A Compassionate Redesign: Technology and Moral Injury in Healthcare
In the ever-changing landscape of healthcare, the conundrum facing non-profit hospitals is both urgent and profound. The situation isn’t just about the financial balance sheet, nor is it only about policies and procedures. It’s a deeply ethical issue — how can we fulfill our collective mission to provide the best care to patients when resources shrink, tensions rise, and the business model of medicine pressures us?
The recent policy reversal by Allina Health, the layoffs of all nurses at MedExpress, and the inherent competition between clinicians reveal the surface of a vast, underlying problem: moral injury. This transcends burnout; it’s a violation of our core belief to put the needs of patients first.
In this context, we must explore not only the application of technology and AI but how its design and implementation must be integrated with empathy, understanding, and a genuine commitment to healing and serving all those involved.
A Complex Battlefield: Clinicians and Competition
Too often clinicians are pitted against one another as resources shrink. The internal competition creates a hostile environment where doctors, nurses, and other practitioners feel overstressed, losing sight of their shared goal: giving patients the best care possible.
This calls for a culture shift. It’s time to view each other with the presumption of charity and to have each other’s backs. Uniting for support, camaraderie, mentorship, and activism is a necessary step in making change. As a surgeon, I have a deep appreciation of the role and value of nurses in the care WE provide. However, as many nurses can attribute, their value is often not measured and is seen only as a cost center in the current healthcare system.
Holding Organizations Accountable
Although care team well-being is now part of the quadruple aim (patient experience, population health, reducing costs, and provider experience), organizations must be held accountable to ensure it is a priority. As suggested by Drs. Dean, and Talbot, if we choose to link patient satisfaction with clinician compensation, why not link clinician satisfaction with executive compensation? It’s a call for equity that resonates with principles of justice. In this spirit, technology should be designed not only to drive returns on investment, but to also address and enhance satisfaction of clinicians.
Building Bridges with Administrators
Bridging the divide and enhancing communication between clinicians and administrators is vital. Its been suggested that administrators join on rounds or spend a night in the emergency department. Such exposure helps them understand the challenges faced by both patients and clinicians.
Likewise, clinicians must also seek to understand the challenges from the administrators’ side. This profound understanding is where commonality and compromises are found.
Technology and AI: A Tool, Not a Panacea
The lure of technology is strong, and the potential of AI in healthcare is immense. But these advancements must be thoughtfully implemented. IT requires hospitals to work with technology partners who understand all the nuances and elements of this complex ecosystem. The design and implementation of any solution should focus on easing this “moral injury” rather than exacerbating it. Technology should be an enabler of compassionate care rather than a mechanical efficiency tool.
A Collective Call for Change
While the challenges confronting us in the healthcare sector are immense, they are far from insurmountable. By adopting and embodying the principles of unity, equity, and empathy, we stand on the cusp of an era where we can rebuild a healthcare system that truly serves all stakeholders.
This transformational journey begins with rethinking existing policies, fostering camaraderie among clinicians, demanding accountability from organizations, and actively engaging administrators. These steps form the necessary foundation for healing the pervasive moral injury within our system — a wound that is profound and tangible.
Those in the technology sector, tasked with innovating for the healthcare industry, must also understand this complex and dynamic landscape. Too often, technological implementations are hindered or stifled due to a lack of awareness of the underlying moral injury.
But healing extends beyond technology. Organizations embarking on revitalizing their cultures and workforce will find success by integrating technologies born out of compassionate redesign. Such a synergy creates an environment where innovation and integrity aren’t conflicting forces but harmonious partners, walking hand in hand. This holistic approach not only addresses the practical needs of healthcare delivery but also fosters a culture that resonates with the very essence of human care and connection.
Dr. Salim Afshar
