Transcript +1 PFCC Clinical presentation 11

Patient and Family
Centered Care
(Communicating with Patients and Family)
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Cultivating Relationships
Patient and Family Centered Care
 How you treat them. (Respect)
 How well you listen to them. (Share)
 How you understand their needs. (Engage)
 How easy you make it for them. (Partner)
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PATIENTS ARE SAYING THEY NEED…
(Updated 1/4/12)
Inpatient
Emergency
Confidence/Trust in Nurses
Staff to do everything to help with pain
Nurses to listen carefully
Staff to describe new medicine side effects
Confidence/Trust in Doctors
Their pain to be well controlled
Good communication between Doctors and
Nurses
Outpatient
Easy to talk about concerns with staff
Staff/Techs to listen carefully
Doctors to listen carefully
Staff/Techs to be considerate of preferences
Nurses to explain understandably
Facility to appear clean
Pediatrics
Medical Practice
An Organized Emergency Room
Confidence/Trust in Doctor
Child to receive all necessary care
Doctor to show respect for what they say
Good communication between Doctors and
Nurses
Doctor to listen carefully
HCAHPS Survey Questions & Scoring
Example: During this hospital stay how often did nurses:
 Treat you with courtesy & respect?
 Listen carefully to you?
 Explain things in a way you could understand?
Rating Scale = Never—Sometimes—Usually—Always
0%
4
0%
0%
100%
Patient Ratings for Pain Control
 Key Driver for nurse, physician satisfaction
 Proactive rounding and management of pain
prior to testing or treatment
 Prompt response to complaints of pain--(consider
door to pain medication (ED), call light to pain
medication (inpatient), or ongoing pain
management (clinic appointments)
 Very few patients have “drug seeking” behavior—
they are like you and me
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What can we do to improve?
BEST PRACTICES:
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AIDET
Managing Up
Key Words at Key Times
Notepad
White Board/OR Case Tracking
Board/Clinic Physician Status
Board
 Hand Hygiene
 Two Patient Identifiers
 ICARE
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TIPS TO ENHANCE
PATIENT EXPERIENCE:
 Sit at bedside
 Listen for up to 2 minutes
 Communicate clearly/ no
medical jargon
 Confirm Understanding using
“Teach Back” technique
 Ask “what questions” the
patient has
 Show empathy
 Provide follow up
information/shake hand
THE BEGINNING . . .
When first meeting a patient:
Shake hands (don’t forget to use hand gel
or wash)
Ask the patient their preferred name
Introduce yourself/manage yourself up
Identify the patient (2 patient identifiers)
Ask a relationship building question
Communicate at eye level (sit when
appropriate.)
This begins the development of the
trusting relationship
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Hand Hygiene
Wash your hands or use hand sanitizer when
entering and exiting the room.
Use key words to help the patient and family
know that you are washing your hands.
“I’m washing my hands for your safety.”
“I’m sorry my hands are a little wet, I just
washed them.”
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A.I.D.E.T.
(every patient, every time)
Acknowledge
Introduce
Duration
Explain
Thank
• Greet the patient
• Smile, make eye contact
• Yourself & Coworkers
• Find out patient’s preferred name
• Anticipate how long
• Time parameters
• What is going to happen
• Why/where/when/how
• Patient/family
• Each other!
Two Patient Identifiers
 This is a National Patient
Safety Goal
 Examples:
 Patient Transport statement
 Near miss O.R. on wrong
patient
 MRI on wrong patient
 Check the direct
source while patient
tells you:
 Full Name
 Date of Birth
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 Let the patient know they
will be asked this
repeatedly—(for their
safety)
Two Patient Identifiers
Do this:
 Scan the ID Band for
medications, compare to
an order, the electronic
record, meal ticket, or
other source to confirm
that you have the correct
patient.
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 Prior to transporting a
patient
 Giving them their food
 Giving medications
 Performing treatments/
procedures
 Prior to documenting in the
patient’s record
Managing Up
Put yourself & your co-workers in a positive light.
 “I see that Dr. Jones is in charge of your care. He is
an excellent doctor and will take great care of you.”
 “You are scheduled for a CT scan later today. The
staff in Radiology will make sure you are comfortable
and get great images for your doctor.”
 “The nurses on this unit provide excellent care. You
are in good hands.”
 “The food is really good here. The cooks do a great
job.”
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Key Words at Key Times
Distracted, frightened or anxious patients
need frequent simple explanations.
Key Words help the patient connect the dots and improve the
perception of care.
Use simple, user-friendly words.
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“I’m washing my hands for your safety.”
“Would you like a blanket for your comfort?”
“I’m pulling the curtain for your privacy.”
“Would you like the door open or closed for privacy.”
“I’m checking your name and date of birth for your safety. “
Questions for my doctors Notepad
(and other health care providers)
Tool to create a dialogue and to help the
patient be an active participant in care.
Give to the patient/family and remind them
to use it to help prepare for interactions
with doctors and other providers.
Ask patient/family--”What questions do you
have for me?”
Questions for my
doctor…
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Other Communication Tools
White Board Communication
– In all inpatient rooms: Provider names, treatment
information, care plans, questions and concerns,
contact numbers for family
OR Case Tracking Board
– Updated by OR staff allowing family to follow OR
progress
Clinic Physician Status Boards
– Updated by staff on wait times
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Other Considerations. . .
Use “narrative care” –
Explain what you are
doing while you are
doing it.
Express empathy: “I am
sure it has been very
difficult for you. . . ”
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Set Realistic Expectations
What does “you’ll be going home today”
mean to you?
 Patient’s often have their bags packed and have
called their ride.
OR
I’ll be right back?
 3-5 minutes
 30-45 minutes
 2+ hours
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Rounding
When Done Correctly:
  Patient Satisfaction;
  Call lights, Falls, & Skin breakdown
 Must be intentional and use key words.
 Make sure possessions are within reach before
leaving.
 Use words such as Safety, Comfort, “What else can
I do for you?…I have time.”
It is NOT just poking your head in or “checking
in”
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Patient Plan of Care. . .
Involve patient even if
treatment plan is simple
Use Teach Back
Current Status
What’s Next?
What’s Long Term? “What
questions do you have?”
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CLOSING THE PATIENT ENCOUNTER
“What else can I do for you?”
Close with
“Thank you”
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Service Recovery
Method
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Role Play Session
Let’s you try out the best practices in a
simulated environment
Take turns playing role of staff, patient, or
family
Group debrief
Ongoing—consciously try to incorporate any
new best practices into care routine
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What questions do you have for me?
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