Preventing Patient Readmissions Improves Bottom Line Results

Organizations that make discharge phone calls reduce non-reimbursable readmissions between 20-30%. Research shows that patient/family likelihood to recommend a hospital is above the 90th percentile when they receive a discharge call. Research shows litigation goes down when a patient receives a phone call after discharge.

So how do organizations execute discharge phone calls?

Who to call:

• Studies show that unplanned readmissions rank the highest among patients who are suffering from congestive heart failure, pneumonia, and complications from surgical procedures such as heart stents and major hip and knee replacements. As organizations make phone calls to discharged patients, this high-risk group should be the first priority.

When to call:

• Hospitals see maximum results when calling discharged patients within 24-72 hours of going home. They catch early signs of adverse events, misunderstanding side effects of medication, therapeutic questions, and nosocomial infections.

Who calls:

• Trained healthcare personnel. The Discharge Call Manager™ software makes it possible to provide high quality calls from non-RN’s, allowing RN’s to provide direct patient care and save organizational dollars. Questions asked during discharge calls can be developed that align with HCAHPS requirements.

What to say:

• Studer Group recommends including quality-focused questions, such as:
  • Do you have any questions about your discharge (home care) instructions?
  • Do you have any questions about your medications? Are you aware of side-effects? (Mayo Clinic Proceedings study: Only 14% of patients knew medication side effects, 28% knew medication names and 37% knew purpose of medications, August 2005)
  • Do you have your follow-up appointment scheduled?
• Many organizations ask Unit Specific questions dependent on where the patient received their care. Studer Group will be happy to share successful questions by unit, in addition to populating these into the Discharge Call Manager. Click here to access our Discharge Call resource page and Question Library.

Why:

Discharge calls produce better clinical outcomes and are the right thing to do for patients and families. It’s a great way to verify that patients understand post-care instructions which reduce preventable readmissions. Most importantly, lives are enhanced and saved.

For best practices and frequently asked questions about discharge phone calls, contact Rachael Johnson.

Announcing a New Study on Behaviors that Impact Safety

The research is clear – teamwork, communication and a collaborative work environment each directly impact patient safety, patient satisfaction, employee and physician turnover, and even healthcare costs. The expectations upon healthcare organizations to address these issues are also clear. With the Joint Commission Sentinel Event Alert last summer, leaders must create and implement a process for managing disruptive and inappropriate behaviors.

What is less clear is how well-trained healthcare professionals are in addressing and managing the types of unprofessional behaviors that undermine these same outcomes. In partnership with Vanderbilt University Medical Center, the Studer Group is launching what we hope will be the largest ever study of disruptive behaviors in healthcare. Our goal is to identify the types and frequency of these behaviors and the tools and skills you have to deal with them. Whether you deliver direct patient care, provide support services or serve in an administrative capacity, I invite you and your colleagues to take part in this study.

This study was first announced in our monthly newsletter and remains open through Friday, June 12th. Click here to complete the survey. The 20 minutes of your time to complete the survey will provide insight into the training and resources needed in healthcare organizations to address disruptive behaviors that affect the well-being of staff and the outcomes of the patients we care for. We commit to sharing the results of the study broadly and free of charge this summer.

Every day, each of you makes a difference in the lives of the patients and families you care for. Thank you in advance for taking the time today to make a difference in your work environment by spending a few minutes to tell us about your experiences.

Yours in Service,

Craig Deao
R&D Leader
Studer Group

Studer Group and Vanderbilt University Medical Center Disruptive Behaviors Study

Have you personally experienced disruptive or intimidating behaviors in your organization? Or have you been in a position where you were aware of others” unprofessional behavior and found it challenging to manage? If the answer to either is yes, were you knowledgeable of your organization”s policies and practices in place to address these behaviors, and did you have the skills for managing the situation?

Effective January 1, 2009, the Joint Commission has a new leadership standard of “zero tolerance” for intimidating and /or disruptive behaviors in accredited organizations. We want to hear about your experiences with disruptive behaviors in your work environment and how well you feel supported to address and manage those behaviors.

In partnership with Vanderbilt University, the Studer Group is launching what we believe will be the largest ever study of disruptive behaviors and managing them in healthcare. Our goal is to identify the types and frequency of disruptive behaviors in healthcare and the tools and skills you have to deal with disruptive behaviors. If you work in health care, whether you deliver direct patient care or provide support services, I invite you and your colleagues to take part in this study.

Click here to complete the survey by Friday, June 5th. The 20 – 30 minutes of your time to complete the survey will provide insight into the training and resources needed in health care organizations to address disruptive behaviors that affect the well being of staff and the outcomes of the patients we care for. We commit to sharing the results of the study broadly and free of charge this summer.

Every day, each of you makes a difference in the lives of the patients and families you care for. Take the time today to make a difference in your work environment by spending a few minutes to tell us about your experiences.

Yours in Service,

Quint Studer

Happy Nurses Day from Studer Group

Today, all across the country we kickoff a weeklong celebration of the nearly 3 million nurses who provide compassion and quality care to the rest of us. At Studer Group we are fortunate to employ, work with and serve thousands of nurses and nurse leaders. While nothing we can write in a blog will be sufficient to thank you for your tireless service, I thought you might appreciate hearing from one of your own. Recently we received the following tips from one of the most effective nurse leaders we have met along our journey. She has maintained patient satisfaction at 99% for more then 4 years, employee satisfaction above 90% for 3 years and single digit turnover as long as we have known her. We asked her to share some tips for nurses. I hope you enjoy these. They will also be part of a book later this year. On behalf of all of us at Studer Group, Happy National Nurses Day!

- Quint Studer

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“Going into the trenches without tools, guidance, and support sets anyone up for failure!!!”

- Sherry Thompson, RN, BS, CCRN

Just some thoughts and what I have learned from my early years as a new manager:

• First and foremost, don’t ever think you have seen it all . . . because you haven’t and you never will.

• You need to keep a presence on your unit, not stay locked away in your office (it is acceptable to close your door and cry occasionally).

• Get out into the trenches on a regular basis, all shifts, even weekends. I don’t mean for you to do their work for them by taking full assignments; what I mean is actually experience some of their functions. I will answer call lights, empty bedpans, start IV’s, give a bath, answer phones if ringing too long, help physicians, help in a code, etc. My presence when they are “sinking” helps calm the storm, even if I don’t do that much. It is the fact that I am present that sends them a message that I acknowledge their skills and respect what they do.

• Rounding on your staff means knowing your staff and making yourself aware of their life outside the hospital. No, you cannot solve their issues, but empathy goes a long way in helping them focus when they are at work. Learn about their families, their pets, their hobbies, about the current crisis in their life and remember to ask occasionally about what is important to them. I have over 80 employees and know at least one thing about each of them, so it is not impossible! They have touched me and I have grown.

• Accountability is the keystone to team morale. Early on in my career as a manager, I tried to be everyone’s friend. Does not work!!! Start with communicating the expectations, use tough love and if that fails, do what you have to do for the whole team. You can save some people and some you can never fix!!! As you round and see positive behaviors, tell that person right then and there how much you appreciate them. If you see negative behavior, tell that person right then and there what is not right.

• Joy and laughter are so very important!!! In the beginning, I was so serious and wanted everything to be so perfect. Patient care is stressful enough and if we cannot have joy and laughter in what we do, we will burn out long before we should. Case in point: Upon waking this morning, I made my usual phone call to the night supervisor to see what census was for my two departments. He told me, “Intermediate got killed last night; they got seven admissions in a four hour span. They weren’t too happy but it did finally settle down.” I hang up and my first thought was maybe I will go back to bed for awhile and go into work after night shift has left. NOT!! This is what I actually did…The moment I arrived on the floor, I walked up to the group of night shift staff and said. “Has anyone told you lately what an awesome team you are? I heard you had a “s_ _ t storm” last night and I also heard you did a great job!” They actually started laughing, not complaining. Negative turned to positive by laughter!!

• I believe that rounding on my staff is the most important and effective tool I have in my manager bag of tricks!!! Happy staff equals happier patients!

• Rounding on my staff with purpose, with putting their needs first, is the one sure way to gain and retain their respect and commitment!

One year I received a wonderful book as a Christmas present from one of my staff RN’s. The author is John C. Maxwell and the title is “The 21 Indispensable Qualities of a Leader: Becoming the Person Others Will Want to Follow.” The chapter on commitment really helped me understand how to stay better connected to purpose in my position as a nurse manager. The author stated that commitment starts in the heart and he quoted NBA legend Michael Jordan as saying that “heart is what separates the good from the great.” Mr. Maxwell teaches that if “you want to make a difference in other people’s lives as a leader, look into your heart to see if you’re really committed.”

So as we celebrate Nurses Week 2009, I encourage you to take the time to look at your commitment as a leader. Is it at a level that is keeping you connected to your staff?

For further resources and information on how to celebrate Nurses Week, I invite you to log onto the Studer Group website: www.studergroup.com/nursesweek

Celebrate our gift of nursing!

Sherry Thompson, RN, BS, CCRN
Director Intermediate/Critical Care Units
Pekin Hospital (Pekin, Illinois)

The above tips are excerpted from a new nurse leadership book which will be released in August 2009. The book was written to provide basic leadership fundamentals to help nurse leaders be successful. Be on the lookout of this great new resource for nurses at www.studergroup.com.

Celebrating Doctors

“More than the application of science and technology, medicine is a special calling, and those who have chosen this vocation in order to serve their fellowman understand the tremendous responsibility it entails.” With these words spoken 18 years ago, President George H. W. Bush proclaimed March 30th as the annual date to celebrate National Doctor’s Day.  Today, hospitals and patients across the nation will thank their doctors for answering the call to practice medicine. One of the best ways to say “thank you” today is to commit year-round to providing a great place for physicians to practice medicine.

Fundamentally, physicians want four things from the place where they choose to practice medicine:

• Quality – Physicians want to know their patients are receiving quality care and very good service even when they’re not around.
• Efficiency – Physicians want a friction-free place to practice medicine where delays, waste and frustration are minimized
• Input – Ask physicians where they feel the organization should focus to make things run better; fix what can be fixed; and then follow-up to let them know what has been addressed.
• Appreciation – Physicians value a “thank you” and acknowledgment when things are going well.

Most of our efforts in healthcare to engage physicians center on the first two items: quality and efficiency. This makes good sense – they’re the most tangible and have the most ability to quickly impact outcomes for physicians, patients and the hospital. However, too often we neglect the last two: input and appreciation. That’s unfortunate, since these are the lowest cost, quickest to implement and most sincere ways to demonstrate professional respect and involve physicians in the hospital enterprise. Here are a few tips to get started:

• Focus, fix, and follow-up. All three are key steps to providing physicians a great place to practice medicine, but failure to follow-up is perhaps the fastest way to breakdown the relationship physicians have with the organization. Here are two examples of how to provide physicians opportunities for input that lend themselves to quick follow-up.
  • Ask physicians to list three issues that act as barriers in the delivery of care for their patients at the hospital. Be sure to also ask them for a potential solution to the problem. Based on the information you collect, publish a simple one-page flyer that lists the issue raised and the action taken.
  • You can create even faster follow-up by using a simple tool like a flipchart or a whiteboard posted in a common area. For example, the OR manager could post a flipchart on a door leading out of the OR with a marker attached by a string. In one column provide a place for physicians to list their barriers, and in the other column the OR manager writes what has been/will be done to address the barrier.
• Round on physicians. By rounding on physicians, leaders demonstrate care and concern. They will also harvest what’s working well, people to recognize, systems to improve, and tools and equipment that need to be addressed. Here are some questions to ask physicians during rounds:
  • Focus on the Positive: “What is going well today?”
  • Harvest Wins: “Are there any hospital staff or other physicians you feel deserve to be complimented or recognized?”
  • Identify Process Improvement Areas: “What systems can be working better?”
  • Repair and Monitor Systems: “Do you have the help and equipment that you need to care for your patients?”
• Send thank-you notes. In a study of the top workplace incentives, the number one strategy was handwritten thank-you notes. There’s nothing difficult about the act of writing a thank-you note, but there are better ways to make them effective for physicians and to hardwire them. For example, ask each nurse leader or unit nurse to send one handwritten thank-you note to a physician’s home on a regular basis. Physicians who receive such a note typically seek out the nurse who sent it. In addition to delighting the physicians and strengthening their connection with the nurse who wrote the note, the specific behaviors mentioned in the note will be reinforced. Let the CEO know who is being thanked and why so she can extend her appreciation the next time she sees the physician.
• Pass along compliments to employees on behalf of physicians. Ask physicians “What is going well?” When Dr. Johnson mentions how much he appreciated the timely lab results in recent weeks, tell the lab manager, “Dr. Johnson wanted you to know how much he appreciates your staff’s on-time lab results over the last month. Please let them know what a difference they are making for physicians.”
• Spotlight physicians who are making a difference at board meetings. For example, the CEO might say, “Dr. Rivera came in during a day off to work with the OR team to develop surgical preference cards for physicians. This has increased efficiency and reduced costs. As the board chair, I recommend the board write a letter of appreciation to Dr. Rivera.”

In the hallways today, take a moment to say “thank you” to the physicians who practice medicine in your organization. Also commit to implementing one new behavior, perhaps one of the ideas above, that you can hardwire so that physicians know how much they are appreciated all year long.

Our mission at Studer Group is to help make health care a better place for employees to work, physicians to practice medicine and patients to receive care. The tips above come from a physician collaboration toolkit available free of charge to partner organizations on our website.  You can find the toolkit and learn more about what we’re doing to help create better places to practice medicine on this resource page: www.studergroup.com/physicians

Yours in service,

Quint

Announcing the Largest Ever Study on Health Care Leadership Skills

I’m writing to ask for your participation in an important research project within the healthcare industry. We anticipate that the findings of this study will impact how we train future health care leaders, just as the previous studies you helped us with proved the dramatic benefits of hourly rounding, identified characteristics of high performing organizations and shed light on issues of work-life blend among women in healthcare.

We are conducting what we hope will be the largest study ever of health care leadership skills. Our goal is to ensure that the next generation of leaders has the skills required to make healthcare even better. Conducted in partnership with The George Washington University, this study seeks to better understand the skills you had as an early careerist, the skills you think are most important for new leaders to possess and skills you believe will be needed in the future.

If you hold a leadership, management, or supervisory position in healthcare organizations, I invite you and/or your colleagues to take part in this study to create recommendations for actions and policies to enhance the skill sets of new healthcare leaders.

Go to www.studergroup.com/leadership and complete the survey by April 10th. The fifteen minutes of your time needed to complete the survey will impact the future of healthcare. We commit to sharing the results broadly and free of charge this summer.

The knowledge gained from the study will help schools and employers better train and retain healthcare leaders, two critical steps toward creating better places to work, practice medicine and receive care.

Every day we all have the ability to make a difference. Here’s an opportunity that will only take you 15 minutes today for results that will last generations.

Yours in service,

Quint

The RN Renewal Plan: Why It’s So Important To Help Nurses Reignite Their Passion for Helping Others.

All nurses are inspired at the start of their career, but over time, the stresses of the job can overwhelm their sense of purpose. Leaders that help nurses re-connect—in turn, see their organizations thrive.

Anyone who works with nurses knows the profession is a double-edged sword: the very qualities that attract caring, compassionate people to the field also burn them out. It’s true. Impacting lives on such a profound level, not only physically but emotionally and spiritually, can be exhausting beyond words. And because the energy and passion of nurses is so intricately connected to a healthcare organization’s bottom line, leaders must take steps to sustain these elusive qualities.

It’s this simple: nurses who find their work rewarding provide better clinical care. Plus, their happiness and fulfillment positively impact other nurses and the workplace as a whole. An organization staffed by nurses who feel a sense of purpose, who engage with their patients on a real, human level, is a healthy hospital in every sense of the word. So helping them re-ignite their passion for their work is a critical business goal.

So, how can leaders help nurses know their impact? Click here to access three “Spiritual Stretches” to help nurses stay connected to the difference they make, excerpted from Inspired Nurse, by Rich Bluni, RN.

It’s no wonder nurses are so inspired at the beginning of their career. They get to share in some of the most joyful times in people’s lives and ease their pain in the toughest times. It’s a privilege. And it’s as important for nurses to nurture themselves as it is to nurture their patients. Taking the time to tap back into this calling will help nurses give the best care possible.

Just envision a hospital filled with inspired nurses working to execute common goals. It’s easy to see why it’s worthwhile to do so: better clinical outcomes, less employee turnover and all the other results of employee motivation equal a healthy bottom line.

Click here to view a free 30 minute webinar on how to create a culture of work-life blend in your organization that will improve employee turnover and satisfaction.

The work we do in healthcare is very powerful. We change lives and bring comfort, joy and healing to each patient we meet.

Physician Engagement and Collaboration: The importance of aligning physicians with organizational goals to achieve and sustain service excellence

Medicine is in the midst of a new era. An era that redefines the influence that patient perception of care is having on market share, reimbursement, and the doctor-patient relationship. Patient-centric care founded on trust and communication has taken on a new priority in healthcare, replacing technology as a driver in the public’s perception of quality. Now more than ever, hospitals recognize the need to work with their medical staffs to develop and execute a service excellence strategy that drives patient satisfaction. Here’s why.

Today, patients are much more savvy in their desire to understand their diagnosis and plan of care. With the Internet age upon us, patients often come to physicians’ clinics, hospitals, or emergency departments informed with ideas on what their diagnosis may be, what tests need to be ordered, and what treatment they feel is necessary. Additionally, the age of transparency has made it possible for patients to differentiate average care from great care. This places a greater burden on us to deliver care that is perceived by patients as meeting their expectations as well as achieving desired clinical outcomes. Our failure to meet patient expectations adversely impacts patient loyalty.

Medicine is undergoing a transformation like none other in its history. We are moving from a pay for service to a pay for performance model. For the first time, reimbursement will be directly tied to patient perception of care. HCAHPS is just the beginning. In the near future, CMS and third party reimbursement will be directly linked to patient satisfaction metrics that will inevitably impact both inpatient and outpatient practices. Given the unsustainable medical inflation rate and continued rising medical costs in the US, a system to reward organizations for delivery of great and cost-effective care from those who deliver anything else but that, is long overdue. The pay for performance concept will drive competition and give consumers greater decision-making ability on where they want to receive care. Organizations that fail to effectively prepare themselves, and execute a successful strategy for the evolving pay for performance initiative will have a hard time surviving.

The common theme that ties together the above discussion points is the concept of patient perception of care. And what drives that more than anything else? Effective communication. Chang’s study as published in the Annals of Internal Medicine in May of 2006 clearly showed that patient’s global ratings of their health care are not tied to the technical quality of their care, but rather, to the quality of provider communication (Volume 144, Issue 9, pages 665-672). Effective physician communication is the key driver of overall patient satisfaction. Resnick’s recently published study in the Journal of Surgical Education (2008;65;243-252) showed that 61% of the variability in patient satisfaction is tied to physician behaviors. The remaining 39% was linked to nursing behaviors. Physicians more than any other group influence patient perception of care the most.

It is critical then, for healthcare organizations that want to effectively compete and survive the tumultuous economic uncertainties facing us today, to engage and collaborate with physicians to create an aligned strategy on the delivery of patient-centric care that promotes effective communication at all levels. Healthcare systems recognize the importance that physicians have on an organization’s ability to effectively compete and financially succeed. The problem is, hospitals and physicians don’t always think alike. There is often distrust, misalignment, and differing opinions between the two sides. This was again demonstrated in the recently released Press-Ganey 2008 Check-Up Report on physician perspectives on American hospitals. Three of the top five listed physician priorities on what impacts the physician-hospital relationship the most dealt with how well hospital administration communicates, responds, and collaborates with physicians to meet their practice needs.

In the evolving pay for performance initiative, physician behaviors will not only influence their own reimbursement, but hospitals’ as well. It is imperative that healthcare systems recognize the importance of collaborating with their medical staffs to create an aligned platform that promotes patient care quality and safety as well as drives patient perception of care, and executes an effective reimbursement and growth strategy that is mutually beneficial. Studer Group recognizes how critical this has become for physicians and hospitals.

Studer Group is creating a physician specific service line for 2009. The physician service line will help organizations engage and collaborate with their physicians. From an initial survey and analysis of an organization’s situation and specific needs, a comprehensive physician coaching plan and strategy will be formulated and executed to drive patient perception of care and satisfaction results. Paralleling the success of Studer Group’s inpatient coaching service line, the physician service line will utilize the evidence-based tools and coaching tactics that Studer Group has developed to achieve successful outcomes for the hundreds of clients that we have partnered with in the past.

This is an exciting yet uncertain time in medicine. There is real potential to significantly impact nationwide patient care quality and raise it to a level never before seen. Pay for performance will drive that. Many organizations face financial constraints never before experienced prior to the recent economic downturn. One thing is clear. Implementing a successful patient perception of care strategy and creating a culture of excellence is not only the right thing to do, but necessary for organizations to survive and thrive in the today’s economic uncertainty. The return on investment for engaging and collaborating with physicians is enormous. It is physician behaviors that ultimately drive patient satisfaction, impact loyalty, and create trust. Studer Group’s physician service line will help physician groups and healthcare organizations achieve their desired outcomes.

If you are interested in learning more about Studer Group’s physician service line, please contact me at wolf.schynoll@studergroup.com, or visit http://www.studergroup.com/physicians.

Yours in Service,

Wolfram Schynoll, M.D., FACEP
Studer Group Medical Director and Physician Coach

“But we’re already doing it!”: Why Validation Is the Key to Effective Hourly Rounds

No doubt about it: Hourly rounding is hot. And no wonder. In 2006 Studer Group’s Alliance for Health Care Research initiated a call light study—whose findings were published in the American Journal of Nursing—which proves how well it works. In addition, during the Institute for Healthcare Improvement’s December 2007 Annual Forum, hourly rounding was described as one of the most powerful ways to redesign patient care, in addition to helping “restore sanity and joy to our workforce.”

Since then, the tactic has been implemented in hundreds of organizations across the country. So it’s no surprise that at conferences I attend, discussion invariably turns to this subject. When leaders are asked whether they are doing hourly rounds, many of them will reply that, yes, they are. And when you ask staff if they are doing hourly rounds, they will also tell you, “We’re doing it.”

So why don’t all organizations experience fantastic results from hourly rounding? First of all, some organizations have been known to deviate from the original formula we set forth. It is critical to follow the eight behaviors of hourly rounding, which you will find explained in detail in the Hourly Rounding DVD and implementation guide available on the Studer Group website at www.studergroup.com.

The eight behaviors of hourly rounding are:

1. Use opening Key Words.
2. Accomplish scheduled tasks.
3. Address the “Three Ps”—pain, potty, position.
4. Address additional comfort needs.
5. Conduct environmental assessment.
6. Ask, “Is there anything else I can do for you? I have time.”
7. Tell each patient when you will be back.
8. Document the round.

In our experience, the main difference between those that are successful and those that are struggling to achieve results is validation—or, said another way, lack of validation. If you want to drive the results described above, you have to Validate, Validate, Validate.

The most often heard excuse from staff regarding hourly rounds is, “We are already in the room that much anyway,” or “I am already doing those things.” Certainly this is the perception that many staff have; however, it is often not the reality. If it were, we would not hear so many patient complaints like, “I don’t see my nurse enough,” or “The staff seems so busy.”

Done right and properly validated, hourly rounding will improve your patient care and satisfaction. Here are just a few principles to keep in mind:

Face time is not enough. Staff must understand that hourly rounding is not about getting in the room every hour. It is about doing the eight behaviors every hour—which just happen to require us to be in the room to do them.

Nurse leaders, it’s your job to validate. It’s the nurse leader’s task to validate that the eight behaviors of hourly rounding are being implemented with enough consistency to achieve results. The key? Rounding logs. I have yet to see an organization be successful in getting the level of results we mentioned above without using them. I also advocate for the use of an annual competency that will add credibility to this skill and make it as important as all the other skills we validate annually. But even annual validation is not enough in the early phases of implementation, which can last sixth months or more. Nurse leaders need to continue frequent validation long enough to ensure that the staff’s initials on the log truly represents that all eight behaviors were accomplished.

Yes, validation takes time—but it’s worth it. If the validation is so critical—why do we have such a hard time doing it? The most obvious answer is time. Validating skills directly by observation is certainly an investment in time, but those organizations that bite the bullet and get it done will tell you the results they get far outweigh the time spent.

Trust, but verify. Many nurse leaders will tell me, “When I verify rounding, the staff feels like I don’t trust them. They think I am checking up on them.” Well…that’s because you are—but it’s the right thing to do. At Studer Group we call it trust but verify. After all, we trust that a physician will do a history and physical on every patient, but we still verify that he has done it. And we trust that a pilot will do his pre-flight checklist, but, again, we verify. As a leader on your unit, you have the ultimate responsibility for the competency of your staff. For critical skills a “trust but verify” approach is necessary—and hourly rounding does qualify.

“Soft” validation doesn’t work. I sometimes see nurse leaders invest the time in doing the validation but use too soft of an approach to get the real value. For instance: “Sara, I appreciate being able to shadow you and validate your hourly rounding skills. I think you did a great job. The only thing I didn’t hear was you using the closing key words. I’ll go ahead and check you off but please be sure to do them next time.” In this case, we have left open the door for Sara to continue to forget to use one of the eight behaviors of hourly rounds—Use closing key words.

Take the ACLS approach. I recommend you use an approach most clinicians are very accustomed to if they have ever tested for ACLS or similar certifications. That is, you need to be 100 percent correct to pass certification. You would never be ACLS certified and have them say, “You were pretty close on that dose of medication; just be sure to check closer next time.” If you are validating skills, take an ACLS approach and give specific and immediate feedback on each of the eight behaviors. This way the staff will know what they are doing well and what they need to do differently.

With diligence in validating skills, a tighter discipline to get all eight behaviors done well, and verification that they are actually occurring with every patient…the results will come.

For more information on tools that are available to help you implement hourly rounding in your organization please click here, or feel free to contact George Scarborough with questions.

Yours in service,

Lyn Ketelsen, RN, MBA

Studer Group Coach Leader

The Power of “I’m Sorry”: Why Service Recovery Matters Deeply In Healthcare–and How to Help Your Employees Find the Right Words

If you or your staff have ever been surprised by a patient complaint–and who hasn’t?—you know how easy it is to say the wrong thing. Well standardized key words can defuse tension, create positive patient perceptions of care and, ultimately, create better patient and organization outcomes.

You know your employees care deeply about their patients. If they didn’t, they wouldn’t be working in healthcare in the first place. Yet, mistakes do happen. Conditions aren’t always ideal. Patients get upset. And no matter how sincerely a staff member wants to “make it right,” sometimes she just can’t find the words. And this is where service recovery training comes in. You can teach your staff to handle complaints and field tough questions the right way–a way that doesn’t only solve the problem, but also reduces patient anxiety and improves patient perception of care.

The way a single employee handles a single complaint–whether the problem is caused by her own mistake, someone else’s, or just the reality of 21st century healthcare–determines how that patient feels about your hospital or practice. When all employees respond to that complaint in the right way, well, it can have a powerful impact organization-wide.

We know there is a strong connection between a patient’s state of mind and her clinical outcome. When we say the right words to a distressed patient we not only increase the likelihood that she’ll give us a high satisfaction score, we actually help her heal. And both factors are critical to an organization’s long-term prosperity.

Here’s the thing: when most of us are surprised by a complaint, we can’t come up with a good response on the spot. Perhaps we get shut down, or get defensive, or toss out an automatic answer that the patient (mistakenly) perceives as arrogant or condescending or indifferent. The patient gets more upset and the situation escalates.

What to do?  Leaders can teach employees the right words for tough situations—apologies that defuse tension without assuming or casting blame. Have your team members come up with the common complaints they get.  Develop great responses to these complaints that put the patient at ease.  Most importantly, practice.  Role model responding to the complaints with the appropriate answers.  You’ll feel the difference.

The newly published “I’m Sorry To Hear That…”: Real-Life Responses to Patients’ 101 Most Common Complains About Health Care by Susan Keane Baker and Leslie Bank ,offers great sample answers. It helps leaders teach employees the right words for tough situations.

For example, let’s say a sample patient complaint is about food: The food is tasteless! The tea is never hot, the cereal is too thick, and the toast is soggy! Baker and Bank’s book offers the following selection of apologies for such a situation:

I’m sorry to hear you’re not enjoying your meal. I’ll check your nutrition orders and ask the dietician to visit you. She may be able to suggest some alternatives. Shall I make you a cup of hot tea right now?

I’m sorry. Good nutrition is important to your recovery. We have some snacks on the unit. Is there something I can get you? I could make you some fresh toast or a sandwich.

Even though some special diets are very strict, our Food & Nutrition team strives to provide tasty food. I’m going to ask your nutritionist if there are spices we can use to add flavor to your meals. What do you use at home?

The idea is for an organization to standardize these responses across the board, so that all employees are singing from the same “service recovery” choir book—and so that all patients in all departments have the same positive experience.

Teaching staff members how to say ‘I’m sorry,’ and say it the right way, is not just a nice thing to do. It’s a strategic business tactic that pays off in tangible ways. Such training helps employees do their jobs more effectively and gain more satisfaction from their work, which results in higher productivity and less turnover.  And of course, it results in happier patients who feel genuinely respected and cared for.

Words are more powerful than most people realize. An empathetic apology takes only a few seconds and costs nothing, yet it can completely change a patient’s perception of care. In hard economic times, especially, that’s no small matter.

Yours in Service,

Quint

For more service recovery resources including information on the book “I’m Sorry to Hear That…” click here.