Posted By Melissa R. Thornburg, MA,
Thursday, April 30, 2020
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With COVID-19 currently monopolizing our daily lives, many of our previously normal routines have drastically changed. From how students are educated to where and how we work, to how we access food and other goods that we need, to how we socialize (or not) and what distance we keep from those we love, this worldwide pandemic has forced a new “normal.” This sudden, but also gradual upheaval has left some safe at home and others still actively working outside the home. However, for all of us, this transition has surely caused a myriad of emotions that can be confusing and hard to pin down, because, just like our routines, our emotions may not be “normal” due to this unprecedented worldwide collective experience.
What is it that you’re feeling? Are you anxious, scared or sad? Are you somewhat relieved because you’ve been forced to slow down and breathe, but worried about your job, finances, and the quality of digital education being provided to your children? Maybe you have cabin fever and are longing to step out, eat at a restaurant or take in a live show? You are missing something, perhaps, and longing for something else. You might feel discouraged, but hopeful that things will soon change and be better. It is confusing, frustrating and chaotic. You may be experiencing both anxiety and grief.
As a psychologist and through my previous role as the Director of Patient Experience at a large healthcare system, it is in my nature to look for peace when experiencing anxiety and grief. Having personally experienced several heartbreaking patient and family encounters in healthcare and hearing and watching news of our courageous frontline staff facing this every day, I wanted to offer some details around how to provide serenity for our healthcare heroes despite the current chaos. I know that it seems highly unlikely given the current pace of work in some of our most significantly affected healthcare systems, but in some way or another, it is possible.
Starting simply, it seems that the effects of sincere gratitude and appreciation both in and out of the workplace have been researched extensively. From that, we’ve learned a heartfelt and genuine “thank you” delivered in person or hand-written can make someone feel appreciated, help motivate them to do more, and can also have a positive effect on their overall health and well-being. This can be accomplished by anyone, whether it be a leader, a coworker or someone from a different department that recognizes how hard staff are working. Even without a budget or extra staff, this simple and effective skill of showing gratitude and appreciation can help during our current COVID-19 chaos. Start with saying thanks, then acknowledge the hard work of all those hospital employees, validate their feelings of anxiety, despair, frustration and grief. Let them know that it is real, it is normal and it is okay to express those feelings without judgement.
Next, consider having a basket of individually wrapped snacks and coffee, water and tea. Put them in an “off stage” private space and allow staff to take 10-minute breaks to not only refresh their minds and spirits but also nourish their bodies. Small cracker packs, chips and cookies seem to be the most popular and accessible choices, but a variety of mixed nuts, trail mix and jerky sticks may also be a slightly healthier option and provide some protein to your busy staff as they go on with their day. Having fresh apples or other fruit is a consideration, but they may need to be washed and wrapped individually.
If you have additional resources, this break can be offered in a Serenity Room. As the Director of Patient Experience, my staff and I found a rarely used conference room that was being used as more of a storage room. With permission, we cleared the room, cleaned it ourselves and developed it into a quiet, healing place for breaks. We put a note out to local churches, community groups, and supportive businesses asking for donations of a number of items including wickless candles, new Apple iPods for music, small desk-top fountains, sand trays, “twinkle lights”, aromatherapy diffusers, essential oils, black-out curtains and recliners. We also asked for individually wrapped snacks, water, scented hand lotions, sleep masks, gel sleep masks that be cooled in a refrigerator, word searches and cross word puzzles. We received several of these items, and others items were donated by staff members. We had enough to create two separate rooms just from the generosity of our community members and staff.
We blacked-out windows, set up comfortable chairs (a couple were unused reclining chairs from our OB unit!) and had soft music playing with the option to choose an IPod that had additional playlists and disposable headphones. We had snacks, aromatherapy diffusers and several essential oils that staff could choose from. We even had small absorbent sticker tabs the staff could put a drop of essential oil on and stick to their uniforms to enjoy for the rest of their shift. They could recline for a few minutes, do a mindless crossword puzzle, or close their eyes and just relax in a softly lit room. The room was well-used and appreciated.
If you don’t have access to all the resources above, try to convert an unused family waiting room temporarily (since visitation is restricted) or an unused family conference room. Use poster board to block windows, plug in a lamp with soft lighting, try to borrow some reclining chairs from OB, and create a simpler version of what is described above. The reality is that staff will appreciate any quiet space and an opportunity to briefly unwind.
Lastly, it is important to provide consistent and ongoing support to staff working the frontlines. To ensure that this is happening, gather a team of qualified crisis intervention and debriefing individuals to deploy as a Support Team, or what we called a Code Lavender team. In our healthcare system, a Code Lavender could be called during or after a sentinel event, a patient death, a staff crisis or a particularly difficult emergency room experience. When this was called, a team of individuals came with snacks, resources, and a willingness to debrief and provide support to the staff involved. Instead of having this as a reactive team for COVID-19, make it a proactive team by having these individuals available and rounding on busy spaces, checking-in on staff and offering support without “getting in the way.” These individuals can also staff your Serenity Rooms and provide quiet and gentle support for anyone who needs it. For more information on Code Lavender click here.
Whether you are able to say a quick but heartfelt “thank you,” offer snacks in a break room or Serenity Room, or even in an empty office away from the chaos, small opportunities to honor healthcare staff during this world pandemic will provide them with the care and support they need to continue to effectively treat their patients with compassion and respect. Look to your community to help provide some of the resources and look internally for skilled crisis intervention or counseling staff that are not currently active in their departments to be called on to make a difference for their peers. At the end of the day, every person deserves gratitude and appreciation, so don’t forget to take care of yourself, too!
Thank you for all you do for patients, families and staff members during this crisis.
Melissa Thornburg is a pCare Senior Performance Improvement Coach. In this role she assists clients on how to use real-time patient feedback and education for performance improvement on key strategic initiatives. Previously at the Planetree organization, Melissa worked as a Patient Experience Advisor with the VA and other organizations both nationally and internationally. Prior to Planetree, Melissa worked at the Cleveland Clinic as Director of Patients First, Experience Facilitator and Patient Experience Champion helping to establish several Patient and Family Advisory Councils and to lead both system-wide and local patient experience initiatives. Melissa earned a Master of Arts degree in clinical psychology from Western Michigan University, and a Bachelor of Arts degree in psychology from Niagara University.
Posted By David Andrews, Shari Berman, Erika Holliday, Barbara Lewis and Zal Press,
Monday, November 28, 2016
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The Beryl Institute Global Patient and Family Advisory Council consists of 15 people from around the world who come together to provide advice on the strategic and tactical direction of The Beryl Institute. Our role is to ensure that the voices of patients and families are central to the focus and decisions taken by the Institute.
Our members are people with chronic conditions, survivors, caregivers and family members whose collective purpose in our work is to use our experience as the guide to system and care delivery transformation.
While reflecting on our experience as members of The Beryl Institute community, it became evident that most patient and family advisors (PFAs) are working in relative isolation in their own organizations. Our council initiated an effort to begin the creation of a patient led and patient driven community within The Beryl Institute. This community will recognize the value of PFAs, honor their work and provide a platform where we share information, resources, education, stories, successes and failures, and through which we can have greater influence.
In the past year, we have focused on the necessary building blocks for a community with PFAs as peer members with access to all the robust offerings and resources of the Institute. The goal is to enable and empower, to build capacity and ability, and to maximize the opportunity of all PFAs to have the kind of impact that will catalyze the change necessary to improve the patient experience in care delivery and design, policy discussions, and research and development.
This has now brought us to the starting point for building our worldwide community that brings people from around the globe together in common purpose.
To that end, we have developed a three-step plan to build that community:
- Phase 1: Gather – We are reaching out to all engaged in The Beryl Institute community to identify PFAs within their institutions. We want to know who they are, where they are, what their roles are and how to best communicate with them.
- Phase 2: Inquire – We are committed to co-creation of a PFA Community movement. To achieve this, we will ask members what they want and need that will help improve the patient experience.
- Phase 3: Build – Based on what we discover, we will build the connections, resources and information the community has identified to build a working network with greater power to influence.
To start on Phase 1, we have a short survey (see link below). Please share widely. The patient and family voice is critical to what we all do. Increasing the impact of PFAs will reinforce their value and enhance the benefit not only to the individual organizations but to the entire patient experience movement. By creating this network PFAs will have the opportunity to be influential partners in the improvement of the patient experience.
Complete and share our survey: https://www.surveymonkey.com/r/PFA_Community
The authors are members of The Beryl Institute Global Patient and Family Advisory Council and form the steering committee for the development of the Patient and Family Advisor Community.
patient and family advisor
patient and family advisory council
Posted By Alison Tothy, M.D.,
Tuesday, July 26, 2016
Updated: Monday, July 25, 2016
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What if bringing visibility to positive experiences helps connect us to our sense of purpose? In a recent shift in the Pediatric ER, I watched an interaction between a nurse and a child. We were getting ready to sedate an eight year old boy. The nurse engaged the patient and made him smile, while gently preparing him for the sedation and the upcoming orthopedic bone reduction. I watched as the patient relaxed under her calm hands and in turn, the father waiting on the bench next to the child took on a calm demeanor, his shoulders visibly unclenching as he observed his child receiving amazing care that was kind, compassionate, and gentle. As the physician, I spoke with the child and the parent, explaining the procedure thoroughly, but with easy to understand language. I answered all questions, and then in partnership with the nurse and the orthopedic resident, proceeded to sedate the patient and reduce the broken arm. With the sedation and reduction completed, I informed the father that everything went well and that his son was doing great. I left the sleeping child and the less anxious father in the hands of the nurse to continue my shift, taking care of at least another thirty patients that evening.
Walking out at the end of my shift, I saw the nurse that helped me with the child during the sedation. It would have been so easy just to walk out the door, wave over my head, and shout "Thanks for all your help, good night, see you tomorrow” - isn’t that the usual sign off after finishing a shift? But instead, I stopped, paused, and then said "Thank you so much for your help with the child that we sedated. You were so good with that child. Did you see how he relaxed when you talked to him about how he looked like an astronaut with the oxygen tubing in his nose? You made him smile. Did you see how he was relieved he was only ‘getting a hug’ from the blood pressure cuff? And, did you notice how reassured the father was, when you alleviated the worry and suffering of his son? Thank you!” Then, I watched the nurse… her eyes lit up, she smiled and sat up straighter. Not much later, I walked out and got in my car, drove home and went to bed. I did not imagine I would think about it again, but I did. Strange, because it was not the usual case that I perseverated over, such as the complicated case, the stressful trauma, the new diagnosis with a bad outcome -- instead, I thought about this powerful interaction I shared with my colleague.
I would like to believe the nurse left her shift with a sense of pride that was always there, but maybe had not felt in a while. I hope that she saw for a moment what I saw in her, the impactful way she cared gently for a patient. I wanted her to realize what it meant for the patient and parent and what her interaction meant for both of us. This interaction led to a moment in which I had the opportunity to highlight how she helped someone in a time of stress and to perhaps help the nurse feel more valued and appreciated. In emphasizing her connection with the patient and parent, I was also able to link back to my own sense of purpose.
Sometimes I forget how much I enjoy taking care of patients and their families. As a Pediatric Emergency Medicine Physician and the Chief Experience and Engagement Officer (CXO), I often have oversight of caregivers as they interact daily with patients and their families. The above interaction reminds me that there is much more than just looking at an x-ray and diagnosing a fracture or looking in an ear and searching for an infection. This encounter above could have been exactly that. Imagine that scenario If I had just walked by and did not stop and chat with the nurse and did not thank her for the work she did? If I had not helped her recognize how she helped changed this patient’s world in the moment? It could have happened, has happened, often happens. It is easy to get bogged down in the clinical work as a physician and the administrative work as a CXO. The day to day grind is exactly that, normalcy that moves me through standard work, allows me to complete tasks.
However, recently I have been increasing my efforts to take a step back and reflect on my work and the efforts of others taking place around me. I have begun to ask "what if”? What if I stop and help someone remember why they went into healthcare? What if I stop and say how can I help this patient, this family, this colleague be healthier, happier, have a better experience and stay engaged? What if I move from bettering individuals, to helping my department, the hospital, and the community engage in their health? These are not far reaching goals if I begin with the basics and consciously make an effort to pause and reach out, when it is easier at the end of a shift to just say a quick goodnight and thank someone without meaning behind it. Changes take effort, but good changes are worth the effort.
So, I chose to make an effort to change. Both as a clinician and as an administrator, I began to pay more attention to engaging those around me. I endeavored to notice how my interactions affected others and how other’s interactions affected patients, families and colleagues. Then, I started to call these moments out. I began to work with others to remember why they chose the job they did, often asking the question "Why did you go into healthcare?” I would provide subtle ways that demonstrated how important each interaction was to another and then tie it back to a sense of one’s purpose. Subsequently, this was connecting me back to my purpose as well.
Several weeks ago I began to think about how my journey has led me to change how I care for patients and care givers and why I continue to ask "what if” questions. As a visible leader in patient experience, I turned the "what if” question back onto myself. What if I could use my leadership to not only give a voice to the importance of strategies, but to also influence how each of us see ourselves as caregivers and its importance collectively as a community of caregivers?
About a year ago, as part of the journey to continually develop my skills as well as improve the experience for my patients, families, and colleagues, I researched the new Certified Patient Experience Professional Certification through the Patient Experience Institute. By definition, a certified patient experience professional (CPXP) is a formal or informal leader who influences the systems, processes, and behaviors that cultivate consistently positive experiences as defined by the patient, resident, and family in settings across the continuum of care. This certification fit my journey both as a physician and administrator. I enrolled, completed the necessary training, passed the exam, and became part of the inaugural certified class this past spring. This is a piece in my ever continuing training to become a better leader, and helps strengthen my ability to cultivate a community of caregivers that can reconnect to the importance of what they do each and every day.
In closing, I would ask each of you to think about the "what ifs” and how that can help us all connect to our purpose in the significant work of healthcare.
- What if we all carry this forward?
- What if we all pay attention to actions that positively affect others?
- What if we help others see the beautiful interactions that occur day in and day out while we care for our patients, their families, and each other?
- What if we were all more connected to purpose?
- What if we advance our skill set so that we can become exemplary leaders in the world of patient experience?
As the Chief Experience and Engagement Officer for the University of Chicago Medicine, Alison Tothy, MD leads efforts to optimize patient experience and engagement across the medical system. From high level strategic planning to oversight in development, implementation, and optimization of national best practice standards, patient-centered care strategies, and innovative approaches to patient care, Dr. Tothy strives to improve patient outcomes through strengthening patient, family, and caregiver engagement.
Posted By Martie Moore,
Friday, May 1, 2015
Updated: Thursday, April 30, 2015
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Today, we live in a complex healthcare world. And unfortunately, the excellent patient care always desired, sometimes gets lost in the chaos.
Yet every day, we have the opportunity to calm the chaos and bring to life what Patient Experience Week is truly about: aligning head and heart with compassion.
As Chief Nursing Officer at Medline, it’s my job to uncover new ways to help clinicians meet their patients’ needs. I spend a lot of time in the field talking with clinicians about patient satisfaction and clinical outcomes. For this week, I wanted to do even more. I talked with nursing students, the future of patient care, about aligning head and heart with compassion.
On choosing healthcare:
"I went to college to become a graphic designer. You were always trying to compete with the next person and it just didn’t match my personality, so I started seeking other opportunities. During that time, my grandfather was going through some bouts of cancer. We had good experiences and bad experiences with clinicians. That’s when I knew I wanted to be a nurse and provide patient care.”
Christopher Galloway, MSN candidate at Resurrection University in Chicago
On defining patient experience:
"To me, patient experience is the overall perception a person has about the care they received from a healthcare provider. No matter the diagnosis, if a person feels that they were well-taken care of, they will be satisfied.”
Julie Neske Bierach, Accelerated BSN program at Goldfarb School of Nursing at Barnes-Jewish College in St. Louis
On your first face-to-face interaction with a patient:
"I felt unprepared to handle that level of responsibility, making decisions that directly influence the well-being of another person who has put their faith in the health care system. Often times, patients value the things that you take for granted. My patient may not remember that I ensured her fluid status was adequate every day, but she was sure to thank me upon discharge for making sure she was warm each morning and had enough blankets and pillows. These experiences highlight the balance between the art and science of medicine.”
Jordan Gales, third year medical student at the Cleveland Clinic Lerner College of Medicine
On dealing with life and loss:
"For those that have ever met me, it’s no secret that I’m an emotional person. In nursing, this is almost a paradox—you need innate compassion and emotion to feel for each of your patients and their individual journeys in order to help them, but on the other hand, nurses deal with loss on a daily basis. And they must learn to move on, and not carry each lost patient with them or that can take a huge toll on them emotionally, mentally and physically. When I think about what I need to do to deal with life and loss, I know I’m the kind of person who will put myself in the affected family’s shoes and think about that person that was taken too young, too soon or too unexpectedly. It will weigh heavily on my mind, and more so my heart. Yet, I know I will bounce back, move on and let it go without forgetting the memories of these individuals.”
Lauren Cummings, third-year nursing student at the University of Iowa, College of Nursing
Martie Moore is chief nursing officer of Medline Industries, Inc. based in Mundelein, Ill, a leading provider of medical products and clinical solutions across the continuum of care. In this role, Moore provides nursing leadership for solution-driven clinical programs, delivers product development to enhance bedside practice and launches quality initiatives across the continuum of care. With what she learned during the nearly 30 years of clinical experience and extensive executive leadership, Moore now develops forward-thinking solutions and programs for those in the field today.
Posted By Bernadette Brady,
Friday, May 24, 2013
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I know that the patient experience is about individuals as much as the organisation. I also
know that in some organisations there are individuals who come up with really
good ideas to improve the patient experience. Visiting a local hospital some
months ago I walked past an enclosure containing birds and lizards. The bird
song was piped into the corridor so as you walked along the corridor you could
hear the birds chirping. It made me smile. There were individuals standing at
the enclosure just having a quiet moment. Each time I visit there are people
just enjoying the difference this enclosure brings to the usual hospital helter
skelter. Often there are children there who are kept entertained while their
parents make phone calls.
This enclosure was the
brainchild of the gardener. He roped in the electrician to help. Together they
have built the enclosure, lobbied for financial assistance to stock it and feed
the occupants and continue to maintain it. They are very proud of their
Alastair is the gardener at Calvary Health Care in Canberra,
Australia. Calvary is a fully accredited 250 bed public hospital. Services on
this campus include emergency department, an intensive and coronary care unit,
medical and surgical wards, a maternity unity, a voluntary psychiatric ward and
ambulatory care and outreach facilities and services.
There are many visitors to this hospital each day, some of
whom are fearful for themselves, some of whom are fearful for people they love.
Hospitals are not somewhere we chose to go to.
Alastair has, over many years, tried to provide areas within
the grounds of the hospital that will allow people to smile, to linger, to
revive. His greatest venture to date though is an enclosure that is situated
adjacent to one of the hospital’s busy thoroughfares. This enclosure takes up
an open air space enclosed by three walls and the glassed corridor. Alastair
has turned this area into an aviary with fish and lizards in the undergrowth.
The aviary is evident to all who walk these corridors. It provides a focal point for all who walk
along the corridor.
Initially Alastair introduced some lizards, fish and a
couple of quail to the enclosure but the crows kept taking the fish. That was
when Alastair enlisted Eric’s assistance. Eric is the hospital electrician. He
helped Alastair to put a net over the enclosure to keep the crows out. This of
course meant they could keep birds in.
The Facilities Manager approved payment for the netting and
the social club provided $220 towards buying birds.
About this time Eric saw an ad in all classifieds for
finches for sale for $2 each. When he rang to say he would "take the lot” the
person selling the birds asked why so many. When he heard where the birds were
to go he donated "the lot”. Another man when he heard what they were doing
donated quails. One man was overwhelmed by the aviary. He donated lizards.
Alastair and Eric have
been impressed by the generosity of local businesses and the community in
supporting their project. One woman donated speakers, a microphone and
amplifier box so the bird song could be heard in the corridors. She then sent
her son to install the equipment.
Alastair gets joy from the
number of people who linger at the window. "There are always people standing
there I have many thank you notes, We get to know the people who are coming
into the hospital regularly. One particular lady who comes to chemo twice a
week told me that coming to chemo she has a smile on her face and on her way
out she has a triple smile, just listening to the birds.”
For Eric "it is about making it easier for the people who
have to come here or the staff who just need somewhere to go and reflect
sometimes. We love watching the reactions.”
one man’s desire to make a difference to patients a community has been formed
with a common goal – to improve the patient experience.
Bernadette Brady, member of The Beryl Institute, has 40 years experience in the Australian health sector as a registered nurse, manager and change agent. She now works with health facilities to improve their knowledge of the patient experience and partnering with patients.
Calvary Health Care