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By Kristin Baird
"We are understaffed." I cannot think of one time in my career when I heard caregivers complain about being overstaffed. Being understaffed, however, is a daily occurrence in hospitals and medical practices across the country. Staff are often running to keep up with the workload. Although being understaffed is a common occurrence, no good comes from sharing that fact with the patients. When you tell a patient or a family that you do not have the staff, they fear that their needs won’t be met. It can even dissuade some inpatients from putting on their call light because they don’t want to overburden the nurses. In other cases, patients will be more apt to put on their call light when they worry that they are competing for the nurse’s attention. In medical practices, telling patients that you are shorthanded may just make the practice look disorganized or ill-prepared to manage patients. Recently, I was doing observations at a medical practice. The team was short-staffed due to vacation and illness. When a patient walked in for a routine blood draw, she was told that they were short-staffed and therefore couldn’t do the blood draw. The patient rolled her eyes and said, “Unbelievable.” It was obvious from her reaction that she was put out by the situation. And no wonder. She had been told that she could come any time for her blood draw. What to do instead In this case, telling the patient that you are shorthanded doesn’t serve you or the patient well. Instead of telling the patient that you are short staffed (which is about you), turn the message into a patient-focused one such as, “Mrs. Jones, having your blood drawn today would be a long wait for you. Out of respect for your time, I suggest that you come in another day this week. What would work best for you?” This makes the message more about the patient and their time rather than your scheduling shortfall. There are many times in healthcare when we cannot give a patient exactly what they request. We can however, re-frame our response to focus on them. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success!
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By Kristin Baird
Surprises can be exciting when it comes to birthday gifts, but patients really don’t appreciate surprises. When I interview patients about what is most important to them about their care, being informed is always in the top two. They want to know what’s going on and what they should expect next. A couple weeks ago I was shadowing in a medical practice. The physician did a wonderful job engaging with the patient and getting to the bottom of her troubling symptoms. At the close of the encounter, however, he didn’t recap the discussion or tell the patient that when he left the exam room, she would be free to get dressed and go. Later, when I interviewed the patient she told me that she liked the doctor, that she felt he had been thorough, but felt like she was left hanging when he departed the exam room. She said, “I felt like he left and I had no idea what was going on. Should I go? Was I finished? Would he be back? What is next?" Another patient on an inpatient unit talked about how irritating it was for her to be picked up for a test that she knew nothing about. She was settling in for a nap when the transporter arrived to take her to imaging for a CT scan. Keep Patients Informed Keep patients informed and remember, how you close out an encounter is as important as making a positive first impression. By taking the time to recap, you are reviewing important points and clarifying next steps. Unfortunately, busy clinicians are mentally moving on to the next task (documenting the visit) or even the next patient. In all clinical settings, patients are put at ease when caregivers tell them what they can expect next. For nurses rounding on inpatient units it can be as simple as, “You can expect me back in about an hour.” Or, “I’ll be back in about 15 minutes to see how that pain medication is working.” Keep the surprises out of the patient experience. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Kristin Baird
We all judge our experiences differently. What is most important to me, may not be at the top of someone else’s list. And vice versa – what someone else sees as most important may not matter at all to me. The only way to find out what is most important to your patients is to ask. If you don’t ask the question, you won’t find out. In spite of this simple logic, many patients go through both inpatient and outpatient encounters without ever being asked what is most important to them. And that is a missed opportunity. When we teach rounding, we encourage nurses to ask, “What is most important to you during your stay with us?” during their initial admission process. Not only does this question help the team to prioritize, but it reassures that patient that you are interested in them just by the act of asking. Even though this best practice has been recommended for years, I only see it successfully implemented about 20% of the time. The good news is that it can be implemented immediately without spending a dime. What About Ambulatory? Asking this question works in ambulatory settings as well. Make it a habit to ask when patients are being roomed and having their vital signs taken. Ask, “What is most important to you about your visit today?” Another way of asking is, “What is the most important thing you want to accomplish during your visit with us today? Everyone appreciates knowing that their feelings and priorities matter. It also helps the provider in knowing what to discuss. Want to know what matters? Ask. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Kristin Baird
Working in healthcare takes an immense amount of technical skills especially when you work in direct patient care. After all, if you screw up an important technical task, you could hurt, or even kill someone. But it is important to keep in mind that the tasks almost always involves a human being at the other end. I can vividly recall how stressful it was to perform my first injections, my first IV starts and first NG tube insertions as a student nurse. I’m sure that during those “firsts” I was totally focused on the task at hand. Out of fear that I would mess up and inadvertently hurt my patient. In the beginning, I’m sure I was more focused on the task than on the person on the receiving end. Over time, as I became more proficient and gained confidence, I could safely share my attention between the human interaction and the technical task at hand. That is what many strive for – the balance between technical competence and the ability to relate on a personal level. One of the biggest challenges clinicians face is, that when stressed, they revert back to focusing on the task and not the interaction. I have a hard time believing that task-focused people just don’t care. Clinicians get busy and overwhelmed and think in terms of lists to be completed. When this occurs, they are often unaware that they have shifted into task mode which may make them appear detached. A few months ago, I was doing some shadow coaching with nurses. A nurse I shadowed was the most talented clinician I’d ever met in terms of her technical skills. She prided herself in this, yet was unaware of how she came across to patients and family members. The nurse seemed abrupt and uncaring to the patient and their family, because her attention was focused on the task and not the encounter. With feedback and coaching, this nurse quickly grasped techniques for engaging with patients in order to build rapport and trust. She always cared. She just needed to show it. Now, here patients describe her as both highly skilled and caring. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Kristin Baird
Healthcare providers are busier than ever before and it’s starting to wear on many of them. What I see when I am up on the units are compassionate and caring doctors and nurses with a lot on their minds as they move from patient to patient and situation to situation. They want to deliver a great patient experience, but find the demands on their time excruciating. When I do shadow-coaching, I often hear the same concern from both doctors and nurses. They want to know how to cope with the sheer demands on their time. They want to be fully present for each patient, but have difficulty shutting off the rest of the noise in their heads including thoughts about the last patient, the pager going off in their pocket, and the list of patients still waiting for them. The reality is that the workload isn’t about to get lighter, which means providers must find ways to cope in order to keep from burning out. Mindfulness is one of the best coping mechanisms that I’ve seen. I’ve witnessed firsthand the immediate impact it has on those who practice it. he challenge is in getting started because many people don’t believe you can achieve mindfulness outside of a quiet, dark room or a mountain in Tibet. You can. It may not be to the depth achieved in a controlled environment, but it is possible. It is a learned behavior. Here is the simple mindfulness practice that I teach: Before entering a patient room, pause outside the door. Use this pause to bring your mind to the present. Touch the door frame while you take 2-3 deep cleansing breaths while saying to yourself, “I am right here, right now.” While foaming your hands, tell yourself that you are washing away distractions. This simple practice takes just a few seconds and reaps huge rewards in patient and provider satisfaction. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Kristin Baird
Word of mouth has always been one of the most important means of communication whether it’s spreading news or sharing opinions. In the old days, pre-internet, if a patient was dissatisfied with his or her experience, chances are he’d tell about 15 or 20 people. Today, patients are texting, tweeting and posting their feelings throughout the entire experience. And chances are, you aren’t in their feed and may never know what is being said. With the click of a mouse, patients are sharing their experiences, good and bad, with the world. Word of mouse is the new word of mouth. In just seconds, your patients can tell thousands about a rude receptionist, long wait time or convoluted processes. And hopefully they are also sharing the great experiences along the way as well. I watched the power of social media unfold before my eyes a few weeks ago when someone made a negative comment on Facebook about their experiences at a pediatric clinic. Within minutes, there were dozens of comments from others sharing their similar, negative experiences, and it snowballed from there. In among the negative were a few positive experiences but they were drowned out by the negative. It was harsh to say the least. Although we cannot prevent people from seeing the negative, we can do our best to create a consistently positive patient experience. Map out your patient experiences to identify opportunities for improvement, listen to patient feedback with an open mind. The minor complaint today could be the snowballing social media conversation of tomorrow. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Kristin Baird
Patient experience (PX) champions are no strangers to resistance. Many people in PX leader roles struggle when implementing change because they hit resistance from a number of sources. Moving beyond resistance is something they must accept in the name of progress. But it’s not easy. To me, there is nothing more irritating than hearing someone shoot down an idea before it ever has a chance. I tend to be a big ideas person and have spent most of my career bringing new ideas to fruition. If you are a patient experience leader who is becoming discouraged by the resisters, try these suggestions: 1. Anticipate resistance and be prepared. Have conversations in advance of the change with key people and try to build buy in. Building buy-in is always the first, and most important step, especially among key stakeholders and influencers. If you can’t get their buy-in, you can at least ask them to not resist or sabotage. Sometimes when you pose it this way to chronic resisters, they are less likely to sabotage. I realize this is a bold move, but it’s important to lay the cards on the table. 2. Be prepared with some specific responses. For instance:
3. Seek support from others in a similar role who can share their experiences. Patient experience champions must be resilient in order to endure disappointments, setbacks and resistance. When you experience these enthusiasm killers, try not to let it get you down. Just keep the words of anthropologist Margaret Mead in mind: “Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has.” Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Kristin Baird
Attitude is contagious and transparent most of the time. Basic human instincts have trained us to look at someone and gauge mood and approach-ability. Your patients and other customers are no different. They judge quickly about someone’s attitude. Both individually and collectively, employees are sending thousands of messages every day about their individual approach-ability which reflects that of the entire organization. And don’t kid yourself, their verbal and non-verbal cues are loud and clear. If this is so obvious, why do we continually encounter poor service in healthcare? It may be pressure to hire and fill positions quickly, but that short-sightedness will hurt you in the long run. We can teach skills, but we can’t teach people to care if that isn’t in their nature. Behavior-based interviewing is a great way to assess an individual, but it is not the only barometer to use during the interview process. Learn to listen with your eyes. Watch how the candidate interacts with everyone. Little things should never be overlooked. Trust your gut. A few years ago, I was interviewing a candidate for a position in my company. Being a small company, where we work very closely and value a collaborative culture, everyone’s opinion matters. One of my top candidates arrived for her interview and was promptly greeted by our office manager with a warm hello. Without a smile, and with minimal eye contact, she stated, “I have an appointment with Ms. Baird.” She was invited to take a seat, which she did, and promptly pulled out her cell phone. In the two minutes she waited, other team members passed by offering a warm greeting. She barely looked up from her phone. On the other hand, when I opened my office door to greet her, she broke into a warm smile, stood, shook my hand and became a bubbly, talkative person. Did her brain chemistry suddenly change making her a friendly and engaging individual? I doubt it. She continued with the interview and did a fair job with the behavior-based interview questions. Her resume was very impressive. After the interview, I asked the office manager what she thought. She immediately told me that the candidate had been dismissive toward her and others. This candidate had given every indication that she wasn’t interested in impressing or engaging with anyone in the company other than me. That wouldn’t fly in my company, so she was not offered the job. If you really value the power of first impressions, remember that everything speaks. When interviewing, don’t ignore the little cues. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Kristin Baird
Every person has the power to do things differently – better than the last time. It takes just one thing. Not a policy. Not a procedure. Just a personal commitment. I see it all the time when doing shadow/coaching, and the impact is palpable. A nurse or a doctor commits to do one simple thing better during a patient encounter and it sends a ripple. They see the patient response and it reinforces a positive behavior. A few weeks ago, I was shadow/coaching a group of hospitalists whose communication scores were fairly poor- trying to help them make necessary improvements. In one situation, I observed a hospitalist who did a beautiful and through job of informing the patient about his condition and treatment plan while standing at the foot of the bed. I asked him to recap for me how he interpreted the patient’s response. He said that it was a good encounter and that he felt he had been thorough. I agreed with his assessment, but I asked him to sit beside the bed during the next patient encounter and pay close attention to how the patient responded. During the next encounter he sat and made excellent eye contact while discussing the diagnosis and treatment plan. After the encounter, I asked what he noticed. He pointed out that the patient seemed more engaged and opened up more. Then I asked him how he felt about it. He paused, smiled and said, “It felt really good. It felt like we connected in a conversation. I felt like he really understood what I was saying.” I pointed out that he spent the same amount of time in both rooms. The difference was clearly a win/win. Not only did the patient engage more, but he felt better about the encounter as well. Coaching nurses reveals the same level of awareness followed by increased commitment. It’s all about recognizing that each person holds the power to do things better in one single encounter. The same thing happens when the registration attendant makes an effort to engage and welcome the patient before diving into the “business” of the encounter or when the housekeeper pauses to ask what else he can do before leaving the room. When people act on their power of one to make a difference, they benefit as well as the patients. It’s the gift that keeps on giving. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Kristin Baird
Service recovery is an essential element of a great patient experience improvement plan. Of course you want to get service right the first time, but sometimes things don’t go as planned. When you have a service failure, it’s the apology that holds more weight than a gift card or coupon. If your associates can’t make a sincere and timely apology on behalf of the organization, you’re at a real disadvantage. But they need to know how to do it. A few weeks ago we were doing service recovery training with front line staff. As part of the training, we give examples of common service failures and ask participants to craft a verbal response. I overheard a conversation that validated the need to practice apologies. It went like this: Jane: This happens all the time. Sue: I know. I see it all the time too. Jane: So what do you say to the patients when this happens? Sue: Nothing. I don’t know what to say. Jane: I know what you mean. It’s awkward so I don’t say anything either. The truth is that many of your team members are at a loss for words when a patient or family member is upset. In fact, many associates say that they consciously avoid approaching anyone who looks angry or upset. That is precisely why they need to practice responses in their own words. Apologies can be awkward, so by practicing, you can begin to normalize your planned response. The best service recovery is a four-pronged approach.
Remember, telling someone to apologize and helping them to practice in their own words are two very different things. Help them build confidence with practice. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! |
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