Development of emotional intelligence in healthcare has been slower to progress than in other industries. This paper defines emotional intelligence and describes benefits related to developing the attributes of emotional intelligence. It explores physician, clinical, ancillary, and administrative use cases documenting the benefits of implementing emotional intelligence awareness. In addition, it describes how emotional intelligence can positively impact healthcare executives in leading their organizations to retain talent, improve patient satisfaction and clinical outcomes.
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Emotional Intelligence & Healthcare Leadership
A lot of research has been conducted on the topic of emotional intelligence. Emotional intelligence is “the capacity for effectively recognizing and managing our own emotions and those of others” (Pharmaceutical Information, 2007). The Harvard Business Review (HBR) released a number of articles which examine emotional intelligence. As described in the HBR article “What Makes a Leader” there are five key components to emotional intelligence including knowing one’s emotions (Self-Awareness), managing one’s emotions (Self-Regulation), motivating self (Motivation), recognizing the emotions of others on the team (Empathy), and developing / handling relationships (Social Skills), (Goldman 2004). Publication of emotional intelligence research started in 1990 and since that time companies have been working to integrate emotional intelligence into their employee selection processes (Freedman 2010). This work started in non-healthcare related industries and is increasingly stressed in healthcare behavioral development today. In an article by the journal BMC Medical Education, Emotional Intelligence is “the set of abilities (verbal and nonverbal) that enable a person to generate, recognize, express, understand, and evaluate their own, and others, emotions in order to guide thinking and action that successfully cope with environmental demands and pressures”(Birks, Mckendree, Watt 2009). Are emotional intelligence attributes just a performance metric fad utilized by senior leadership to stimulate change within the organization? Or does it lead to enhanced effectiveness of healthcare executives and the organizations they lead?
One of the reasons emotional intelligence is critical to success is that it is effective in handling stress. Healthcare is a multifaceted, evolving and stressful environment. Managing the stress of change management in healthcare is a skill that healthcare leaders must acknowledge. A study was performed at a large urban hospital with professional midwives and obstetricians. It found that emotional intelligence is predictive of performance 66 percent of the time, of stress up to 24 percent and of stress management 6.5 percent of the time. This study found in examining senior leadership in relation to the focus group that emotional intelligence made the biggest difference in the supervisory and leadership roles (Freeman 2010). This provides indication that emotional intelligence actually is more important to recognize as one is in transition to higher management and leadership levels.
Another study performed indicated that emotional intelligence can actually be improved throughout life. The study focused on supporting staff of a large healthcare center. It utilized an emotional intelligence test focusing on emotional sensitivity, maturity, and competence. This study measured the ability to respond to interpretation of human expressions with empathy and scored competency of self-control against age / maturity. Findings revealed that maturity of emotional regulation tends to be after the age of forty and that emotional sensitivity grows with experience (ie. age) as well. The study also found a significant difference in the perception of emotion intelligence between gender showing that both men and women have equal ability to increase emotional intelligence but that women tended to be stronger than men as it relates to empathy and self-regulation (Freeman 2010). This provides evidence that emotional intelligence is learned with experiences. Therefore healthcare leaders can influence supporting staff’s development of emotional intelligence in handling operational stress management. It is important to ensure the development concentrates on the right part of the brain to achieve successful results. Emotional intelligence training must focus on the limbic system which requires motivation, extended practice and feedback on behalf of the student to advance capabilities (Goleman 2004).
Healthcare leaders need to recognize the importance of emotional intelligence competency in order to make it a part of their organizations’ culture. There are a number of case examples showing that healthcare executives believe that their own development of emotional intelligence is imperative to successful implementation of initiatives for their organization. For example in the Journal of General Internal Medicine, the Cleveland Clinic Lerner College of Medicine designed an exploratory study in order compare leaders and physician perspectives with respect to required leadership qualities. The purpose of the study was to gauge what is necessary to develop current and future leaders. This study centered on leaders that expressed interest in gaining new academics and leadership skills. They structured interviews to gather data from leaders and found that both developmental and established leaders agreed that knowledge, people skills, emotional intelligence and vision are all characteristics required for leaders to be successful. The interviews indicated that healthcare poses unique leadership challenges and the complexity of healthcare institutions is greater than other industries with respect to training. Physicians tend to be far less willing to receive direction and collaborate on training necessitating the need for healthcare leaders to possess mature emotional intelligence skills; especially in areas such as empathy, self-awareness and self-restraint. The study provided evidence that leaders need and desire emotional intelligence training. Healthcare leaders admitted in the interviews that often one is promoted based upon academic and clinical accomplishments. Therefore they lack and desire training in other skilled leadership competencies such as emotional intelligence. The leaders agreed that knowledge is important however 70 percent stated that emotional intelligence was the most admired attribute (Taylor, Taylor, & Staller 2008).
Healthcare leaders agree that emotional intelligence is important element for leadership. But there is also evidence that leaders should promote development of emotional intelligence for their clinicians as well. A study published in the March 2011 issue of Academic Medicine highlighted a study performed by Jefferson Medical College of Thomas Jefferson University. It was established in order to quantify if there is a relationship between physician empathy and clinical patient outcomes. Researchers measured 29 physicians associated with 891 diabetic patients by utilizing the Jefferson Scale of Empathy as an instrument to measure empathy. The scale rated and provided a physician score on their “empathy awareness” based on the context that patient care requires a cognitive attribute that involves understanding and intention to help. After scoring the physicians’ empathy skills, the study compared them with the patients’ ability to control hemoglobin Alc and LDL cholesterol levels. The study concluded that good control of A1c and LDL levels was significantly better with patients associated with physicians having high empathy scores than with patient of physicians with low empathy ratings. This suggests that empathy should be a key component in overall physician competence (Jefferson University Hospitals 2011).
As referenced in a research study documented in the Journal of the Royal Society of Medicine (JRSM), healthcare policy and practices are trending towards emphasizing the principles of patient-centered care. Providing patient-centered care is a “multi-dimensional concept which addresses patient’s needs for information, views the patient as a whole person, promotes concordance and enhances the professional-patient relationship”(Birks & Watt 2007). There is a variance in the level of patient-centered care provided by professionals practicing within healthcare organizations. Healthcare executives are therefore interested in ways to improve patient-centered outcomes. Training professional staff on emotional intelligence generates self-confidence, sensitivity to patient needs and trustworthiness. These attributes can actually play a part in improving outcomes (Birks & Watt 2007). Evidence of this is documented in JRSM where a study involving 30 physicians and 138 patients provided evidence that emotional intelligence plays a role in patient satisfaction. An extensive study involving 213 dental students found that perceived stress is lower when the student possesses higher emotional intelligence scores. Decreasing stress levels help to retain talent and quality nursing staff is extremely important in patient-centered care. A correlation between low emotional intelligence scores and nursing burnout and attrition was found based on study conducted on 380 nurses. It indicated that emotional intelligence can improve the working relationships within the healthcare culture; increasing the likelihood of retaining talent (Birks & Watt 2007)
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A Clinical Connections journal article written by Erik Swensson, MD, FACS agrees with the premise that emotional intelligence improves healthcare culture. He emphasizes the continual challenge for physicians and leadership professionals to routinely coach and hold peers accountable. The article stresses the need for professionals to possess emotional intelligence skills involving self-awareness, self-management, social awareness, and relationship management. Healthcare professionals need to move away from “protecting our own” and towards “helping our own,” he stated. Emotional intelligence establishes a foundation for building a caring environment and establishing a culture of collaborative safety (Swensson 2012).
The International Journal of Collaborative Research on Internal Medicine and Public Health suggests that making emotional intelligence a core competency for the healthcare professional will result in enhancing clinician-patient relationships. Patients feeling empowered, knowledgeable and in control of their healthcare tend to make healthy lifestyle modifications. Clinicians whom are trained in emotional intelligence skills can help patients with self-awareness, self-regulation, and motivation. This requires time to listen to patient concerns (ie. empathy). Enhanced relationships will thereby result in an increase in desirable health outcomes (Coelho 2012). Cultivating the patient-clinician relationship may affect a patient’s emotional intelligence on initiating legal action against providers because the patient is part of the care solution and overall more satisfied with the care provided. Research indicates that more satisfied patients are the less likely they are to take legal action. Therefore cultivating emotional intelligence may be a mechanism towards a reduction in healthcare legal cases and costs associated.
Today’s healthcare environment demands pay for performance. Healthcare executives need to expand their overall emotional intelligence competencies in order to recognize and expect these attributes in leaders and clinical professionals within their organization. Executives have to establish and take ownership for their culture. In doing so they must consistently demonstrate the leadership qualities they expect to be exhibited by their administrative and clinical staff. As evidenced in the studies described above executives will benefit by investing in their own emotional intelligence education and should extend it to all levels within their organization. Doing so will provide a caring culture, reducing healthcare costs, retaining talent, and motivating clinicians to provide excellence in patient care.
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