The end of the year was a time of self-reflection and evaluation. At ExperiaHealth we were not immune to this inclination. We’ve been discussing some of the lofty programs we’ve seen implemented at hospitals around the country. We’ve seen staff-wide communication training programs that help physicians and staff speak clearly to patients and family members. We’ve seen manage-up programs that help clinicians and staff communicate more clearly with one another. We’ve even seen quiet-at-night programs that use fancy sound-dampening and decibel-measuring tools to ensure that patients get a good night’s sleep.
All of these programs are important and effective. But they take a massive and coordinated effort on the part of administration, physicians, and staff to implement, manage, and monitor. We decided to focus our start-of-year attention on the low-effort, high-impact practices that can be implemented immediately, with limited investment and minimal overhead. Here are our picks for the top five most underrated patient experience practices that every hospital and health system should consider for 2013:
5. Code Lavender™.
Code Lavender recognizes that when emotional crises occur in the hospital, it is important to acknowledge and address them as when physical crises occur. Like a code-blue that gets called when a patient needs immediate resuscitation of the heart or lungs, a Code Lavender is called to ask caregivers to direct healing intention or prayer to those in need of emotional resuscitation. Originally conceived for patients or family members who were going through a particularly difficult decision or transition, Code Blue was extended at the request of an insightful nurse who recognized the need of her fellow staff-members to receive healing support when they were going to have to remove several long-term patients from life support. At its simplest, Code Lavender is a call to acknowledge the profound emotional needs of those who work or seek care in the hospital. With burnout and emotional fatigue levels approaching 60% among physicians and nurses, Code Lavender lays the foundation for emotional healing that reminds caregivers that their needs matter, increasing satisfaction and well-being. It is a simple practice that supports patients, family, and staff.
4. Informed Hope.
A core tenant of medicine is that patients should be informed in a balanced way of both the potential benefits and risks of any treatment or procedure before they embark on a care plan. Informed consent is essential to respecting the patient’s right to self-determination, but in the world of modern medicine and its fear of lawsuits and reprisals, informed consent can overshadow the equally important need for hope and positive healing energy. Informed consent and the collection of advanced direction and the like can and must be addressed prior to a medical procedure. But as that procedure approaches, patients also deserve to receive Informed Hope. This concept came to us from a surgeon who made it a practice in every surgery to have each member of the surgical team look the patient in the eye, introduce themselves, and describe their role in helping the patient to come through the surgery with the best possible outcome just prior to administering anesthesia. This gives the patient positive reassurance that she is in good and caring hands when she surrenders herself to her care team. It also reminds the members of the surgical team of the profound and sacred responsibility they are given by the patient. This surgeon also made sure each member of the surgical team introduced themselves to each other once the patient was under, to build teamwork and enable team members to speak up if they saw anything amiss. This combination of best practices takes little time or effort, yet has a significant impact on safety, outcomes, and the patient’s peace of mind.
3. The Sacred Moment at Admission.
When a patient is admitted to the hospital, the focus tends to be on the physical ailment, insurance paperwork (which can overshadow all), living wills, and other such paperwork. These interactions are important, but they overlook the fact that every patient is also a human being with concerns, interests, and needs that span well beyond the procedure and payment. Devised by caring physicians at Twin Rivers Regional Medical Center in Kennett, MO, the Sacred Moment at Admission carves out a time for a doctor, nurse, or other designated member of the care team to sit down with the patient and ask critical questions about the patient’s fears and concerns, his spiritual needs, his designated communication person, and even whether he tends to be hot or cold (which allows for the correct provision of blankets). As important to the sense of connection and recognition the Sacred Moment inspires in patients is the sense of purpose it restores to staff members. One nurse told us that conducting the Sacred Moment with a patient on a busy day reminded her that the reason she got into healthcare in the first place was to care for people. And that brought a genuine smile to her face that lasted all day.
2. Random Acts of Kindness.
Ann Curry recently repopularized the idea of random acts of kindness when she tweeted that people should do 26 acts of kindness as a tribute to the victims of the Newtown, CT tragedy. We applaud her initiative, and believe that generating and celebrating random acts of kindness is as beneficial to the giver as to the receiver. In their book, The Healing Power of Doing Good, Allan Luks and Peggy Payne document effects of doing good including a greater sense of calmness and relaxation, which may also ease pain (from headaches to back pain) and reduce high blood pressure. They also suggest that kindness may increase your energy level and can even reduce excessive stomach acid. In a world where healthcare workers are constantly asked to do more with less, and patients and families are asked to navigate a system that is far from perfect, random acts of kindness go a long way. We encourage you not only to perpetrate these acts, but to celebrate them when you see them in others. The health systems that do this best – such as University of Pittsburgh Medical Center and Norton Healthcare – create a storytelling culture around positive actions of staff members to spread the positive vibes and reinforce the value of paying kindness forward.
1. Overlay Experience Mapping onto LEAN Initiatives.
Many hospitals are pursuing LEAN approaches such as Value Stream Mapping and Kaizen events to identify waste in their processes and design new streamlined approaches to deliver care. We applaud these efforts, and see them as an opportunity to innovate new ways to hardwire empathy and human connection into newly efficient care approaches. At Experia we work with teams that are undertaking LEAN mapping efforts to not simply identify and catalog the 7 types of waste, but also to look for the key moments in the interaction between patients, families, doctors, and staff that elicit a powerful emotional response. This involves adding 1-2 people to the mapping process (patients, external consultants, or LEAN team members) whose sole focus is to observe and talk to patients, families, staff, and physicians to understand their informational, emotional, physical, and clinical perception needs. By documenting these and going into the redesign process with a clear intention to hardwire empathy into new care processes, hospitals emerge from their LEAN initiatives with a truly transformed experience. One experienced LEAN Master Black Belt recently told us that having been through the process recently with the experience mapping lens added to the traditional LEAN approach, she will never go back to the old way of value stream mapping again.
The ExperiaHealth team is committed to advancing and spreading best practices across the spectrum of patient experience improvement initiatives. We succeed when the hospitals and health systems we work with become the centers at which patients and family members want to seek care, and at which physicians and staff want to spend their healing careers. We wish you hope, joy, innovation, and superlative HCAHPS scores in 2013 and always!