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Communicating the Patient Agenda: It's a Team Sport

Delivering a consistently excellent patient experience requires engagement by far more than the inpatient nurses on your team. You'll need to engage leaders, physicians, ancillary staff, and others across the care continuum. Here are just a few examples of how Studer Group partners are using Evidence-Based LeadershipSM tools and tactics to deliver results.

Share Patient Stories at LDIs

"While patients aren't able to assess our clinical competency, they're eminently qualified to judge us on how we treat them. So when the wife of a recent patient who had passed away unexpectedly in our care contacted our CMO, we invited her to share their story at our upcoming Leadership Development Institute (LDI).

It was one of the most powerful moments I've experienced during my years as a leader. She didn't chastise us for getting the diagnosis wrong, but shared powerful examples of how we let them down in other ways...like the way a frustrated respiratory therapist made derogatory comments about equipment that projected neither compassion nor competence and dehumanized her husband. Many different department leaders had been involved in a root cause analysis of the case and took it hard.

But the second day of the LDI-when I re-arranged the agenda so we could process it together- leaders who hadn't been named stood in defense of colleagues who had. They said, 'This isn't a story about you, but it's about us as a team...what we did right and what we can do better.'

It was the second most powerful moment I've experienced in my career and it bonded us in our quest for excellence. My only suggestion to others who want to do this is to give more warning than I did before you share such stories. Connect the dots about why you are bringing a patient to share in that kind of a forum so no one feels surprised or unprepared. Trust is paramount."

Brian MooreBrian Moore, CEO, St. Mary-Corwin Medical Center, Pueblo, CO

Build Trust with Pillar Communication Boards

"At Rutland Regional, we use pillar communication boards to help connect staff to purpose. We explain why we are measuring the results posted and how our day-to-day work contributes to those results. Every leader has one for their area that is current with results and information that their staff and physicians need to know about...such as patient or customer satisfaction, quality, financial, and employee engagement results, market share, stoplight reports, and more.

We're transparent in sharing our results, whether they're improving or not, and we talk about why. This builds trust and engagement so staff contribute their input and ideas. For example, in addition to posting results from patient surveys, we include information on patient feedback, content we've harvested from patient callbacks, staff recognition, thank you letters, and our service standard of the quarter.

We also provide leader orientation to the boards, help develop content for their boards, set clear expectations on keeping the boards up-to-date, and validate quality and completion through senior leader rounding."

Darren ChildsDarren Childs, director, quality improvement and marketing/PR, Rutland Regional Medical Center, Rutland, VT

Use Pre-Shift Huddles

"At UnityPoint Health, we've trained leaders from 25 units so far on how to lead daily huddles that include a focus on how their unit can improve readmissions and communication, two key performance indicators we're laser focused on. Some units are working on improving completion of white boards in patient rooms. During leader rounding, we measure completion daily and ask about barriers during huddles.

We learned that one challenge was a difference between the shifts. Nurses on the night shift placed a priority on sleep for patients who'd often waited in the ED before a late admission and so didn't complete the boards. After discussing it at the huddle, we hardwired a process to get those done during the morning Bedside Shift Report. We also connected the importance of completing the boards to patient safety which resulted in nurse's higher engagement.

Nurses on one unit said our physician communication was not as effective for patients 80 years and older. So they agreed at the huddle to round with physicians and assess whether they were sitting down and making eye contact. They used the huddle as an opportunity to learn from each other on how best to empower their physician colleagues to improve without creating conflict."

Jodi Geerts BSN, RN, CPHQ Jodi Geerts BSN, RN, CPHQ is director of regulatory and risk management at UnityPoint Health, Waterloo, IA
Wendy SmithWendy Smith is best practice consultant at UnityPoint Health, Waterloo, IA

Validate, Validate, Validate!

"I had an epiphany after years of working with Studer Group tools and tactics: I was the problem. I blamed our inability to sustain results on being busy, short staffed, a new building...you name it. But once I truly committed to championing patient care, everything changed. Today, we've sustained an overall hospital rating at the 86th percentile for the last three years.

We did it by setting new expectations for leaders, tracking accountability, and then using a validation matrix to validate performance for everything we ask them to do: from nurse leader rounding and AIDET® to communication boards and cleanliness of the room. The nurse executive must be involved in these processes.

Every year we identify the HCAHPS composites where we have the biggest opportunity (i.e., high correlation, low scores) to improve our overall recommend rating. When we decided to focus on responsiveness, for example, to improve the nurse communication composite, we validated AIDET and Hourly Rounding® and sent out a report with the number of patient call lights daily to signal its importance.

We are always elevating our level of validation. This year we have created a calendar for nurse leaders to round on staff on weekends and evenings to elevate the consistency of performance. But to truly hardwire a culture of excellence, you can never stop validating as a nurse leader."

Neal Loes, RNNeal Loes, RN is CNO at Mary Greely Medical Center in Ames, IA

Get Community Input

"Our patient satisfaction has moved from the 8th to the 88th percentile over the past four years. And we've sustained that even as our ED is in the midst of a major remodel.

We began by including employees in every step of the design process...and then taking their input and showing how we'd phase construction, care for patients, and utilize extra beds while renovating older rooms.

We set the stage with community members by explaining that our goal was to improve access and experience for the community. In fact, we trained staff to use key words to that effect when speaking with patients who were in a hallway bed or those who could hear construction noise. As a result, we've had minimal complaints related to hallway locations as we continue to pull until full. It's been very well received. And employee engagement is at the 90th percentile."

Tom Rounds, BSN, RNTom Rounds, BSN, RN is director, emergency department at Rutland Regional Medical Center, Rutland, VT
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