WORDS THAT TRANSFORM THE PATIENT EXPERIENCE Wendy Leebov, Ed.D. Managing Partner Language of Caring 1
We partner with healthcare organizations to help them achieve an unparalleled patient experience and a culture of caring through exceptional communication.
THE POWER OF WORDS FOR ME: THE WHY? 3 3
WORDS Words are encyclopedias of ignorance because they freeze perceptions at one moment in history and then insist we continue to use these frozen perceptions when we should be doing better. Edward de Bono, MD Authority on creative thinking and innovation 4 4
WORDS CREATE WORLDS. 5 5
THE AGENDA 1. Change leadership through words the words we use to drive improvement and transformation 2. Words for in-the-moment effectiveness and caring 3. How to engage your team in a language revolution 6 6
WHICH WORDS DO WE USE TO DRIVE TRANSFORMATION? 7 7
HOW OUR WORDS HAVE EVOLVED Guest Relations 8 8
HOW OUR WORDS HAVE EVOLVED Guest Relations Customer Service 9 9
HOW OUR WORDS HAVE EVOLVED Guest Relations Customer Service Service Excellence 10 10
HOW OUR WORDS HAVE EVOLVED Guest Relations Customer Service Service Excellence Patient Experience 11 11
HOW OUR WORDS HAVE EVOLVED Person, Guest Relations Customer Service Service Excellence Patient Experience Care Family, Member, Client, Customer. Resident, Consumer???? 12 12
CHANGE LEADERSHIP THROUGH WORDS -- THE WORDS WE USE TO DRIVE IMPROVEMENT AND TRANSFORMATION Words that limit our thinking, achievements and imagination Words that drive improvement and transformation re: patient experience 13 13
WORDS THAT LIMIT OUR THINKING AND IMAGINATION 14 14
FROM PATIENT TO PERSON FROM DISEASE MANAGEMENT TO WELLNESS 15
FROM COMPLIANCE TO ADHERENCE 16
DISCHARGE PLAN 17
CAREGIVER AND CARETAKER? Care Team Care Partner Health Partner 18 18
FROM NURSES STATION TO TEAM STATION 19 19
AND WHAT ABOUT OUR VERBS? Serve Coach Partner Advise Engage 20 20
THE QUEST FOR THE MOST TRANSFORMATIONAL WORDS 21 21
SUGGESTED ACTIONS: INITIATE DIALOGUE ABOUT WORDS IN YOUR ORGANIZATION In meetings: Stop the action to zoom in on words. In newsletters, blogs, employee forums and contests: Spotlight limiting concepts and invite word play. 22 22
INITIATE THIS DISCUSSION WITH YOUR TEAM. Are these words outmoded? Discharge Plan Nurses Station Patient Compliance Employee Other? Yes No Alternative What should we call the people we serve? Which verbs describe what we do for or with them? Patient, Patient, Consumer, Customer, Member, Family, Team, Person, Guest, or Serve, Advise, Care for, Support, Partner with, Help, Coach, or. Best? Most versatile? Best? Most versatile? 23 23
WORDS FOR IN-THE-MOMENT EFFECTIVENESS AND CARING Intent vs. Impact We need to be self-conscious about our words. Our words often have an unintended impact. 24 24
PEOPLE WHO SAY THESE WORDS MEAN WELL. As soon as possible Hopefully I ll try To be honest It s our policy You have to The truth is Calm down Yes, but Like I said 25 25
INTENT AND IMPACT DON T MATCH. Staff Member Says As soon as possible Hopefully I ll try To be honest It s our policy You have to The truth is Calm down Yes, but Like I said What Do Patients Hear? When I get around to it Who really knows? Not sure I can do it. No promises! I was lying up until now. That s the way it is. Like it or lump it. I make the rules; you follow them. I probably shouldn t tell you this. You re out of control. No. You re irritating me. 26 26
THE DALAI LAMA Real care of the sick does not begin with costly procedures, but with the simple gifts of affection, love and concern. 27 27
WHY ARE OUR SCORES STUCK? 28 28
WORDS THAT MAKE OUR COMPASSION AND CARING COME ALIVE The Language of Caring 29 29
Situation: (Patient to Caregiver) I m in terrible pain. I want more medicine NOW! What is your first response? 30 30
TWO KINDS OF COMMUNICATION Heart Head Emotion, Caring, Empathy Tasks, Information, Analysis, Explaining, Fixing, Plans 31 31
BOTH AND HAVE BENEFITS! When we speak from the HEART: Patients, families and coworkers feel important, cared for, and understood They can hear the HEAD part much better When we speak from the HEAD: The people we serve get valuable information They appreciate answers and solutions 32 32
Situation: (Patient to Caregiver) I m in terrible pain. I want more medicine NOW! >90% <10% 33 33
Situation: (Patient to Caregiver) I m in terrible pain. I want more medicine NOW! Head Responses How would you rate your pain from 1 to 10? You can have more medicine in 20 minutes. Where is your pain exactly? I ll check with the doctor to see if there s some other medicine that might work better. Heart Responses I m so sorry you re in pain! It must be very hard for you. I want to help you so you can feel comfortable. 34 34
Best Practice HEART-HEAD-HEART SANDWICH 35
Effective Language: Heart-Head-Heart PATIENT: I m in terrible pain. I want more medicine NOW! I m so sorry you re in pain. I want to help. Let me talk to the doctor and see if there is something that might work better for you. I really want to ease your pain. 36 36
AWARENESS IS NOT ENOUGH. We need to build the language skills for communicating with Without these skills, our commitment to compassionate care is rhetoric. The good news: These skills are LEARNABLE. 37 37
WORDS THAT MAKE OUR COMPASSION AND CARING COME ALIVE The Language of Caring Skills 38 38
THE LANGUAGE OF CARING SKILL SET Mental Model: HEART Skills: 1. The practice of presence 2. Acknowledging feelings 3. Showing caring nonverbally 4. Explaining positive intent 5. The blameless apology 6. The gift of appreciation 7. Say it again with HEART 39
SKILL 1: THE PRACTICE OF PRESENCE "The greatest gift you can give another is the purity of your attention. Richard Moss 40
WHAT IS PRESENCE OR MINDFULNESS? Jon Kabat-Zinn Paying attention undivided attention Staying on purpose---consciously In the present moment Without judging Only when you are mindful with patients will you release your innate compassion. 41
PRESENCE: A MENTAL DISCIPLINE Quiet your racing mind. Take a deep breath. Shift to a posture of presence. Lean forward. Face the person fully. Give your undivided, respectful attention. Open your heart. Tune in. Don t think about what you re going to do next. 42
You-hoo! I m over here! 43
SKILL 2: ACKNOWLEDGING FEELINGS Use words to reflect back the feelings you think the other person may be having. You sound upset. You look frustrated. I imagine this must be quite a relief for you. People feel understood when we show regard for their feelings, not just their words. 44
How are you feeling today? Fine. 45
SKILL 3: SHOWING CARING NONVERBALLY Sixty percent of all human communication is nonverbal So that means 90 percent of what you're saying ain't coming out of your mouth. Alex "Hitch" Hitchens 46 46
I ll be with you in a minute. 47
SKILL 4: EXPLAINING POSITIVE INTENT "Intentions compressed into words enfold magical power. Deepak Chopra 48
POSITIVE INTENT SHOWS MORE CARING. The Action Explained Here s a blanket. Statement of Positive Intent I want you to be nice and warm. At night: I m here to take your vital signs. Please tell me your current medications. I m sorry to wake you. I want to be sure all is well with you ALL through the night! I realize my coworkers have asked for this same information. Sometimes medications change since we saw you last. We all check it often for your safety. 49
LANGUAGE TIP: FOR YOU AND WITH YOU Less Caring I ll take your calls while you re out. Let s get you scheduled. More Caring I ll take your calls for you while you re out. Let s get you scheduled. I want your next few appointments to be very convenient for you. So, let s talk about. I want to set the agenda with you. So, please tell me what you want to discuss today. 50
SKILL 5: THE BLAMELESS APOLOGY Show that we feel bad that the person is somehow suffering without placing blame or blaming others. The words 'I'm sorry' are magic words. They show openness and strength, not weakness. They mend relationships. They touch hearts. Wendy Leebov 51
BLAMING APOLOGIES Sorry, but it wasn t my fault! I m really sorry. It s a ZOO here today! I m sorry you had to wait. We re really short-staffed. 52
BLAMELESS APOLOGIES I m sorry this wasn t what you were expecting. I m so sorry you were inconvenienced. I m sorry it takes so much of your energy and time to come here so often. 53
SKILL 6: THE GIFT OF APPRECIATION Thanks Appreciation A compliment Admiration..when people least expect it! "The deepest principle of human nature is a craving to be appreciated. William James 54
THE GIFT OF APPRECIATION You re very brave a real inspiration to me. Thanks so much for speaking up. Your father is so lucky to have you advocating for him. 55
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SKILL 7: SAY IT AGAIN WITH HEART! "If your words are soft and sweet, they won't be as hard to swallow if you have to eat them. H.H. Breckenridge 57
SAY IT AGAIN WITH HEART! When you ve done all you can and the person is still not satisfied Say hard things in a caring way without backing down The skill of last resort How? Express a lot of Repeat your main message your bottom line ---as often as you need to, always with caring.. 58
EXAMPLE: NO SMOKING But I m a smoker! I ve smoked for 18 years. If I can t smoke, I ll get sicker. Caring: I realize not smoking is very uncomfortable for you. Bottom line message: Still, for the safety and health of all of our patients and staff, there is no smoking here. 59 59
THE LANGUAGE OF CARING SKILL SET Mental Model: HEART Skills: 1. The practice of presence 2. Acknowledging feelings 3. Showing caring nonverbally 4. Explaining positive intent 5. The blameless apology 6. The gift of appreciation 7. Say it again with HEART 60
THE BOTTOM LINE Caring gets lost in a sea of tasks and procedures. People don t know we re caring unless we put WORDS to it. An attitude of loving-kindness is not enough. We need to help our teams develop language skills, so they can effectively put words to their caring. 61
RESULTS: IMPROVED SCORES 62
PHSJ OVERALL/STAFF RESPONSIVENESS Would Recommend Overall Rating Call Button Q3, 2014 Q2, 2012 Staff Assist to BR 50 60 70 80 90 100 63
PHSJ RN ITEMS Explain Things Listen Carefully Q3, 2014 Q2, 2014 Courtesy and Respect 50 60 70 80 90 100 64
BD RN ITEMS Courtesy and Respect Listen Carefully Q2, 2014 Q4, 2012 Explain Things 50 60 70 80 90 100 65
PHSJ PHYSICIANS: INPATIENT MD Composite MD-Listen Carefully MD-Explain Things Q2, 2014 Q2, 2012 MD-Courtesy and Respect 50 60 70 80 90 100 66
RESULTS: PALPABLE CULTURE CHANGE Kindness Emotional Generosity Engagement Ownership Harmony Communication Initiative Collaboration 67 67
RESULTS: BREAKTHROUGHS IN ENGAGEMENT Patients and families were saying things to us that they have not been saying before, because we changed the conversation. Rachel Biblow Children s Hospital of Philadelphia 68 68
WHAT DOES IT TAKE TO CREATE A LANGUAGE OF CARING EPIDEMIC? Groundwork and Planning Sustainability Leadership & Physician Engagement Expectations and Accountability Staff Engagement & Training Skill Practice and Application 69
WORDS CREATE WORLDS. 70 70
RECAP 1. Thought leadership through words the words we use in our quest to advance the exceptional patient experience 2. Words for in-the-moment effectiveness and caring 3. The need to engage your team in a language revolution 71 71
WE NEED TO THINK OF WORDS AS ACTIONS. Words are tools. They do things. We have the power to choose and change our words. 72 72
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Questions/Comments? Wendy Leebov, Ed.D. Language of Caring, LLC 215-413-1969 wleebov@languageofcaring.com 74
Upcoming Webinars March 5: Reigniting the Joy of Practice: Remembering Our Patients are the Source presented by Daniel L. Kopp, MD, Physician Consultant, Creative Health Care Management March 17: Pxi (Improve) Model: A Data Driven Model presented by Pam Prissel, MS, MCHS, Patient Experience Manager and Terri Veneziale, MBA, Patient Experience Manager, Mayo Clinic Health System April 14: Leaning in to Our Patient Experience Journey presented Nancy Lawrence, Patient Experience and Executive Office Coordinator and Sarah Baughman, Patient Experience Council member, St. Thomas Elgin General Hospital May 5: Patient-Centered Caring: A Model to Improve the Patient and Family Experience Presented by Jane S. Mahoney, PhD, RN, Director of Nursing Practice and Research and Susan Hardesty, MD, Senior Vice President and Medical Director, The Menninger Clinic May 4: Patient-Centered Caring: A Model to Improve the Patient and Family Experience Presented by Jane S. Mahoney, PhD, RN, Director of Nursing Practice and Research, The Menninger Clinic, Associate Professor, Baylor College of Medicine and Susan Hardesty, MD, Senior Vice President and Medical Director, The Menninger Clinic, Associate Professor, Baylor College of Medicine May 19: Enhancing the Patient Experience with Volunteers presented by Doug Della Pietra, M.Div., Director, Customer Services & Volunteers, Rochester Regional Health System June 23: ONE Experience: A System Approach to Keeping Patients First, Always presented by Connie Bonebrake, Chief Patient Experience Officer and Patrick Ratchford, Vice President, Patient Experience, Carolinas HealthCare System
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