Question on the Description

Planetree/Culture of Care WE ARE ALL CAREGIVERS!

 Human Interactions

 Access to Information

 Family Involvement

 Food and Nutrition

 Healing Environment

 Arts Program

 Integrative Therapies

 Spirituality and Diversity

 Healthy Communities

 Measurement Components provide the

Patient-Centered Roadmap

Planetree Model Components

Planetree Categories: Affiliate: Part of a membership club Designated: Organization meets cri

teria for being a PC institution Designated with Distinction: A teaching Hospital for Patient & Family Centered Care

• Patient & Family Partnership Council

• *Food is Care

• *Caregiver Center

• Health Science Library

• Patient Access Tablet (PAT)

• Patient Access Navigator

• Cancer Center Health Coach

• Staff Wellness Room

• Healing Tea Cart

• *Bedside Integrative Therapies

• Recovery Care Model

• Family Presence During Resuscitation

• Aranow Art Cart

• *Music Therapy

• NWH Ethics Committee

NWH Patient & Family Centered Care

Single Plan of Care: 1 plan we all know & share with patient!

Staff Education: Planetree Retreats;

Staff Coaching/involvement;

Management Overnights

Patient Safety: Life Wings, MORE-OB,

Readiness Rounds, Just Culture!!!

(

NWH Patient & Family Centered Care

PATIENT CENTERED PROCESSES: “Realign Process around what is most important to our patients”

Process Redesign Teams ~ (Underway)

 Transitions of Care

 Operating Room – ‘Room Ready’

 Revenue Recovery

 Mother/Baby

Process Teams ~ (Redesign Completed)

 Daily Care

 Emergency Care

 Environmental Readiness

 Food is Care

 Bed Management

“To be the Leader in

Patient-Centered Care

and

to become a Process

Driven Organization”

Joel Seligman

Process Redesign Approach

Encompasses:

Processes End-to-End

Culture

Infrastructure

Technology

Roles

Resources

Replicated Institutions

Connecticut: Danbury Hospital

Iowa: Mercy Medical Center

Michigan: Midland Hospital

New Jersey: Englewood Hospital, Overlook Hospital, Shore Medical

New York: Montefiore Medical Center, White Plains Hospital

Westchester Medical Center

Pennsylvania: Hospital of Pennsylvania

Australia, Brazil, Canada, Chile, Denmark, England, Malaysia, The

Netherlands, Scotland, Sweden, Turkey

The NWH Center for Patient Centered Innovation http://nwhc.net/about-us/patient-centered-care\

BEHAVIORAL EXPECTATIONS

• Customer Focused – Always anticipates and exceeds the expressed and unexpressed needs of others. Builds strong relationships and delivers customer-centric solutions.

• Teamwork – Inspires one another to work together to achieve organizational goals. Creates a feeling of belonging and strong team morale.

• Execution – Demonstrates expertise in role. Takes ownership and accountability of work. Makes well-informed and balanced decisions in order to efficiently handle deadlines

and achieve excellence.

• Enable Change – Adapts to shifting organizational needs. Seeks opportunities to champion new processes and ideas. Anticipates and responds to change to improve work

outcomes.

• Organizational Awareness – Recognizes and works to achieve business goals. Understands complexities of the organization and works to overcome obstacles.

• Develop Self – Takes action to increase knowledge and skills. Embraces challenging assignments. Seeks learning opportunities.

7

STORYTELLING: REIGNITING THE

PASSION

Instructions: In small groups, share…

“Why did you get into HealthCare?” “What keeps you here?”

6

My Personal Story

A CULTURE OF C.A.R.E

Connectedness Awareness Respect Empathy

C A R E

10

C

O

M

M

U

N

I

C

A

T

I

O

N

What

are my

patients

worried/

fearful

about?

EMPATHY vs. SYMPATHY E

FUELS Connection DRIVES DIS-Connection

EMPATHY EVIDENCE Patient satisfaction is critical to determining healthcare provider and institutional reputations. Medical professionals who communicate with empathy have higher patient satisfaction ratings. (Riess, 2012) Over 80% of malpractice claims are the result of communication failures and the likelihood of an unhappy outcome is correlated to low physician empathy. (Hickson, 2002; Levinson, 2004) Patients who experience empathic care have better medical outcomes. (Hojat, 2011; Rakel, 2009; Kaptchuck, 2008) Adherence to treatment recommendations Increases when medical professionals deliver patient-centered, compassionate care. (Halpern, 2010) Communicating empathically increases clinician job satisfaction and reduces burnout. (Krasner, 2009; Shanafelt, 2009; West, 2011) Enhanced empathic care and physician well-being are highly correlated. (Shanafelt, 2005) Empathic clinician communication improves the quality of all interactions with others; patients, their families, colleagues, and loved ones. (Halpern, 2012) Video by Helen Reiss: Introduction to E.M.P.A.T.H.Y.

INTRODUCING: C.O.N.N.E.C.T.

C Contact: Smile, make eye contact, shake hands, touch on shoulder (as culturally appropriate), sit vs. stand

O Opening Greeting: Say good morning / good afternoon

N Name/Title: Introduce yourself by name and title

N Needs: Assess and address patient / customer needs

E Explanation: Set expectation of role and time together; pause to assess patient/customer’s understanding

C Close: Close by asking if there is anything else you can do

T Thank: Thank the patient / customer 13

“Ask-Tell-Ask” Patient Centered Communication

• ASK the patient to describe understanding of issue - Start where they are! Repeat your understanding of their perspective

• TELL the patient in straightforward language what you need to communicate (Sit down!)

• ASK the patient to restate the information in their own words Clarify and address gaps and concerns – Reassure!

Not “Tell-Tell-Tell”

Empathy is a mindset – a choice.

It is also a limited resource, like a fossil fuel, which we cannot extend indefinitely

LET’S GET TO KNOW EACH OTHER!

Instructions:

Pull out your cell phones and find a picture of someone you love.

Turn to the person on your left and introduce your loved one.

PATIENT EXPECTATIONS

Think of the person you shared on your

phone… if they were a patient, what would

you or they EXPECT?

HCAHPS – Hospital Consumer Assessment of

Healthcare Providers and Systems MEDICARE.GOV

21

20

Oh No! Now What???

How we handle leaves a “Lasting” Impression!

Apologize: “I apologize.” “I’m sorry that happened to you.”

Listen: Pay attention, make eye contact, and listen to the patient/customer.

Solve: Propose a solution, or find an alternative.

Thank: “Thank you for bringing this to my attention.”

L.A.S.T

WE ALL MATTER

Every matters

Every matters

MOMENT Every matters 38

25

Where are these people from and

what do they believe?

How does culture

affect our work?

Language Barriers

 Less likely to receive care

 Less likely to understand

care

 Increased risk of medical

errors

 Reduced quality of care

 Increased risk of unethical

care

 Less satisfied with care “Once in Spanish

means 11

Family Members as Interpreters

“I couldn’t explain to my mom everything the doctors were telling me.” 7 year old girl, asked to interpret for her Spanish-speaking mother and tell her mother that her little-brother to be is dead.

Source: Haffner L. Translating is not enough: Interpreting in a Medical Setting.

West J Med 1992;157:255-259

Every culture has special

nuances. Some cultures

tend to not say "no” as it

is a sign of disrespect.

Rather, than disagree,

they tend to remain

silent. You do not need

to be an expert in every

culture, just respect and

be aware the role culture

plays.

If there is something you don’t understand, ask. Questions posed

in a respectful way, inform patients that you interested in

understand their culture

Are you self-aware? Mindful of your own cultural beliefs, values, and behaviors? How do these affect your interactions with patients? If you cannot manage your biases for the sake of the patient, do you recognize that limitation and defer to a colleague? Are you aware and accepting of cultural differences? Do you understanding the dynamics of differences? There is great power in our titles, white coats. Do you respect and work with patient differences in opinions, treatment options, or do you “work” the patient to fit what we think is best for them? Can you assess your cultural knowledge? Do you know when to ask for help with particular populations you may be less familiar? Are you comfortable adapting to diversity? How do you adapt to the needs and preferences of patients? Are you open to different approaches to the same problem?

Cultural competence in clinician communication Pediatr Rev. 2009 February ; 30(2): 57–64. doi:10.1542/pir.30-2-57.