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Top tags: patient experience  healthcare  communication  culture  patient  HCAHPS  Leadership  patient engagement  empathy  physician  survey  compassion  perception  physicians  technology  caregiver  community  data  employee engagement  family engagement  healing  Hospital  improving patient experience  collaboration  Consumerism  Expectations  interactions  patient and family engagement  pediatric  person-centered care 

Rounds for Change

Posted By Irene Brennick, Monday, April 25, 2016

As a volunteer director, I often make patient rounds with my CNO. At my hospital, staff and volunteers alike make patient satisfaction a top priority. We frequently round on patients, not only to assess their needs, but to also find out what didn’t go right so we can learn from it, correct it and make things better for everyone. During one particular interaction, I discovered how easy it can be to change a patient’s perception of the hospital from negative to positive.

My CNO and I walked into a room and encountered a female patient and her husband. We inquired about their experience, and their response revealed an opportunity for improvement. The woman said she was admitted through the emergency room, sent to another unit and finally arrived at the room she was currently in.

The patient told us how sick and scared she was. Her experience in the ER was somewhat of a blur, but she remembered very clearly an abrupt nurse in one of the units. She said the nurse didn’t listen to her, and her husband echoed the lack of attentiveness on behalf of the nurse. Once she was brought to her private room, however, she said she had received nothing but the best treatment.

After she recounted her story, my CNO told the patient "I am very sorry to hear that, because what I hear is that the care is very good. I will investigate the situation, and again, I am sorry.” I too have always heard about the exceptional treatment people receive in our facility, and was quite surprised to hear anything negative at all regarding the care. This patient and her husband started to protest a bit stronger. They repeated their story about how the nurse treated them in the unit.

I thought to myself, remember it is the patient’s perception of care and sometimes we have to do our best to make the patient experience better. When this patient goes to fill out a patient satisfaction survey we want to have eliminated or decreased the negative impression of our hospital. Before we left the room, I looked closely into the woman’s eyes and simply said, "I’m sorry you believe you didn’t receive the treatment you deserved. It’s not ok, and we need to do better.”

I wanted to let the woman know that I too heard her. If I were a patient and felt I was not treated compassionately, I would be upset as well. What happened next was pretty amazing. As we started to get up and walk out, the woman said, "Well, people are only human and everyone has a bad day. I don’t want to get anyone in trouble and really my care was very good.” At that moment I knew, just by being heard and acknowledged, the woman went from being upset, to all smiles, as she chatted about how she was feeling much better and hoped to be discharged soon.

I learned that day that making rounds is very important and we must really listen to what our patients are telling us. If a patient claims to have had a bad experience, they had a bad experience. It is our job as hospital staff to make the situation better, rather than be defensive. It is much better to just listen to our patients. Their information is a gift, and we should acknowledge their concerns. We should apologize, investigate and correct. Only then, will our patients begin to forgive any imperfections that occurred during their stay, and they could even become our greatest advocates. We want our patients to have the best experience when in our facility.

Since 2003, Irene Brennick has managed over 700 volunteers at Los Robles Hospital in Thousand Oaks, California and puts on health and education events as their Director of Community Services. She has a total of 24 years of experience developing and implementing dynamic volunteer programs. She has also addressed tens of thousands of people and her story has been featured in the L.A. Times, Daily News, and on television and radio. Ms. Brennick also speaks on topics that include, finding one’s purpose in life, the importance of giving back through volunteerism, and how anyone can be an inspirational public speaker.

Tags:  compassion  leadership  listen  patient advocate  perception  rounding  volunteer 

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Patient Experience: Above and Below the Surface

Posted By Don Prisby, Monday, March 2, 2015
Updated: Wednesday, February 25, 2015

Can listening to icebergs teach us something about listening to patients?

One morning last week, I was tuned in to National Public Radio (NPR). The feature story was about a gentleman who "listens to icebergs." Listens to icebergs? Really? In some way, I sensed a kindred connection with this Arctic audiologist of sorts. But I just couldn’t put my finger on it.

As the story unfolded, I learned that the majority of an iceberg’s structure is under water, beyond our field of vision. That which can be readily seen relays only partial information about the iceberg’s actual state. What was asserted in this radio interview is that each iceberg emits audio clues that, once aggregated into patterns, can be considered correlative indicators of that iceberg’s current state, be it melting or perhaps moving. The iceberg’s voice can also reveal what it’s about to do - either cascade into the deep, dark blue or worse, menacingly float into the shipping lanes.

Then it dawned on me why this story inspired me. Why is that, you ask?

Because you and I, in our various healthcare roles, are like the iceberg attendant. By listening to patients’ input about their care on a daily basis, we gain insight about conditions, behaviors and processes that impact the patients’ well-being. Additionally, similar to icebergs, most of what our patients are really experiencing is below the surface. When we listen to our patients intently, we are likely to avoid being caught unprepared for immediate concerns or finding ourselves on a "patient-care Titanic," about to hit an obstacle below the surface.

One of our missions as patient experience professionals is to track immediate and long-term trends based on patient feedback. We seek to hear, in real-time, insights from our patients, gleaned from attending deeply to their verbal, emotional, psychological and physical concerns - those that we can observe right away, and those that we understand only by actively listening.

But what does actively listening to the patient mean? Lagging data from 45-day-old survey responses is important - yet not enough. Actively listening on a daily basis requires the commitment to:

  • Hear in real-time the urgent concerns of our patients
  • Turn that input into insight · Share that insight with our front-line staff
  • Look for team members or practices that can be coached or improved right away
  • Discover trends that tell us more about our future success
  • Act on leading indicators
  • And listen. Again. And again. And again. Daily.

Leading hospitals I’ve worked with have realized dramatic increases in operational and clinical performance by actively listening, in real-time, to the patient. Then, they take active steps to improve behaviors often associated with improving HCAHPS scores. These same hospitals have also achieved other benefits such as engaging non-clinical staff in the mission of care and increasing staff loyalty through the daily sharing of input that has come directly from their own patients. An iceberg will not thank you for your concern, but a patient can - and often will.

With real-time insight and rapid-cycle improvement, we will gain new awareness. We will improve clinical and operational processes. We will assure a healthier and more effective care environment. And we will avoid the financial, reputation and patient-care disasters that might otherwise be lurking, unknown, unseen, unheard, under the surface and up ahead – for the next shift, or for the next patient.

For more insight about how some organizations are using leading insight to improve clinical, operational, staff engagement, safety and care improvement, The Beryl Institute has recently published this Case Study about the VA New Jersey Health Care system success using real-time insight for improvement.

Don Prisby is a business development executive with Minneapolis-based TruthPoint, a technology enabled performance improvement firm focused on delivering patient insight and performance improvement services to healthcare systems nationwide. Don is an avid reader and recently was a guest speaker at Concordia University’s (St. Paul, MN) MBA program presenting the topic "Intrinsic and Extrinsic Elements Influencing Culture Change.”

Tags:  HCAHPS  listen  patient engagement  Patient Experience  real-time 

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The Patient Perspective

Posted By Randi Redmond Oster, Thursday, May 1, 2014
Updated: Wednesday, April 30, 2014

One thing I know is the hospital. Not because I’ve worked there or I’ve studied anything to do with clinical settings but because my son has Crohn's disease, my husband has a pre-existing condition and my 85 year old mother has lived with my family for 17 years.Between the three of them, I’ve been to the hospital over a dozen times, maybe close to 20. I’ve learned while the patient may have different symptoms, clinicians seem to share the same approach when dealing with a healthcare crisis. They focus on their job, just as they should. They are specialized experts. While the condition or symptom or pain may be new to us, they have been trained to find a solution.Facts prevail. Data is gathered. Recommendations made.

Each time as I sit and wait for the doctor to tell me what is wrong, my hands sweat. I feel lost, confused and scared. Deep down, I wish I was someplace else. But the doctor focuses with laser sharp precision on the medical issues.My heart just races as we are many times forced to choose a course of action. I may not make my best decisions when my heart is breaking for my loved one. One time, my son was hospitalized when our doctor was out of town. I had never met the doctor recommending surgery and wasn’t even sure she knew my name.Yet, I was supposed to trust her unconditionally. She focused on his diseased intestines, the surgeon on the operation, the anesthetist on keeping the patient asleep.

But who was looking at Gary’s emotional health? Who was helping Gary learn to cope with a chronic life long disease beyond recommending medications that could possible cause cancer down the road? I truly believe they care about their patients. However, the system does not give them the time to spend with us. In the hospital, we never knew when the doctor would arrive. We’d just wait and wait.When they did arrive they often seemed rushed. When Gary had to choose between three different medications, some with harsh side effects, the doctor visited the hospital room for 15 minutes. As he raced through the benefits and risks of each choice, did he know our point of view? Did he ask? I made sure to tell him.

After Gary’s operation, as he rested comfortably the next day, I went to the cafeteria to get some lunch. I saw some of the residents who kept poking Gary awake each day. I was thrilled that the operation was a success and wanted to thank them for their efforts. As I passed one of them on line, he stared down at his tray. I guess I was hoping this refrain didn’t apply as it did in my years as a corporate executive: "It’s business, it’s not personal.”

So from my corporate days, creating high performing teams, I’ll share the secret to my success. LISTEN to the customer and your business, just like your patients, will thrive.

Randi Redmond Oster is an award winning author of newly released Questioning Protocol. She worked in the corporate world as an electrical engineer and a process expert for almost 20 years. Her life – and her work – took a sudden turn when she had to care for her aging parents plus spend a month advocating for her chronically ill son in the hospital. Her Six Sigma skill set, engineering degree and compassion as a mom makes for compelling, engaging and valued sessions.


Tags:  experience  listen  patient  perspective 

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