Katie Owens - Healthcare Speaker and Executive Coach

Lead Author, The HCAHPS Imperative for Patient-Centered Excellence

Tag: Patient Experience

Four Lessons United Airlines Can Teach on the Importance of Person-Centered Communication in Healthcare

Effective communication is always determined in retrospect.

Communication is usually determined through the rear-view mirror. Did our town hall convey the tone and vision intended? Did the patient understand not only the importance of taking their medications but the instructions for following correct dosage? Did the employee hear the difficult feedback in a way that will lead to constructive outcomes? My belief is that every United Airlines team member had the best intentions when following their protocol. However, they missed the mark in that trust and relationships are the foundations of communication.

Despite our best intentions, good communication happens through the eyes of the beholder(s).

We may believe we are good communicators but do our recipients of the message agree? While Stephen Covey famously said, “We judge ourselves by our intentions and others by their behaviors,” we need to remember that United Airlines flipped this scenario. These employees and leaders, while following the integrity of their policy, neglected to account for how passengers, the media and consumers at large would judge their behaviors. Real-time video has allowed us to get a glimpse into a precarious situation. We need to remember that we are always on stage in this virtual age. Are our actions always displaying trust and respect for our patients, their loved ones and our visitors? While our missions should prohibit us from ever “re-accommodating” a patient, chances are we use words that could inadvertently leave a negative mark on the healthcare community.

We must pick ourselves back up off the floor (sometimes more often than we’d like to admit).

Even the pros mess up. United Airlines CEO, Oscar Munoz, has a reputation for being an effective communicator and feel confident their airline is made up of hard-working, well-intentioned employees. Negative things happen in travel and in healthcare. More important than the gaffe itself, are the demonstrable steps organizations and individuals take to persevere afterwards.

Think this can only happen to United Airlines? Think again.

We operate 24/7, every day of each year. Our patients and their loved ones can now share good, bad and shocking information with a snap of a mobile device. In our work, we have found it essential to establish person-centeredness as an integral value and a communication competency that needs to be cultivated by every individual who wears a badge in your organization. We recommend two proven models: Language of Caring’s Heart-Head-Heart for person-centered communication and HealthStream’s RELATE for person-centered behaviors. Seek out opportunities to institute deliberate practice and cultivate communication competencies for not just regular daily needs but simulate crisis scenarios.

Consider using two criteria: are my words and actions building trust? Am I displaying caring and compassion? At the end of the day, every person we encounter gives us the opportunity to display trust, respect, and compassion. We need to be ever more vigilant when we feel we are sliding into territory that could lead to irrevocable circumstances.

Compassion is a Human Mandate

This week I had two humbling opportunities to contribute to the national patient experience dialogue and share deep convictions for compassion in health care. Gregg Loughman, General Manager & Vice President of PX Solutions at HealthStream, and I presented a webinar series, hosted by The Beryl Institute, on the CAHPS Imperative for Patient-Centered Care. I also had the honor to travel to New York City for an interview with CBS News to discuss the impact of surveys in improving the patient experience.

  1. By Establishing the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey, Centers for Medicare and Medicaid Services (CMS) took bold and progressive steps to spark a conversation about the importance of every patient having a voice in the quality of care received. Until that point, the patient experience was considered a “nice to do” and now the patient experience is among the top priorities for healthcare executives, staff and providers.
  2. Whether you love or hate any patient experience survey, they have been designed by patients and their loved ones to convey the behaviors that reflect quality care. There is no doubt that working to achieve the level that “Always” or “Best Possible Hospital” requires; however most times we would want those same criteria for our loved ones. We cannot have two separate standards for what we would want and what we provide.
  3. The CAHPS Surveys were never designed for organizations and caregivers to chase scores or penalize. They were created to capture feedback on the total health care experience and give data to help develop competencies that lead to safer, higher quality care. The feedback creates opportunities to celebrate the best in our organizations and improve reliability at the bedside.

Recent research that I have had the opportunity to conduct has demonstrated that high performing cultures lead to a more engaged workforce, better patient experience performance, lower turnover rates and more favorable performance with value-based care measures. I encourage everyone to take the CAHPS Survey that most applies to their work area. Take the survey from the shoes, slippers and gowns of your patients. Use this as an opportunity to talk about why the patient experience matters in your organization. To me, the government never needed to mandate compassion but their progressive steps created recognition that compassion is a human imperative- every person, every time.

Surveys on patient experience

 

20 New Year Tips to Help You Elevate the Patient Experience in a More Efficient and Effective Manner

With 2016 coming to a close, I thought I would include 20 tips for 2017 to help elevate the patient experience in a more efficient and effective manner. I like to call it #PXHACKS!

Wishing you a happy New Year that will bring you greater heights of success and prosperity.  -Katie

  1. Ask your team what made them feel most reassured when they have been a patient. Rate your department on those criteria.
  2. Set a measurable, time-bound patient experience department goal. Strive to achieve a target that links to your organizational goal.
  3. Ask your staff to take Patient Experience Survey most related to their work environment. Educate how patients hold us accountable
  4. Create a list of Zero Tolerance words (short staffed). Engage your team to turn negative words into reassurance.
  5. Engage high achievers as champions in Patient Experience journey-those motivated & passionate- let them create momentum with you.
  6. We are always onstage with the Always Patient Experience-Compassion, Verbal, Non-verbal Cues.
  7. Upon visit, have admissions ask patients and families what is most important for their care. Use whiteboard to document.
  8. You are empowered. If you see trash pick it up, greet colleagues, patient and families with eye contact and a hello.
  9. Sit at eye level when communicating important information.
  10. Narrate your care and process. Never assume patients and families understand what you are doing and why.
  11. Always reinforce your patients and their families are in good hands with you and your organization.
  12. RELATE w/ every patient: Reassure, Explain, Listen, Answer, Take Action & Narrate Care, Express Appreciation.
  13. Block 30 minutes every week to walk in the shoes/crutches of your patients. See & feel patient experience from their perspective.
  14. Set Expectations early and often. Remember every person in your care is not used to the role of patient.
  15. Reward & recognize employees for going above & beyond for Patient Experience. No one ever feels over recognized at the end of each week.
  16. Give staff feedback about their performance. Share Survey results, patient experience comments and rounding feedback.
  17. Seek patient and family feedback when implementing programs. Let the voice of your healthcare community guide you.
  18. We miss the mark with Hourly Rounding & Bedside Report. It is not about the checklist or task but patient engagement and empowerment.
  19. Go on a ‘gurney journey’ to empathize with your patients and design improvements.
  20. Establish PX competencies for individuals who wear badges across the care Train and validate behavior.

What are your 2017 #PXHACKS (Patient Experience) Tips? Send me your feedback. If you enjoyed this post you may also like the article titled, “Can We Afford to Stay in Our Lanes to Achieve Patient Experience Excellence?”

 

Make Time to Stay Engaged this Holiday Season

It’s hard to believe that 2016 is almost over. With the holiday season upon us and the hustle and bustle of getting it “all done,” it’s easy to focus on the areas that aren’t working and the times we feel we are less than perfect. In our busyness, we can soon forget the moments that bring us joy. We should all be still for a moment and be reminded of why our professions in healthcare are so profound. Two influences impacted my focus for this November blog: a lunch outing with my family and a recent interview I had with Win Howard, CEO Asante Three Rivers Medical Center.

My family recently visited one of our favorite waterfront restaurants on Fort Walton Beach, The Gulf. While trying to enjoy my lunch I was also entertaining my rambunctious four-year-old son when suddenly I was captivated by a sign that steered my attention.

Win Howard

So many times, I hear leaders, staff, and providers experiencing burnout…overwhelmed with the “to do”s, frustrated by the growing documentation and protocols, the heightened emotions faced with the rising expectations of patient care. Yet, in my experience, the best days we have are when we can look back on any given day and see the good that happened and that we were able to share with those we touched. What I love about this message is we get to choose… We get to decide each day how we want to spend 1440 minutes in 24 hours. Do we want to spend it doing good for others or live in frustration and anguish? I bet for all of us who have been patients or loved ones of patients, we want every single person to be engaged and focused on making our experience one filled with compassion and high-quality care.

We found in our HealthStream Benchmarking Study on healthcare workforce engagement, that leaders are three times more engaged than their direct reports. We have to find ways to create daily inspiration and reconnect our teams to purpose. Here are a few ideas to create engagement despite our distractions.

Put excellence on a pedestal

Seek out what is working well. Begin each staff meeting with thanksgiving, reward, and recognition. Ask team members about moments made them proud. Ask patients what has made their visit or stay excellent. Get specific details so you can share with your team. There are plenty of times to address areas of improvement for quality, patient experience, and financial performance. Try your best to create environments where you build on your bright spots while you close gaps in other areas.

Obtain and share stories

In my interview with Win Howard, Win talks about the profound experiences that have impacted his leadership in creating a more patient-centered culture at Asante. Win is an accomplished CEO with high levels of employee engagement and patient experience outcomes, designations for patient quality, yet when he speaks about the moments that have created the most memorable experiences, they are ones of care and compassion- especially at the most difficult times.

Create visual cues and contagious experiences

Keeping focused amidst distraction requires attention, yet when you enlist others you get a contagious movement. Enlist your teams to have compassionate scavenger hunts. Take pictures using your mobile device to bring back examples from your daily activities or life outside of work (of course in compliance with your digital and social technology policies).

As we move into the last month of the year, let’s make demonstrable gains to restore engagement and put the culture we want at the forefront. There is no time to wait until this becomes a New Year’s resolution.

To request the full report of HealthStream’s Benchmarking Study please visit my contact page.

 

Can We Afford to Stay in Our Lanes to Achieve Patient Experience Excellence?

As I was driving to the Nashville airport after a successful week at HealthStream Summit I saw a traffic sign that read, “Stay in Your Lane.” It caused me to reflect on how often we inadvertently give messages to our best and brightest talent to keep their eyes focused on the road ahead and not to waver. Looking at my own career and experiences, the most memorable moments, achievements or sources of support came from those chances to go above and beyond or be on the receiving end of an individual willing to go the extra mile. Can we afford to stay in our lanes to achieve patient experience excellence?

The Patient Experience

When it comes to the patient experience, there is not a person in our care that wants us to deliver a checklist, only do our job. They want to know they are our biggest priority- they want to trust us that in their moment of need, we will not stay in our lanes- we will unapologetically go above and beyond for them. We will be brave to speak out in the event we see an error, pray with them when they are scared or losing hope, comfort their loved ones and sit at their bedside just a moment longer.

The realities we face in our day to day grind can sometimes cause us to lose perspective. My dear colleague Kathy Boswell, Director of Organizational Development at Brookwood Baptist Health, shared; as leaders if our employees do not see us at our best, how can we expect each patient to see us at our best. Kathy reminded me that we are always on stage.

I was asked to be the opening keynote at our Patient Experience Workshop (attended by a group of national leaders who are passionate about every patient receiving the best care possible) and decided to poll the standing room only crowd. I wanted to know what actions or behaviors made them feel most reassured when they were a patient. The results (below) were compelling… When we are a patient, we want confident employees, communication, and eye contact. None of these require a capital investment. We are all called to re-sensitize the powerful role we play each day as soon as we put on our badge. It’s time to take action! I challenge you to stand up and stand out among your colleagues. Lead by example and BE the difference in the lives of your patients.

Stay in Your Lane

Let us not get distracted by the grind, our glance time, our productivity and forget that every patient deserves our very best. We can’t have a different standard between what we would want for ourselves or our loved ones and what we want for our patients. Do you think we can afford to stay in our lanes to achieve patient experience excellence? Let me know your thoughts by leaving a comment.

If you enjoyed this article you may be interested in “20 Tips to Help Elevate the Patient  Experience in a More Efficient and Effective Manner.”

Common Sense for Improving the Patient Experience

Three proven techniques — “personnel” attention, setting expectations and accountability — can transform your hospital’s culture.

At the risk of stating the obvious, all health care begins and ends with the patient. Yet, we are falling short on instilling behaviors and systems centered on the patient. In fact, hospitals have a dismal disappointment rate of 29 percent: According to the most recent Centers for Medicare & Medicaid Services HCAHPS survey, American patients believe they were treated at the best possible hospital a mere 71 percent of the time.

If you consider how hospitals, physicians and the industry as a whole are judged, the patient experience can make or break your reputation as well as the bottom line. My challenge to you is simple: Use common sense to create a solvable scenario for our leaders, employees and physicians who care deeply about being successful.

Critical Questions
Patient surveys and the potential financial impact of value-based purchasing have elevated the patient experience to one of the most pressing issues currently facing health care organizations. The Beryl Institute’s 2013 benchmark study, “The State of Patient Experience in American Hospitals,” revealed that patients rank their care experience as one of their top priorities. Yet, a 2013 HealthLeaders Media study revealed that 58 percent of health care leaders have not made specific patient-experience investments.
In this time of unprecedented change, financial pressures and competing priorities, how will your hospital meet or exceed quality measures? How can you avoid the financial penalties associated with underperformance? How can you create systems of accountability and recognition to ensure that your culture achieves results?

Patient-centered excellence is the commonsense answer to these questions and more. Each patient is your hospital’s core responsibility, but are you committed to providing service excellence? Is your staff taking the time to remember that “the gall bladder in 205” is really a retiree named Miss Peggy who volunteers as a crossing guard in her neighborhood? Does Mrs. Jones know without a doubt that her care and needs are your priority on any given day, despite emergency department volumes greater than 100,000 visits per year? If not, patient-centered excellence is not a priority at your hospital.

I am going to outline three proven techniques that can put your hospital on the right track to improving the patient experience.

Cultural Transformation through “Personnel” Attention
HealthStream Engagement Institute poll given to 250 health care leaders ranked “people” last in their list of priorities. How can we ask our team to create exceptional quality, financial or experience outcomes if we are not developing and engaging the people who achieve our results?

What does it take to transform a culture? Unfortunately, it does not happen overnight. Cultural transformation is a journey that begins with “personnel” attention. It involves learning new skills and creating opportunities to mentor staff and leaders.

To put this into perspective, I have yet to find a hospital that excels in patient-centered excellence that does not value and nurture its own personnel. From senior leaders to physicians, and the environmental team to valet drivers, your personnel must take ownership in your hospital. They must feel heard and respected and ultimately be a part of the conversation.
Take a moment to rate your hospital’s commitment to patient-centered excellence. Answer the three challenge questions listed below.

patient-centered excellence

If you cannot rate your teams predominantly between fours and fives, chances are you are encountering one or more of nine common barriers to cultural transformation:

1. failure to set clear direction and mission;
2. lack of staff ownership and buy-in;
3. fragmented communication;
4. lack of recognition and rewards;
5. failure to hold staff accountable for performance;
6. inadequate data-collection and measurement process;
7. satisfaction with the status quo;
8. insufficient leadership commitment and visibility;
9. lack of an open and trusting environment.

I encourage you to review these barriers and then do the exact opposite.

Great Expectations
An easy-to-remember but tough-to-implement mantra is “every patient, every time, every interaction.”

Just as it is your leaders’ job to set expectations with your personnel, your personnel must strive to set proper expectations with patients. The first step for staff is to try to understand the patient experience from the patient’s perspective. The second step is to deliver a consistent experience to every patient, every time. Unless we understand the patient’s perspective, we will be unable to deliver the best experience possible.

Another key factor for staff is knowing that there’s a big difference between what’s important to the patient and what’s important to us as health care providers. Human beings are not used to being patients, so we have to help them know what to expect during their hospital stay. After all, they spend most of their lives outside the hospital. It is our role and privilege to understand and manage what the patient sees, feels and experiences.

An example of properly setting expectations is explaining what kind of noise a patient will hear at night, going so far as to illustrate that the patient might hear noises different from those in his or her home. Additionally, we need to tell the patient that “ultimately our job is to make you feel secure. We’ll respond 24/7 and take care of you during your stay.”

Accountability and the Patient Experience

Accountabilities predict the outcome. This is a fact that I have witnessed countless times. The challenge lies in properly evaluating behaviors and setting accountability measures. We are astute at holding people accountable for financial and quality measures, but the patient experience can be tricky. We need to establish, clarify and champion specific accountabilities for the patient experience.

Evaluation with consequence sustains results. The best way to illustrate this claim is to imagine the best nurse, physician and technician in your hospital. Now imagine the ones whom you would not want within 20 feet of your loved one. If you pulled annual performance evaluations from both, would there be a difference? If not, there is a lack of accountability and consequences. We need to remove this deficit to transform the patient experience.

Tools and tactics work best one at a time. The three I have outlined here — “personnel” attention, setting expectations and accountability — will get you on the right track. I guarantee that recognizing patient-centered behaviors will elevate your market position and financial performance. Patient-centered behaviors cost nothing, but they earn dividends. Are you prepared?

Katie Owens is the Vice President of HealthStream Engagement Institute based in Pensacola, Fla. She is the lead author of “The HCAHPS Imperative for Creating a Patient-Centered Experience.”

To Access Article:
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Patient-Centered Communication: Verbalizing while using EHRs

Effective patient-centered communication is the foundation of high-quality healthcare. Nearly all healthcare interactions — from making appointments and registering to discussing medical symptoms, treatments and care options — rely on effective communication. Technology, in particular, electronic health records (EHRs), holds the power to improve our communication with our fellow healthcare providers and our communication with patients and their loved ones or denigrate it.

While electronic health records can create the opportunity for real-time documentation and information sharing, we must leverage this tool to enhance our interactions with patients. At HealthStream Engagement Institute, we recommend three important tools to support the intersection of EHRs and patient-centered communication:

1. Use “words that work,” ban “words that don’t work” and take advantage of your investments in leading technology to provide the best patient care possible.
Words

patient-centered communication

Words that work are designed to create a positive impression of your organization; however, words that don’t work are likely embedded in your organization as well (especially when it comes to EHR technology). By working with and engaging your teams, you can identify the words that don’t work, create crosswalks to words that do work and have fun in the process.

2. Narrate your care and process: Explain every step. Whether you are entering demographic information at admission, conducting bedside shift reports or validating medications, we cannot assume patients understand the intricacies of care delivery.

3. Use RELATE, our patient-centered communication model, to engage patients while documenting their care electronically.

Reassure: Discuss the importance of bedside documentation to assure the highest quality care. Verbalize your commitment to quality. Acknowledge any fear or anxiety a patient or their loved ones may be feeling.

Explain: Explain the process for documentation and how the information will be used.

Listen: Listen for any questions the patient may have about charting, care delivery.

Answer: Answer their questions in easy to understand terms. If possible, use techniques like “teach back” to validate the patient’s understanding of your explanations.

Take action: Narrate your care and process every step of the way.

Express appreciation: Thank the patient for the opportunity to participate in their care.

 

Katie Owens is Vice President at HealthStream Engagement Institute. She works with senior teams to front line staff to establish alignment and engagement and coaches how measurement and data influence behaviors and drive outcomes for patients and their families.

Published in EHR Intelligence, 2014

https://ehrintelligence.com/news/patient-centered-communication-verbalizing-while-using-ehrs/