Hardwired Results: Issue 22

with Patrick Bucknum, CEO of Columbia Valley Community Health, Wenatchee, WA

As a federally qualified health center, Columbia Valley Community Health (CVCH) excels at patient engagement with thoughtful and creative solutions. Because the organization serves a patient population that struggles with good reasons for disengagement—from poverty and lack of transportation to mental health disorders and chemical dependency—it’s worked hard to close the engagement gap.

As a result, CVCH has moved from the 57th to the 87th percentile in patient engagement over the last three years. Here are three best practices it’s used that will boost patient engagement in any organization:

At CVCH, 40 percent of patients speak Spanish and tend to exhibit cultural characteristics—like being respectful but passive when they don’t understand—that can cause misunderstandings with caregivers. As a result, all providers at CVCH are fluent in Spanish. In fact, if they’re not, they attend a three-week immersion program in Guatemala. Even still, translators are available to help with complex or nuanced communications.

In addition, providers use motivational interviewing techniques to ensure patients hear what there are saying. “It’s a two-directional communication approach,” explains Bucknum. “They begin by assessing whether a patient is ready to hear what they are going to say and also use the teach-back method at the end to ensure key points were understood and to assess a patient’s willingness to follow the physician’s advice.”

While many organizations are bringing patients in today to talk to staff and leaders, it’s frequently designed to hone marketing communications rather than to design a truly patientcentric approach to care. But at CVCH, the composition of its Board of Directors mirrors its patient population, including Spanish-only speakers and a migrant farm worker.

“They tell us about the issues patients are trying to communicate that we aren’t hearing,” adds Bucknum. “Whether it’s that a clinic or department name doesn’t translate well to Spanish or the fact that we need another adult dentist, they bring what the survey responses are trying to tell us into the Board Room. They use that front line perspective to shape a more meaningful strategic plan.”

When CVCH heard from patients that wait times were a problem and patients were anxious, they rolled out AIDET® with some strong gains in patient engagement. But it wasn’t enough. Eventually, they uncovered other drivers of anxiety for patients: sitting on an exam table, waiting in an overcrowded waiting room, and a sense of loss of control when entering a healthcare environment.

As a result, the organization redesigned its waiting rooms to feel more like a Starbucks or Barnes & Nobles experience, with small tables for kids and reading nooks for patients. CVCH also replaced two out of three of each provider’s exam rooms with “talking rooms.” Since only one out of five patients needs to disrobe, the new rooms facilitate patient-provider conversation without raising anxiety and blood pressure, as is common for patients who sit on an exam table.

And finally, CVCH sensitized its care providers to the plight of waiting patients with a recent clinic pilot of technology that tracks patient wait time in exam rooms for providers. Each provider can see how long a patient has waited before opening the door to an exam room.

“Ten minutes feels very different to a waiting patient than it does to a busy physician,” notes Bucknum. “This seems to be working as I just don’t see waits in the 20 minute range anymore.”

And now, we want to hear from you. What patient engagement strategies is your organization using successfully? Please share by sending them to D.Ritchie@StuderGroup.com.