Archive for October, 2010

Stop Devaluing Your Patients! The Illusion of “Patient Centered” Care

October 25, 2010

In healthcare, we always talk about, “patient-centered care.”  I do believe healthcare organizations have the best intentions, however, in reality, I find just the opposite both in my work as a healthcare speaker / consultant and with my own experiences as a patient.

“Just a Patient”

I have been a healthcare professional for over 20 years, however in 1999 I became a patient after being diagnosed with Stage III Colon cancer (I am well today). After treatment was completed, I recall going to my oncologist’s office for a follow up visit. I was wearing a suit as I was on my way to a client meeting. In the office, I was talking to a pharmaceutical representative. During my conversation, a nurse ran up to the representative and said to him, “You don’t need to talk to him. He is just a patient.”  Immediately another nurse (who knew me), ran up to the nurse who made the comment and said, “I can’t believe you said that him! He teaches healthcare professionals how to communicate with patients and now he will use us as a bad example!”  The second nurse then said to me, “You aren’t going to mention this story, are you?”  I told her, “Of course I will not mention the story.”  Ha!

Are the people you serve, “Just patients?”

Discouraging Patients from Taking an Active Role in Their Care

In healthcare, we discuss patients being their own advocates and taking an active role in their care.  Once again, what is said and reality are often not the same.  In my work at coaching healthcare professionals, I have seen patients bring print outs from their Internet research, only to be told, “Don’t worry about the Internet, I know what is best.”

When patients come to you with Internet print outs, the first words out of your mouth should be, “THANK YOU!”  We need to encourage people to take an active role in their health, not discourage them.  The conversation should then follow up with a discussion of legitimate websites (e.g., NIH) versus quack websites.

Patients Matter

When I speak at healthcare events, I always position myself as a healthcare professional who also happened to be a patient.  For one event, I made the mistake of first discussing my patient experiences and then I saw just how poorly patients are seen in the healthcare system.  The meeting coordinator said to me, “How nice you want to share your story. However, this is a program for professionals only. No patients are invited.”  Even though I explained I was a healthcare professional, once they saw me as a patient, I immediately had no value. I felt like I was verbally patted on the head and told to “run along.”

Let’s stop talking about putting patients first and just do it!

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

Match Your Patients Energy Level

October 21, 2010

 

When people come into the healthcare system, it is a safe bet that they are not doing cartwheels in your hallways. They don’t feel well and their energy levels are probably low.  However, if we are high energy (which is great!), that would actually overwhelm people. Patients may be turned off by healthcare professionals that are busting at the seams with enthusiasm. A friend of mine told me her daughter who was hospitalized with pregnancy complications. Her daughter was in significant pain.  The daughter mentioned one nurse who used to bounce in the room full of energy; the daughter found this boundless energy too much for her.

It would seem to make sense that energy and enthusiasm are excellent characteristics of a healthcare professional.  They are!  However, when establishing rapport with patients we have to think about matching energy levels.  If our energy level is very high and  the patent’s energy is very low, we could experience a communication disconnect. This is exactly what happened with my friend’s daughter. The nurse though being high energy would be a good way to establish rapport.

We need to meet patients where they are. We need to meet then at their level of energy. Does this mean that if a patient is depressed and low energy we need to become depressed? Of course not!  However, what we need to do is lower our energy a bit so we do not cause a communication disconnect.

Mirroring and matching are techniques used to establish rapport at the unconscious level. This is created by becoming like the person with whom you need to make a connection. We need to make a connection with patients! When talking to patients look at their gestures and vocal inflexions. In a subtle way try to “match” these behaviors.  Subtle is the key word; we do not want to make it obvious or the patient may think we are mocking  them. People feel more comfortable with people who act like them.  For example, if your patient uses a lot of certain hand gestures, you may need to increase your level of these hand gestures.

If you look at people in the workplace or social situations who seem to be very engaged, notice they most likely have similar body language and tone of voice.  They are in sync.  We need to be in sync with our patients through the the strategies of matching and mirroring.

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

Study Reveals HUGE Communication Gap Between Patients and Physicians

October 18, 2010

The Archives of Internal Medicine recently published a study that surprised many physicians who thought they were communicating effectively with patients. A group of Yale researchers study results are very concerning.

Several findings revealed a very significant communication disconnect between patients and physicians.  The gap is alarming.  Here are two examples:

Physician Name — Study found that:

Patient Survey: More than 80% of patients did not know the physician taking care of them.
vs.
Physician Survey: The majority of doctors thought the patients knew their name.

Admission Diagnosis — Study found that:

Patient Survey: About  50% of patients did not know their admission diagnosis.
vs.
Physician Survey: The vast majority of doctors thought the patients had understood their diagnosis.

These results indicate significant works need to be done to narrow the gap between what healthcare professionals say and what patients understand.  This comes through education.

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

The Cleveland Clinic Improves the Patient Experience … by Improving the Hospital Gown!

October 12, 2010

The hospital gown. They have become a standard joke among comics who talk about being in hospitals.  If patients do not fasten them just right, their derrieres (or other body parts) may be on display for all to see!

The Cleveland Clinic wants to change the hospital gown and they have enlisted the help of a glamorous fashion designer! Fashion icon Diane von Furstenberg created a unisex patient-friendly, comfortable, wraparound apparel that looks good on everyone.

Jeanne Ryan, committee chair, stated, “The original goal had been to improve patients’ hospital experiences. We wanted to provide people with some dignity. They come to the hospital, it’s very stressful and then we ask them to take off their clothes. People said they feel exposed.” The gowns are expected to become available to all patients in the Cleveland Clinic’s Ohio facilities sometime in 2011.

Everything a hospital does creates either a negative or positive “patient experience.”  This initiative certainly enhances the patient experience.  From my work at enhancing the patient experience, I know that these little changes have a big impact. Bravo to the Cleveland Clinic!

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

MD Anderson Cancer Center Offers Innovative Patient-Professional Communications Program

October 8, 2010

The Interpersonal Communication And Relationship Enhancement (I*CARE) programs are excellent educational tools developed to enhance the communication skills of oncology professionals. The program is part of MD Anderson’s Department of Faculty Development. The program developers strongly believe that “skillful communication is a competency that can be taught and learned.”

The I*CARE program mission: “Most cancer clinicians have not had the opportunity to develop their skills in managing difficult patient encounters such as those where there are strong emotions, stressed families or uncomfortable conversations when transitioning a patient to palliative care or discussing end of life. Oncology providers want to extend their role beyond treating disease to establishing a therapeutic and supportive alliance with the patient and family. Our goal is to assist you in sharpening the skills necessary to manage these challenging encounters.”

I*CARE PROGRAM INITIATIVES

I*CARE Website

The website, http://www.mdanderson.org/icare, contains the MD Anderson Cancer Center’s Video Library of Clinical Communication Skills and is an educational resource for communication skills development. The video library helps with understanding the basic principles of communication and advanced skills such as discussing end-of-life issues and error disclosure by providing specific protocols that can be used and illustrating them with video re-enactments.  Free Continuing Medical Education (CME Ethics credit is available) and Risk Management credits are available to physicians enrolled in The University of Texas Professional Liability Insurance Plan. People may download materials for teaching purposes.

Programs

There are many program options, including fellow & faculty forums, interactive workshops, train-the trainer sessions, conferences and the quarterly Achieving Communication Excellence (ACE) lecture series.  One program, “On Being An Oncologist,” features actors William Hurt and Megan Cole who assume the personas of various doctors. Using dialogue gathered by physician focus groups, they share their feelings about the stress of caring for patients with life-threatening illness; the time pressures; the challenge of breaking bad news; the need to keep hope alive; the balancing of sympathy and empathy and keeping personal boundaries, as well as dealing with both the patient’s and their own emotional reactions.  A workbook with reflective exercises can be downloaded for both teaching and learning purposes.  In the Spring of 2011, there will be a new program launched for patients and families to learn how to communicate their needs to their medical team, and specific information on the cultural aspects of communicating with patients. 
One-on-one Coaching

Trainers observe healthcare professionals with patients and feedback is provided.

Research Opportunities

There are many ongoing research projects such as assessing aspects of the patient / oncologist relationship through audio taping clinical encounters and the impact of empathic statements on a patient’s emotional state.
These outstanding initiatives are making a big impact in helping oncology professionals successfully connect with patients on an interpersonal level.

Walter F. Baile, M.D., is the I*CARE Program Director and Cathy Kirkwood,
M.P.H., is the I*CARE Project Director. For more information about I*CARE, visit: http://www.mdanderson.org/icare

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

Houston’s St. Joseph Medical Center offers Innovative Method to Communicate with Non-English Speaking Patients

October 7, 2010

St. Joseph Medical Center (http://www.sjmctx.com) recently became Houston’s’ first hospital to use a unique translation system.

A special phone is set up with two handsets, one for the patient and one for the professional.  Based on the language requested, a trained medical interpreter is immediately brought on the line to help the patient and professional communicate.

The phone system is produced by CyraCom (http://www.cyracom.com) and offers interpreters specializing in 150 languages.  The trained interpreters are familiar with medical terminology, which is critical when speaking about healthcare topics.

If the language is not immediately obvious, patients review a card attached to the phone that has questions in their language. They can use this card to select their language.

Every patient room at St. Joseph has one of the phones. The sets are also located in the medical records department, triage and the front desk. There are a total of 400 phones throughout the hospital.

In healthcare, clear and concise communication is critical. This innovative tool helps avoid language-related issues to provide the best care to patients.

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256