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The Beryl Institute Patient Experience Blog
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Do You See What I See?

Posted By Tiffany Christensen, Monday, December 4, 2017
Updated: Monday, December 4, 2017

As a person who lives with cystic fibrosis and has had 2 double lung transplants, I have experienced many stages of illness. I have understood from a very young age that having this illness is something people feel badly about and sometimes even wonder why “bad things happen to good people.”

But what if we have it wrong? What if illness isn’t the worst-case scenario? What if instead of looking at me with pity, I should be looking at you with pity because you don’t see what I see?

In my lifelong career as a patient, I have had people respond to me in all kinds of ways. The reactions were more pronounced as I grew sicker and they reached their peak during the time I wore oxygen. When I was wearing oxygen, some people would stare, some people would look away and others would approach me and say things that often caught me off guard. One man in Target said, “You shouldn’t have smoked so much.” One woman in Macy’s said, “I’ll pray for you.” My cousin asked, “Why would God do this to you?” Almost all of the people I encountered said—with their eyes— “You poor thing, I’m so glad I’m not you.”

While the intentions were almost always good and the reactions easily explained as a reflection of each person’s internal relationship with life, death and uncertainty, none of them ever hit the mark.  Nobody I came across ever reflected back to me what my perception of myself happened to be.

I felt physically weak, yes, but everything else about me felt strong. I felt connected to the universe, I felt a strong understanding of my purpose in this world and I felt lucky to have the lessons of illness laid before my feet day after day. The very last thing I wanted was pity. If anything, I would have liked admiration.

Imagine for a moment a patient laying in a hospital bed. They are curled up slightly around themselves, pale in the face and not very interested in interaction. Imagine walking in to see that patient. What might you think? What words come to mind? Vulnerable? Sad? Weak?

Now imagine walking into that same room with a very different lens. If you could see into that person’s mind, what do you think you would find there? Simply because they are not talking does not mean they aren’t thinking. Just because they aren’t emoting does not mean they aren’t feeling. So why are they so quiet? What are they doing?

They are enduring. They are bracing themselves against pain or discomfort. This takes energy and concentration. This takes a great deal of STRENGTH.

What if, like a marathon runner grimacing as they finish their final miles, we looked at the patient curled up in the bed and did not see weakness but, instead, saw determination and grit? What if we encouraged them, like we would do on the sidelines watching athletes riding their bikes in an Iron Man, telling them “You’re doing great! I know it’s hard but you’re amazing!” What if we stopped pitying people who are sick and saw them as people we could learn great lessons from? How would this change the way we deliver our healthcare?

Being sick is often an isolating experience. Not only because of the physical symptoms that limit our ability to live an active life, but because of the perception of weakness others project onto us. As I shared earlier in this post, during the time that I wore oxygen, I had a lot of comments from friends, family and strangers about my appearance of health. What I almost never received were questions. I longed for questions rather than statements. Here are just a few that I would have liked to hear:

  • “I know you have bad days and better days. On a scale of 1 to 10, what’s today?”
  • “Is there something I could do right now to make your life a little easier?”
  • “I want to support you and I’ve never experienced anything like what you are going through. Can you help me understand what life is like for you?”
  • “You know I love you and I worry about you, but I’m feeling strong today. Is there anything you want to talk about that you’ve been keeping inside because you were afraid it would be too hard for me to talk about?”

And then there is this one statement I longed to hear:

  • “Caring for you while you go through this illness is really hard. Sometimes I get sad, angry…you name it. But, I want you to know, I wouldn’t trade it for the world. Having you is worth every second of this struggle.”

The internal world of sick people isn’t always going to match mine so this is by no means a prescription. At the same time, nothing bad can come from seeing patients differently. If you see them as strong, perhaps they will gain more strength. If you ask them questions, they may not always want to talk about it in that moment, but they know where to go when they do.

Illness forces us to focus on what matters in this life. Let those who live with it be our teachers while we admire them as they take on their personal marathon. I hope you can begin to see what I see and watch how it shapes the way we deliver care.

 

Tiffany Christensen
Vice President, Experience Innovation
The Beryl Institute

Planning to attend the IHI National Forum later this month? Join Tiffany Christensen’s Keynote session with Dr. Rana Awdish, MD, lead by IHI President Derek Feeley, as the two women touch on how they are using their patient experiences to improve healthcare. You can also join Tiffany during Sunday’s Learning Lab, the CEO Summit and her “meet the author” luncheon. 

Tags:  communication  impact  improving patient experience  perception  purpose  relational healthcare 

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Don’t Underestimate the Importance of the Small Things

Posted By Deanna Frings, MS Ed, CPXP, Wednesday, November 1, 2017

Recently I traveled by motorcycle through my home state of Wisconsin enjoying the colors of fall. In planning this trip my husband and I were very intentional in choosing our route, selecting our clothes and determining the day we left.  We knew that paying close attention to these things was very important if we wanted to see the best color possible on the most scenic roads staying warm, dry and safe.

I would categorize these items as having a great impact on the overall quality and safety of our experience.  Many might say, they are the big important things.  In healthcare, there are many big important things in providing high quality, safe care.  And in my experience, we are typically very good at paying attention to these big, important things.

But what was affirmed for me during this trip is that doing things with a clear purpose, being present and intentional can have an equally huge impact on the overall experience even in the most insignificant interactions.  In fact, it is the small things that can often have the greatest positive impact.

When riding on the back of a motor cycle there isn’t much for me to do except to enjoy the scenery. My mind wondered a bit and I started thinking of the importance of being intentional.  Intentional in my work, intentional in my personal life and intentional in my relationships and all that I do.  It’s easy to get lazy and forget the importance and the impact intention can have on oneself and on others. It really does come down to presence, awareness and the power of choice.

At The Beryl Institute, we understand the power of choice and recognize that in every interaction, we have a choice to make. So, for the remainder of the trip it was my goal to create positive moments by being very intentional in the interactions I had. The criteria I used to measure my success included receiving a comment of appreciation such as a “Thank you”, noting a smile as a result of the interaction and/or walking away with an overall positive and warm feeling.

We came upon road construction several times throughout the week. On many of these occasions, the road merged into a single lane which required members of the construction crew to flag vehicles through from each direction ensuring our safety. At more than one of these locations, we were the first vehicle stopped by a person holding a stop sign waiting patiently for our turn to pass through.

I have always wondered what it must be like to be one of these individuals standing in the elements for several hours a day holding a ten foot stop sign. There have been a few occasions when I would nod slightly but on this occasion, I wanted to acknowledge the person and to let them know how much I appreciated the job they did to ensure our safety. On a motorcycle, it was very easy to have this conversation. I could see a smile come across the gentleman’s face and he nodded. As we passed through, he waved and said, “Have a great and safe ride.” This small but purposeful gesture, created a moment that enhanced this part of our journey.

Test number two came when we stopped for lunch. On a motorcycle trip of this length, stopping for lunch is a highlight of the day. Its time off the bike and that is always welcomed. It’s fun to stop at simple cafes and dinners and this particular stop was extremely enjoyable.  Not so much because of the food but rather our waitress who was extremely personable and good at what she did. I have always enjoyed watching people do what they do every day especially when you can tell they enjoy their work. 

She had purpose, presence and did everything with intention. It was fun watching her work the room. She acknowledged us the minute we sat down and indicated she would be with us in a just a moment. As promised, she came over immediately after delivering hot food to another table, introduced herself and seeing the clothing we were wearing and our helmets asked, “are you staying warm out there today?” She was helpful with the menu, anticipated all of our needs and provided us with a lovely 45-minute break off the bike.

As she was cleaning the dirty dishes from the table and leaving us the check, I asked her how long she had worked here and told her how much I enjoyed watching her as it appears she really enjoys her work. She was beaming at this acknowledgment and went on to share that it brings great joy to her when she can offer great service to her customers and thanked us for coming in today.

The final experiment came during a service recovery opportunity after being on the bike for a long 6-hour day. Upon entering the parking lot of our hotel, we were required to take a parking ticket from an automated machine that would subsequently open the gate. As we started moving through the gate, it immediately lowered itself onto the motorcycle prior to us passing completely through. It took all my husband’s strength to stop the gate from lowering all the way onto the bike and for those brief 20 seconds until I hit the button for another ticket, it was a bit terrifying. Not the most comforting way to end the day. 

We were greeted by a very nice young man at the registration desk. He noticed we were a bit distressed and inquired how he could help. After hearing our explanation about the gate prematurely closing, he did all the right things you would hope an employee would do at a time when service recovery is warranted.  He acknowledged our concern, apologized it happened and immediately went to work to make amends. As he completed the registration process, he once again apologized for this situation. We thanked him for his help.

Later in the evening when we came down to dinner, I wanted to once again acknowledge how much what he did meant to us. I proceeded to the desk to explain to him what I did at The Beryl Institute and how much we talk about the importance of service recovery.  The term was new to him but he really appreciated that I took the time to share this information and to thank him once again.  As I walked away, I turned back and he was fast at work welcoming another couple to the hotel with a great smile on his face.

Sometimes we never know the impact a small gesture might have.

Four years ago, I met a gentleman by the name of Andreas. At that time, he was a student at DePaul University. Jason Wolf was participating in a patient experience panel discussion for the class. Following the class, we joined the students for a light meal and further networking. Andreas was sharing how much he was learning about patient experience and his desire to ultimately find a job in the field but was concerned about his lack of work experience. During our conversation, I was very impressed with this young man. He had a clear vision, defined purpose and he was building an intentional plan to achieve his goal. And from where I was sitting, he had a true passion about patient experience. It was this that I wanted to reflect back to him. I simply put my hand on his shoulder and said, “Andreas, you are the Patient Experience;” I took one of our IMPX pins and secured it to his jacket.  He simply smiled and said, “Thank you”. 

Four years later, Andreas along with his colleagues presented at the Patient Experience Conference. Andreas came up to me during the conference and recounted that evening four years earlier and shared with me how much it meant to him. It gave him continued confidence to work toward his goal of working in the field of experience. I also noticed he was wearing his IMPX pin.

It was hard to hold back my tears. To think of the impact that small gesture had and the vivid memory it still holds was humbling. But you see, we all know because of our own experiences the positive and lasting impact these small gestures can have. Leading with purpose, being present and doing things with intention can positively impact both the big and small things in our everyday interactions.

In conclusion, I encourage you to think about these simple examples and the lasting impact they had on these individuals as well as the positive impact they had on me. There is an important conversation going on in the patient experience community about employee engagement. At the heart of our humanness, it is being in relationship with each other that keeps us engaged in caring for those we serve. And it’s all big and important stuff.

 

Deanna Frings, MS Ed, CPXP
Vice President, Learning and Professional Development
The Beryl Institute

Tags:  caring  employee engagement  impact  interactions  journey  patient experience community  power of choice 

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