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The Beryl Institute invites members to submit posts on patient experience related topics. For guidelines and information on submitting a post for consideration, please contact us at info@theberylinstitute.org.

 

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Virtual Care Visits: Delivering Care that is Patient-Centered and Compassionate

Posted By Theresa Dionne, MA, CPXP, Thursday, April 30, 2020

Virtual care visits, once a “nice-to-have” for patients and providers, have quickly become a “must have.” Due to COVID-19, healthcare professionals across the United States have been propelled into the future of virtual medicine as a means of necessity to continue delivering care to patients. The response to the question asked by many providers, “How will we continue to compassionately care for patients and keep them safe?” has been answered and answered swiftly. Some would say old school is the new school; we are “going back to the future” in that doctor visits are at home again as in days past. Virtually, that is.

Now that many healthcare organizations are up and running and connecting with patients via various platforms such as Apple FaceTime, Google Duo, Skype, and Epic Video Visits, providers want to maintain great patient-centered, compassionate care but are concerned with how best to preserve patient-provider engagement.

As a provider, you demand best practices for your in-person care patient visits and the same holds strong for virtual care visits. Virtual care visits invite a multi-dimensional response to the way healthcare is delivered. Providers want to ensure professional, safe, efficient care, while ensuring privacy and quality are honored. At the same time, patients, even those truly welcoming virtual care visits, are entrusting this virtual method of care delivery.

For various reasons, some may struggle and resist virtual care visits, while most will support them. In time, this will be a win-win for providers and patients. These days, for many reasons, we find patients of all ages embracing telecommunication technology for medical treatment. For some, not having to take time off from work or limiting travel time to receive care is also greatly appreciated. For others, receiving virtual care is simply expected in this day and age.

We hope the following is useful advice for providers asking, “How do I continue to honor the provider-patient relationship during virtual care visits?” The answer is threefold: 1) trust the technology; 2) trust yourself; and 3) trust your patients.

1.     Trust Technology: Practice, Practice, Practice

 

a.     Attend and review training sessions offered until confident; rally with fellow colleagues to share best practices.

b.     Know the various Virtual Care Visit platforms available. Have your organization’s IT number handy for when concerns arise.

c.     Be sure to document clearly, connect with the patient portal and know the appropriate billing and coding instructions.

 

2.     Trust Yourself: Represent the best of yourself

 

a.     Review the patient’s medical concern and history; set an agenda, ask clear questions and take a thorough history of present illness. Clinical guidelines apply to virtual care visits just the same as in-person visits. Utilize Shared Decision-Making concepts. This may sound like, “Hello Mr. Chance. I looked at your medical history before our video visit.  I understand you are having some headaches. First, let me ask you some questions to help get a better understanding about your headaches. Then we can talk about your thoughts and concerns of how to manage your care.

b.     Always make a personal connection as you begin. Use the patient’s name and maintain comfortable eye contact. If this is a first virtual visit, reassure and invite the patient to ask you questions at any time. For example, you may say, “Mrs. Rose, I want to make sure I do a great job caring for you.  Please ask me questions as we visit here. I LOVE WHEN PATIENTS ASK QUESTIONS!” And don’t forget to smile, which is especially needed these days!

c.     As you close the virtual care visit, express thanks and explain next steps, such as, confirm where the patient will pick up their prescription, schedule a follow-up visit and/or advise who will call them back as needed. You may close with, “Thank you, Mr. Norman, for meeting with me by video and sharing your medical history. What questions do you have regarding what we talked about today before we end our visit?  Please confirm the name and location of the pharmacy you choose. Also, remember Maria will call you in two days to schedule your follow-up visit.”

 

3.     Trust Patients: Patients want to learn from you

 

a.     Share your screen to invite patients to see important images such as lab results; encourage them to take notes of any instructions or write down follow-up questions they may want to ask. This may sound like, “Miss Mary, can you see the chart on the screen clearly?  Let’s talk about what we are looking at.”

b.     Utilize the “TeachBack” tool to ensure patient understanding. TeachBack sounds like this, “Ms. Maple, I want to make sure I did a good job explaining your follow-up care. In your own words, please tell me the three steps we talked about regarding your new medication for heartburn control.”

c.     Invite patients to share what they appreciated about the virtual visit and how you can improve their experience. Invite their input by asking, “Tell me Mr. Smith, are you comfortable meeting with me on the computer this way? What can I do better to improve your experience?”

 

This advice is intended to inspire you to continue to provide the excellent compassionate care you deliver to patients.

As we observe social distancing, healthcare professionals are finding that virtual care visits provide an alternative way to compassionately connect with patients. Delivered effectively, virtual care visits will maintain the trust of your patients while keeping them, yourself and your team members safe.  

 

Click here to review a web-side manner tip-sheet.

 

 

Theresa Dionne, MA, CPXP, Consultant, Patient Experience, is a communication specialist and celebrates over 10 years in Patient Experience. In 2016 she joined Methodist Medical Group in Dallas, Texas. In addition, Theresa is an instructor in the “Introduction to Coaching” course for the University of Wisconsin’s on-line Health and Wellness Program. Her passion is encouraging employees to embrace patient-centered approaches and focus on relationship building in healthcare.

Theresa Dionne, MA, CPXE, Consultant, Patient Experience, is a communication specialist and

Tags:  connection  COVID-19  social distancing  technology  virtual care visit 

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Connecting with Patients is Key

Posted By Tom Scaletta MD CPXP, Thursday, February 15, 2018
Updated: Thursday, February 15, 2018

I think everyone today can agree on the importance of having communication tools to interact with patients and family members. However, in the era of value-based healthcare, doing a good job interacting with patients is not nearly enough.

At my organization, we have created a simple communication tool called G.R.E.A.T.™ that will help inspire a service-minded culture. This service standard helped us align our mission/vision/values with our culture and leads to enhanced patient satisfaction, improved care quality and a more engaged staff. Connecting on a deeper level with our patients and being mindful of their understanding of what is going on are essential components in achieving optimal outcomes.

A key component of the G.R.E.A.T. ™ is the ‘R’ that stands for ‘relate.’ To truly connect to our patients (or their family members), it is essential to have a personal conversation separate from the medical issues (of course, assuming the patient is not in any immediate distress). 

An easy way to create a rapport with patients, across generations, is to ask about one’s aspirations or accomplishments.

  • With younger patients, “What profession are you planning?”
  • With middle-agers, “What is your profession?” and
  • With older patients, “What was your profession?”

Such questions typically leads to some back-and-forth banter that creates a nice bond. You will find you like the patient more … and they will like you more. The content of the conversation is not important though it must be authentic and empathetic. This type of interchange will create trust, the foundation of the people experience, that of both patients and providers. 

These conversations are beneficial not only for the patient but also the providers of care. A great patient experience requires a great provider experience and a great provider experience requires a great patient experience. The closer you get to your patients the further you get from burnout.

I would like to share a story of this in practice. I was working a typical emergency department shift with a great team and had a steady influx of patients all evening. At 8 pm paramedics rolled in with an elderly, demented lady from a nursing home with right-sided weakness that began yesterday. A CT scan uncovered a golf-ball sized tumor with swelling. She had a history of breast cancer so this likely represented a metastatic lesion. Typical care ensued -- fluids, steroids, comfort medications and a call to the hospitalist for admission.

I then phoned the patient's daughter (and power of attorney) to suggest that she and other family members begin discussing how aggressive they wanted the treatment plan to be. The daughter interrupted, "Doctor, could you just go to my mom's bedside and say 'Dr. Peters, you were right'?" After my "Huh?" she explained "My mom is smart and knows her body. She has a PhD in both psychology and religion. Last month, a doctor told us she has progressive, incurable dementia. When he left the room my mom turned to me and said 'Well, yes, I'm certainly more confused but I'm not demented. They just haven't figured out what this is.'"

So, I went to her room, sat down, described the situation, and ended with "Dr. Peters, you were right." She turned to me beaming with pride and confidence and said "I knew it!" 

She certainly did.

I slipped a copy of her CV that I found online into her chart. I wanted everyone to know this amazing woman that all of us were privileged to care for.

Tom Scaletta, MD CPXP CPPS, obtained an undergraduate degree in mathematics and computer science and worked as an computer programmer before entering medical school. He completed a residency at Northwestern and is board-certified in emergency medicine and clinical informatics. Tom serves as the emergency department chairperson and medical director of patient experience for Edward Elmhurst Health. While President of the American Academy of Emergency Medicine, Tom collaborated with the Emergency Nurses Association to create a Code of Professional Conduct. His white papers, “The Seven Pillars of Emergency Medicine Excellence” and “The Calculus of Patient Satisfaction,” were published by Medscape. Tom designed the first patient callback system in 1996 and the first automated means of text/email contact and staff notification in 2012. His models were praised by the Robert Wood Johnson Foundation and Urgent Matters (George Washington University), an organization that evaluates emergency medicine innovations.

Tags:  communication  connection  empathy  patient experience  provider experience 

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How We Are Bringing the Voices of Patient and Family Advisors Together

Posted By David Andrews, Shari Berman, Erika Holliday, Barbara Lewis and Zal Press, Monday, November 28, 2016

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.

Tags:  community  connection  global  inquiry  networking  patient and family advisor  patient and family advisory council  PFA 

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