Posts Tagged ‘nurse’

Narrating Care: Why the Words You Say Maximize the Impact of the Care You Provide

April 6, 2011

Often after I do a speaking presentation, people will come up to me to ask questions and share steps they are taking to improve performance. Some of the saddest moments are when it’s evident that someone is working very hard to serve patients and it appears many of the right steps are being taken—but the objective results are not there.

I’ve identified a common theme in these situations. Even when many of the correct steps are being implemented, one critical step often is not: explaining what you’re doing and why you’re doing it. Sometimes explanations have more impact than behaviors. That’s why narrating care is so powerful. Here are several examples:

Example 1: A hospital wanted to improve the patient’s perception of speed of direct admissions. Through process improvement it had reduced the average time to around 20 minutes from a previous average of over 40 minutes. Yet, patient perception of the speed of admission process stayed the same. The issue was that the change was not explained to patients—so they had no basis for comparison. It simply seemed slow.

The recommendation was to say to each patient: “The admission process you are going to go through used to take an average of 47 minutes. However, we’ve worked hard to speed up the process and now it should take less than 25 minutes. When you’ve completed the process, we’d like your feedback on it.” The hospital implemented these key words and patient perception of care went up.

Example 2: An Emergency physician told me the story that while he tried to make all the patients comfortable he was not explaining the actions he was taking. For example, “I want you to be as comfortable as possible—would you like a blanket?” or “I have ordered pain medication to make you more comfortable.”

While he and the other physicians had always done these behaviors, they had not connected the dots for the patient. Once they started doing so, the patient perception of care (satisfaction results) improved.

Example 3: A hospital’s HCAHPS result on noise was not good. To remedy the problem, the organization had put softer wheels on carts, eliminated paging, and even purchased quieter keyboards and put up signs asking people to keep noise levels down. Unfortunately, no improvement was experienced in the HCAHPS.

Here is what took place next. The staff explained to the patients and family members that they wanted the unit to be as quiet as possible so the patient could get rest. They even explained the steps they had taken, such as the softer wheels and the elimination of paging. They added: “While we do all we can, we are a hospital and some noise is inevitable as we’re caring for patients. Still, if it’s too noisy, please let the staff know and we will do all we can to keep things as quiet as possible.”

Guess what? Perception of quietness went up and noise went down.

I see healthcare professionals working very hard, taking many of the right steps, and I see their disappointment when those results are not there. Often, they end up trying even more actions—which may still not make a difference.

My suggestion is this: before you make even more changes, first take the time to better explain what you’re doing and why. The patient’s perception of care will improve and you’ll have a new appreciation for the true power of words.

Sincerely,


Quint Studer


Quint Studer, CEO
Studer Group
http://www.studergroup.com/

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Happy Nurses Day from Studer Group

May 6, 2009

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


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.