either have or you don't. It's actually a skill that can be developed. I really, I think that's interesting. And I don't think people, many people understand that, so I'm glad you said that. Yeah. Yeah. I wanna switch a little bit and talk about burnout s- from someone who, did get burned out during the pandemic. It, I personally think it's unresolved. It's, oh, it's talked about still. So you work closely with nurses and physicians. What do you think people outside of healthcare don't understand about the emotional burden clinicians are carrying? And what actually, what are f- what are the fixes? You know, I, we hear a lot of like self-care platitudes, which I personally don't think work, but what is the fix? Ice plunge. No Come on now. Sorry. I'm, I'm calling in from Austin, Texas. No, I, so yeah, it is a very good question, and it's... I'll back it up a little bit so that the- when I started doing research beyond just the books that I was reading. So the books come down to the three biggest reasons that nurses are leaving the profession, and in particular, and I know your audience is wider than just nurses. but the thing that really set me on this was the fact that in a seven-year period, there's 900,000 nurses that are leaving the profession, and that's 20% of all of the existing ones, and the schools can't keep up to, to replenish that stock. So and the three reasons that it boils down to are blame, bullying, and burnout. And I think that There's a, there, there's a, just plain old caseload is obviously huge, right? and that's w- you would at a glance think that it's really just that, right? It's just the caseload, the amount of, of work that they have, the nature of the work itself. But the thing that in a lot of the work that I've been doing and just talking to people, it's the blame and bullying has a huge emotional toll. to back it up even more, like I said, my, my wife is a veterinarian, and they have This is very dark, but it, varies from year to year that it's either dentists or veterinarians have the highest suicide rating of any profession. And for vets, what I see the burnout being is a combination of a crazy caseload, right? There's always, they'll always add another appointment, and they're trying to get them to go from, when they started out a clinic it's, it's 25-minute appointments, then it's 20-minute appointments, then it's 15-minute appointments, and then it's just double book it, right? So they're, like, trying to get an impossible caseload out of every single hour. But on top of that, they get abused by owners because they have... They're really distrusted, right? the mechanics of the medical community because people think they're trying to rip them off all the time. And then they feel not supported by ownership and management. And that combination of things that's where there's this really weird triangle of all three happening at the same time. So to, get back to the question that y- that you asked, and it is a great question the burnout piece I think- comes back to the same thing that we're talking about with the patient experience, right? That what's missing is the humanity. So the best medical systems that, that I've worked with are all doing something around blame. But the... There's just work and, all these different ways of like trying to assess where there is a systemic break- breakdown instead of a personal one, and sometimes it is somebody's fault, right? A person didn't follow the procedure. But The thing that's, trickier is bullying, and I think that very few people probably think that they're bullies. And again to bring it back to the vet world, I know that it's like when a veterinarian snaps at a baby vet and eviscerates them they were just letting them know, right? I wasn't being a bully. I was just letting you know. And it- it's a compounded problem because you have Very Type A personalities, right? So in vet school, in med school, in, in nursing school, whatever it is, you spend basically 20 years competing with your, w- with your colleagues, right? and it's as cutthroat of an educational system as possible so that the person that knows the most is the one that's gonna shine. So you go from cutting each other's heads off to be the smartest one to suddenly you're working on a team. And a lot of time there's zero leadership training given to somebody. And like nurses in particular, the thing I hear from all the time is like, "Yeah, they made me a nurse supervisor because I'm a good nurse. I don't know anything about leadership or supervision." and then the compounding part of it is that you have Gen Z coming into the workforce, very smart kids, and it's the first generation where basically being offended is a personality. So you have this multiplying factor of you have people that were never taught how to lead, or they were just always in this cutthroat s- leadership position that you have to snap at people or you have to chop somebody down in order to, in order to get ahead with an increasingly sensitive workforce, that also those people are the most likely to leave, right? Between one and two years is where people leave. That's where baby nurses disappear in particular. I don't know what the stats are with physicians. But, so the answer to that, I think, and I'm getting some results around this, is to have a framework to help Everyone, not just leaders, but it definitely really helps for it to be a top-down thing, is a framework to teach a lesson in a way that makes the person feel like they just connected with the person that taught them that lesson instead of they just got destroyed by them and for me, the way to teach a lesson is to do it from the standpoint of somebody that learned a lesson. That makes total sense. Yeah. And there... I have a whole framework around that, that basically like, we practice giving somebody, like correcting somebody in an empathetic way. And it's actually from... and there's quite a few other things that I use that are pulled from sales language and training. Nice. I feel like- Yeah ... You gotta get solutions from unlikely sources, yeah. Yeah. Like a comedian or something. Yeah. Yeah. But- speaking of comedians, like we- we've gotta talk about levity. and most people think it means you're making a joke, or you're not being serious. But- h- how do you explain it as a strategic communication to- tool that, that actually builds trust, and clarity, and safety in a healthcare environment? Yeah, that's a good question. So the working definition that I use for levity is treating a serious subject with humor. So it's not treating it unseriously. It's just holding ourselves lighter in the way that we approach things, right? So it's like, I have no misgivings that somebody's gonna take s- do some levity training and it's gonna be all, all yucks at the hospital or the nursing home or whatever their environment. But by- carrying ourselves lighter as a person and not just this absolute perfect professional, then we become more approachable, right? And again, it's about building trust. And the- a thing happened, actually it was very funny, at that Padana conference that we both spoke at. I put up on this... There's a slide of the top seven or, yeah, the top eight medical mistakes, right? The top eight most common medical mistakes. And in a room full of, of leaders, and there's, there's phy- physicians and nurse leaders in there as well ask everybody who's made one of these mistakes, who's made two all the way up to all eight. And the person that's made all eight of them always winds up laughing their ass off and holding their hand up the whole time. And it's like, And what do you do? What's your, what's your role?" And it's always as high up as you can possibly get in the organization, right? Because it's that person's been there 30 years or something. Yeah. And and this one, I don't think I've ever done it this way before, but I said, "Has anybody not made any of these mistakes?" And this girl raises her hand, and she had like a pretty snarky look on her face. I was like, "You haven't made a single mistake ever?" She goes, "No." I was like, "How do you achieve such perfection?" She goes, "Follow the rules." And Like, I've never seen somebody lose 200 people so quickly. It was just like an entire room turned on her, but then it also t- it turned out that she was, like, two years in. Oh, yeah. so like there's, there, there's some... A- and I might have gotten off track from what the original question was, but when we carry ourselves lighter, and as you can strive to be as close to perfect as possible as a professional, but still maintain your humanity and maintain a lightheartedness about yourself, right? And there's actually been a bunch of studies that show that people bet against perfection, right? So one of the studies was London School of Economics did a did a s- a project where a speaker would go in front of a, i- in front of a classroom, and on, on the way in, knock something over or trip over a cord. Every single time a speaker did that, the class liked him more or her more than when a blind group on the other side, they did the same thing. They didn't like them as much, right? And it's because people see some sort of, of little imperfection as, a- as humanity, and they start to connect with it. They... It's Oh, man, I would've done that," right? And then there's also, there's increasing research as well that people want to know something about the person that's taking care of them, and that there's been studies where when treated by a stranger that's a a physician for the first time when knowing only what they read in their bio, if the bio includes something about their personal life, being their family or their hobbies, they get a 20% increase in their empathy scores. Yeah. That professional wall that's been trained in is, I think building a bigger disconnect with the patient. I mean, That makes s- sense. Yeah. But yeah. I wanted to touch on that stat that I said about ... I mentioned that that eat their young, nurses eat their young, and you- in your website, you said 78% of nurses agree with that phrase. Yeah. Which is crazy. It's crazy. So why do you think this culture still exists, and w- what can leadership do, or other, other people what, what can they do to stop the cycle rather than just saying, "Oh, nurses eat their young"? Yeah. It's a complex problem obviously, but I think the things that we underlined before around blame, bullying, and burnout are ... The blame and bullying piece is something that r- really has to be addressed, and it has to start at the top, and there has to be a framework for y- you know, how we're a- approaching mistakes. But also, it's like there's a carrot and a stick, right? And a big part of what I do when I'm working d- directly with leadership is it's very Socratic, and I basically put to them what you're saying, right? But my thing is, and the thing I'm kind of obsessed with, and I'm, I'm actually working with some Wharton professors right now around this subject, is the idea of gamifying change, and there's a right way and a wrong way to, to gamify something. And if it feels like the biggest scold in HR made a game it's always going to read as such. But, There's there's things such as keeping streaks, like of of positive interactions, keeping... There's shout-outs there's little rewards that we can give to create team spirit that really make a difference. And a perfect example of that is one of the guy who was the COO at Tanner that brought me in, he had a team follow him from California to Georgia, and then from Georgia to Virginia it was like five or six people that moved because he wanted to work with them because he made it fun and they had basically like a system for rewarding people for doing things the right way, and it's non-monetary compensation obviously, right? You can only keep paying somebody so much. And, a- and there's also w- weird rules around it. But basically just to to create a culture from the top down that is recognizing not just excellence but also positive change some of the things that we work on is patient handoffs, of, like, how to do a really positive patient handoff. So they'll count. It's like, all right the goal this time is that we're gonna do 10 days of everybody doing positive t- patient handoffs, and there's a pizza party at the end of that, whatever it is, right? They were gonna get the pizza anyway. But by creating a streak and kind of a game of it they're creating some team spirit, as well as creating little situations for like, little kind of micro little kind of micro awards and acknowledgement of the most improved. Whoe- whoever it was that's the most curmudgeonly It's the same thing as making the bad kid the safety, as the s- the school safety officer, right? it's a, a way to empower this person to get some positive feedback. That's great. That's a really great idea. And I just will say everybody loves a pizza party, especially in healthcare. Love a pizza party. Yeah, that... if nothing else, during COVID, we we got those nurses and doctors a whole lot of donuts and a whole lot of pizza. The you can't underestimate how far that'll go. Yeah. But but what I was saying i- at first, in that it's like, there's a Socratic approach to take to it with that problem-solving. And a thing that I love to do is to break leadership teams into, pairings and say, "Okay. In order for these positive changes," we list out what the positive changes are that we've identified that we wanna, want to make both in terms of patient experience and also in terms of internal communication. In order for these things to work, one team, I want you to write down everything that can't happen, and the other team, you're gonna, you're gonna create a list of everything that has to happen in order for these changes to, to take place. And what you f- find in doing that is that yeah and it's, it takes time. It's a really kind of- Not combative, but it's a, debated process. But what you find is that they already know the answers, right? The answers come from within the group, and they know way more, way, way more than I would possibly know, right? I don't know what their systems are called and everything but they know where the breakdowns are, and they know where they can decrease friction. And, a- and also what their coworkers and what their teammates are gonna respond to. But the thing that's incredible about that exercise in particular is that 100% of the time they are an exact mirror of themselves, right? They know whatever's the what must not happen is always the exact opposite of what they put up on the board for what has to happen. That's interesting. Yeah. I'm telling you, 100% of the time that works. They're... If, a- and if we tell them there's five things that have to happen, all five of them are an inverse. That's crazy. I love that. But it- I'm gonna think about that, I think. Thanks. And and what's also interesting about it is that you don't solve the problem by not discussing it. Yeah. And there's, I think, a very corporate, fluffy BS way about it of Okay, folks, it's gonna be all positive communication around here, and that's what we're g- we're gonna try to get. We're gonna play the positive communication game." okay everybody's eye just roll eyes rolled back, and, y- a- and nobody wants to play this game. But when you approach it as, "All right, we're gonna be real here and tell you we've got a very big problem," right? How many of you agree with this statement: nurses eat their young? Let the hands go up. Okay we have there's 900,000 nurses leaving the profession, and our annual turnover here is 35%, right? Or 28%, whatever it is. It costs 100% of a nurse's salary to train a new nurse. And also, nurse job satisfaction is the second-biggest indicator of a five-star hospital review. Yep. It is. Yeah. Yeah. So knowing that, how are we going to fix this problem, right? Where... You tell us where are the blind spots that we have and how can we make this better? Yeah. And and make them a part of the process and not just people that are getting strung along for these KPIs or whatever that they... It be- it's just another thing that they have to do, as opposed to you have some agency here, and we wanna help you change your environment for the better. Where does it start? Yeah. Love that. So I'm gonna... This is a l- I ask this last question- I ask this last question to almost every guest, and I'm really excited to hear your answer. If you were put in charge of healthcare in the United States, what is the first thing you would change and why do you think that single shift would create the biggest ripple effect for patients and caregivers and healthcare staff? I would pay myself so much more. But after that, what else? Yeah, I think that starting in in med school, there has to be a lot more discussion of communication. I think there needs to be real listening training. There, there-- They have to learn the right way and the wrong way, very importantly. Just treating communication as important as any- anything else. It's as important of a skill as anything that, that you're gonna learn in med school. It's as important as anything that you're gonna learn in the book or on the job. And like I said, the-- everything in patient reviews is about how you communicate. So the Dr. House idea that you're gonna be this phenomenal doctor that's also a complete jerk is absurd, right? If we can get people to lead with actually connecting with the patient and actually connecting with that person, we will see better health outcomes That is profound. It sounds very simple and common sense, but it is profound. So I really- Thank you. Well- I hope you get your wa- Well, thank you. I mean, it's, It's funny because I'm, I'm so aware of the fact that I'm a comedian, right? And, like, I'm just somebody that ... Sometimes I get asked like, "Well, why do you think that you have what gives you the right to tell doctors and nurses the right way to do this?" And I think you need an outsider's approach sometimes, right? That it like, it has to kind of come from, a completely different set of fresh eyes. And I am also hyper-aware of how I am not famous as a comedian. So it's like my job is basically walking into a room every night sometimes four or five times a night in front of a new audience, and getting them to like me within 30 seconds. And like, that sk- that's a skill that took me 10 years of doing it almost every night to think, before I could say Yeah, I'm actually an expert in that." it really does it just takes a ton of reps and a ton of thinking about, how could I have done that better to create a connection a little bit quicker? Yeah. And I'm gonna say, you say you're not famous as a comedian. I'm gonna say yet. Not famous yet. Sure. I'll take that. So if people wanna learn more about you, how- can they do that? How can they find you? You can always follow your boy on LinkedIn. I post stuff all the time there. Also, richieredding.com. And you can go to my speaking and healthcare workshops. You can alwa- there's also a bunch of links there that you can book an appointment if you think that your healthcare system or whatever it may be could benefit from some levity and listening training. I'd be more than happy to talk. And also if you wanna see some dirty jokes, go to Instagram. Not safe for work. Awesome. Rich- It's richiedoescomedy on Instagram. Sorry. Didn't mean to cut you off. That's your... It's... No. No worries. I loved this conversation. It was a lot of fun. Richie Redding, thank you for joining me. Thank you so much.

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website. We would love to hear from you.

So, until next time, stay curious, stay compassionate, and keep taking healthcare by storm.