How to Deal with Difficult-for-Me People

How to Deal with Difficult-for-Me People Webinar Presented by: Wendy Leebov, Ed. D. Partner, Language of Caring, LLC Here you ll find: THANK YOU FOR JOINING US! Webinar Slide Presentation Notes Pages Info about our Blended Learning Programs and Implementation Services that Produce Lasting Breakthroughs in HCAHPS & CG- CAHPS Scores o Language of Caring for Staff o Language of Caring for Physicians Company Overview Link to sign up for HeartBeat - our tool-packed monthly e-newsletter and receive free toolkit gift 51 QUICK Employee Engagement Activities to Transform Your Meetings and Huddles

HOW TO DEAL WITH DIFFICULT-FOR-ME PEOPLE Wendy Leebov, Ed.D. Partner, Language of Caring 2 WEBINAR LOGISTICS 60 minutes Questions? Type into Question or Chat box on the control panel at the right of your screen (see orange arrow) Click Send Program is recorded available online Technical problems: Call GoToWebinar Tech Support at 805-617-7000 Press 1, then select the best option for assistance 3 3 1

We partner with healthcare organizations to achieve an unparalleled patient experience and a culture of caring through exceptional communication. We offer 2 breakthrough skill-building strategies that elevate HCAHPS and CG-CAHPS scores. o Language of Caring for Staff o Language of Caring for Physicians www.languageofcaring.com 4 4 NEXT WEBINAR http://languageofcaring.com/webinars/upcoming-webinars/ Suddenly a Patient or Family Caregiver (Complimentary Registration) Presented by Trina Bogart, Dorothy Sisneros, Amy Steinbinder and Wendy Leebov When doctors and patient experience professionals become patients or patients' support persons, they see health care experiences from the other side of the stethoscope. This proves both eye-opening and personally transforming. In this webinar, four people with a long history as patient experience champions talk about their experiences "on the other side. Tuesday, September 29, 2015 1:00 pm 2:00 pm EDT 5 5 HOW TO DEAL WITH DIFFICULT-FOR-ME PEOPLE Wendy Leebov, Ed.D. Partner, Language of Caring 6 2

DIFFICULT PEOPLE? 7 7 VERY CHALLENGING! 8 9 3

I LEARNED FROM LINDA 10 10 DIFFICULT PEOPLE OR DIFFICULT-FOR-ME PEOPLE? Are they inherently difficult? We don t know! Is something about them triggering us? Perhaps so! Are we doing and saying things in ways that make them act difficult? 11 11 SEVEN WAYS WE MAKE PEOPLE DIFFICULT 1. Communicate unrealistic expectations. 2. Keep people waiting. 3. Don t anticipate. Be reactive. WAIT for a problem to occur, a complaint to be voiced, a need to emerge. 4. Allow systems problems to go on and on, affecting person after person. 5. Fail to connect to people personally or earn their trust and confidence. 6. Tell people what to do. Don t ask permission. Give them no choice or power. 12 12 4

WE HAVE A CHOICE! 13 13 FOUR STRATEGIES FOR DEALING WITH DIFFICULT SITUATIONS OR DIFFICULT-FOR-ME PEOPLE 1. Reframe difficult people 2. Prevent frustration and desperation 3. Speak the Language of Caring 4. When all else fails, use Say it again with HEART 14 14 STRATEGY 1: REFRAME DIFFICULT PEOPLE. Adjust your mindset. Change your self-talk. 15 15 5

TFAR Thoughts Results Feelings Behavior/ Actions 16 16 REFRAME DIFFICULT PEOPLE ADJUST YOUR THOUGHTS. AND IT WILL INFLUENCE YOUR BEHAVIOR AND RESULTS Cognitive Behavior Modification (Meichenbaum) 17 17 YOUR SELF-TALK CAN HELP OR HURT YOU! From Here she goes again what a pain in the neck! To She must be nervous! How dare he say this? It wasn t MY fault! This isn t about me. 18 18 6

REFRAME DIFFICULT PEOPLE ADJUST YOUR MINDSET. ADOPT AN OUTLOOK OF LOVINGKINDNESS. Give the person the benefit of the doubt. Assume the person means you no harm. If you feel frustrated or blaming, shake it off. Put yourself in the other person s place. Stop wishing the person were different! 19 19 AND CONSIDER: WHAT PUSHES YOUR BUTTONS? Nasty Demanding Impatient Entitled Accusing 20 20 TRIGGERING: AN EXAMPLE It s never enough You re never enough 21 21 7

YOU CAN RESIST GETTING TRIGGERED BY CHANGING WHAT YOU SAY TO YOURSELF. 22 22 HELPFUL SELF-TALK It s not about me! Entitled I have a chance to make a difference right now. This person is anxious and upset. This might be very hard for them. Even when a person acts difficult, I can be caring. 23 23 HELPFUL SELF-TALK It s not about me! Accusing I have a chance to make a difference right now. This person is anxious and upset. This might be very hard for them. Even when a person acts difficult, I can be caring. 24 24 8

HELPFUL SELF-TALK It s not about me! Stubborn I have a chance to make a difference right now. This person is anxious and upset. This might be very hard for them. Even when a person acts difficult, I can be caring. 25 25 HELPFUL SELF-TALK It s not about me! Demanding I have a chance to make a difference right now. This person is anxious and upset. This might be very hard for them. Even when a person acts difficult, I can be caring. 26 26 HOMEWORK FOR YOU: WHO PUSHES YOUR BUTTONS? Entitled No So- So YES! PREPARE! What can you say to yourself? Demanding Insulting Impatient Inconsiderate Outrageous expectations Won t take NO for an answer 27 27 9

USE YOUR POWER IN THE MOMENT. Pause. Breathe. Ask yourself: Are my thoughts helping me feel and show caring? If not, What self-talk will help me feel more patient and compassionate? Erase and replace. 28 28 All that we are is the result of what we have thought. The mind is everything. What we think we become. Buddha 29 STRATEGY 2: PREVENT FRUSTRATION AND DESPERATION. We KNOW: Some elements of the patient experience make person after person angry, anxious or frustrated! Proactively, make changes that prevent or reduce these irritants. 30 30 10

STEPS WE CAN TAKE TO PREVENT DIFFICULT INTERACTIONS Make process improvements Anticipate and communicate before people feel the need to complain Adjust our expectations to realistic ones Give options/power to people when they will otherwise feel powerless 31 31 CASE IN POINT: WAITING WAITING INFURIATES! We know a lot about the psychology of waiting. Anxiety makes waits seem longer. Waits of uncertain length are harder to tolerate. Waits feel longer when you don t know reason. People are less tolerant when the wait seems unfair. Pre-process waits feel much longer than in-process waits. Waiting alone feels longer than waiting in a group. Occupied time feels shorter than unoccupied time. If people think you feel bad about the wait, they will be less angry. 32 32 TWO MUSTS Hourly Comfort Rounds (the 4 P s) Potty Pain Position Possessions Before I go, is there something else I can do for you? 33 33 11

PROCESS IMPROVEMENTS ARE WIN-WIN! For patients and families Fewer accidents Less impatience Less humiliation Appreciation For caregivers Reduces call-light use Reduces falls Reduces cleanups Patients and families are less CHALLENGING 34 34 USE LANGUAGE THAT PREVENTS DIFFICULT SITUATIONS. I want to help you! I realize this can be so frustrating. Thank you so much for your patience. Thank you for taking the time to do this. I realize it s a nuisance. 35 35 PREVENT! We KNOW what makes person after person anxious or frustrated! Proactively, make changes that prevent or reduce these irritants. 36 36 12

STRATEGY 3: SPEAK THE LANGUAGE OF CARING Key to preventing people from becoming difficult Key to easing anxiety and defusing difficult situations 37 37 QUICK EXPERIMENT: PICTURE IT. How would you greet a patient if you want them to think you are arrogant really full of yourself? Impact on: Their thoughts? Their feelings? Their behavior? 38 38 PICTURE IT. How would you greet a patient if you want them to think you are distracted or bothered? Impact on: Their thoughts? Their feelings? Their behavior? 39 39 13

PICTURE IT. How would you greet a patient if you want them to feel like the most important person in your world at that moment? Impact on: Their thoughts Their feelings Their behavior? 40 40 FACT Your behavior affects how the other person feels, thinks and acts. You have the power to make people difficult or not difficult. 41 41 WANT TO MAKE PEOPLE ACT DIFFICULT? USE THESE WORDS! Dear, honey, sweetheart That s not my department. You can t. That s against our policy; Hold your horses. there s nothing I can do. You re not my only patient. Are you sure about this? You must be mistaken. That s hard to imagine! You ll have to... I ll try I m sorry. We re short-staffed. It wasn t my fault. That s never happened before. That doesn t sound likely (or possible). You ll have to be more patient. 42 42 14

CONSIDER THESE FACTS When dealing in a non-stressful interaction with people: 50% is emotion 50% is logic/business In a stressful interaction: 90% is emotion 10% is logic/business 43 43 TWO KINDS OF COMMUNICATION Heart Head Emotion, Caring, Empathy Tasks, Information, Analysis, Explaining, Fixing, Plans 44 44 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 45 45 15

Best Practice HEART-HEAD-HEART 46 Usually, when we feel pressured, threatened or defensive, communication stops. 47 HOSTILITY CURVE.WHEN YOU ARE DEFENSIVE Patient Anger 48 48 16

HOSTILITY CURVE WHEN YOU LISTEN, SHOW EMPATHY AND ARE NOT DEFENSIVE Patient Anger 49 49 THE LANGUAGE OF CARING: HEART SKILLS WITH THE POWER TO DEFUSE DIFFICULT INTERACTIONS 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! 50 2015 Language of Caring, 50 LLC 50 SKILL: THE PRACTICE OF PRESENCE Quiet your racing mind. Focus your whole self on the other person. Give your undivided, respectful attention. Open your heart. Tune in. Listen to the person s thoughts and feelings. Don t think about what you re going to do next. 51 51 17

INDICATORS THAT YOU ARE NOT PRESENT INFURIATE! Silence or non-responsiveness Turning your back without apologizing and explaining Walking away with no explanation or goodbye Acting tired, bored or distracted Looking at your watch Muttering Interrupting Texting while the other person is talking 52 52 SARA S STORY 53 53 SKILL: ACKNOWLEDGING FEELINGS You sound upset. You look frustrated. People feel understood. They calm down and become more rational. 54 54 18

ACKNOWLEDGING FEELINGS: DON T MAKE MATTERS WORSE! You feel. You are. Don t tell ME what I feel! 55 55 SKILL: SHOWING CARING NONVERBALLY Our nonverbal behaviors and tone can make people more or less difficult. Listen to the difference: I ll be with you in a minute. I ll be with you in a minute. 56 56 SKILL: EXPLAINING POSITIVE INTENT Patients feel: Mystery Fright Anxiety Out of control; powerless What s happening? Why are they doing this to me? 57 57 19

How dare you wake me out of a sound sleep to take my vitals?!? 58 EXPLAINING POSITIVE INTENT You make clear that your intentions are in the best interest of the patient. You re on their side. If the patient doesn t want what you want, they can say so, regaining power. 59 59 SKILL: THE BLAMELESS APOLOGY Show that you feel bad that the person is somehow suffering without placing blame or blaming others. Magic Words: I m sorry. Spoken with sincere regret! 60 60 20

BLAMING VS. BLAMELESS APOLOGIES Apologies that infuriate: 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. Apologies that soothe: I m sorry this wasn t what you were expecting. I m so sorry you were inconvenienced. 61 61 WHEN APOLOGIZING. Don t Blame others Those guys on 3 rd shift never get it right. Fuel people s distrust. I m sorry. We re short-staffed. Stop at the apology. Do Make everyone look good. Build confidence in whole team. They do a great job. I m sure there must be some good reason for this. Demonstrate can-do approach. Let me find someone who can help. My colleague is busy with other patients right now. I ll be glad to help you? Figure out options. Leap into action. 62 62 SKILL: THE GIFT OF APPRECIATION Thanks Appreciation A compliment Admiration..when the person least expects it! 63 63 21

PATIENT S DAUGHTER IS HOUNDING YOU FOR HER FATHER S TEST RESULTS. You know, your father is blessed to have you advocating for him and caring so much. I ll be SURE to call you right away when his results are in. I already SAID I would let you know the minute I get the results! 64 64 THE LANGUAGE OF CARING: HEART SKILLS WITH THE POWER TO DEFUSE DIFFICULT INTERACTIONS 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! 65 65 THE LANGUAGE OF CARING DEFUSES DIFFICULT SITUATIONS Turn up the warmth, and you ll turn down the heat. 66 66 22

STRATEGY 4: WHEN ALL ELSE FAILS, USE THE SKILL: SAY IT AGAIN WITH HEART! 67 67 SAY IT AGAIN WITH HEART. Decide on your bottom line your main message. Say it directly with HEART. Keep repeating it in a kind, calm way. If the person keeps pushing or says, Yes, but, don t address (or get hooked by) each comeback. Use FOGGING. 68 68 FOGGING: HOW TO AVOID GETTING HOOKED Don t disagree or agree. Say something to defuse the situation. That may be. I hear you. Perhaps so. You could be right. Then, go back to saying your main message again with HEART. 69 69 23

EXAMPLE: A COWORKER TREATS YOU WITH DISRESPECT You say I know you care and I want to support you. When you say negative things to me in front of the team, I feel disrespected. It makes it hard for me to support you. Make your point with lots of HEART. S/he says Oh come on! Can t you take a joke? Anyway, I was just speaking the truth! And you shouldn t be so thin-skinned! Excuses, resistance You say You might find it funny. I just want to say again that I want to work together well. And when I feel disrespect from you, it s hard for me to support you. Make your point again with HEART 70 70 EXAMPLE: ANGRY, IMPATIENT PATIENT You say I realize you re very anxious to get your Make your point with lots of HEART. results. And I want to ease your mind. I ll make sure you have them the minute they re available. S/he says This is ridiculous. My friend got her results much faster. Person persists, remains angry You say That may be. I want to ease your mind as soon as possible. The best I can do here is get your results to you in two days. That s when they ll be ready. I m so sorry it s so hard to wait. Fogging Main point again with HEART 71 71 TEST YOURSELF! Can you keep your composure NO MATTER WHAT the other person is saying? 72 72 24

FOUR STRATEGIES FOR DEALING WITH DIFFICULT SITUATIONS OR DIFFICULT-FOR-ME PEOPLE 1. Reframe difficult people 2. Prevent frustration and desperation 3. Speak the Language of Caring 4. When all else fails, use Say it again with HEART 73 73 WHAT IF NOTHING WORKS? Consider involving a third person to help. In your mind, reframe: I took the high road! I tried! Forgive yourself. Try again next time. You never know! 74 74 ARE YOU A LEADER? A CHANGE AGENT? Help your team become more effective with difficult-for-me people at work and beyond Wipe out the language difficult people. Be a role model. Provide coaching and practice. Hold Strength and Composure Training on Say It Again with HEART in the face of resistance and persistence. 75 75 25

Kindness is in our power, even when fondness is not. Samuel Johnson 76 THE WISE WOMAN AND THE STONE 77 77 Questions/Comments? wleebov@languageofcaring.com 78 26

We partner with healthcare organizations to help them achieve an unparalleled patient experience and a culture of caring through exceptional communication. FOR BREAKTHROUGHS IN THE PATIENT EXPERIENCE Language of Caring for Staff Language of Caring for Physicians Free video previews at www.languageofcaring.com For information? Contact: Jill Golde, Partner 314-571-9607; jgolde@languageofcaring.com Dorothy Sisneros, Partner 602-615-1192; dsisneros@languageofcaring.com 80 80 Wendy Leebov, Ed.D. wleebov@languageofcaring.com 215-413-1969 81 27

Language of Caring for Staff the skill-building solution that drives the patient and family experience to a breakthrough level Help everyone in your organization speak the Language of Caring, so patients, families and coworkers feel their caring and become more trusting, less anxious, and engaged. The Results: An energized, gratified workforce, a stellar patient experience, improved safety, higher CAHPS scores, and better outcomes Typical Implementation Process Groundwork and Customization languageofcaring.com Leadership Kickoff Facilitator Training Employee Jumpstart Workshops Learning Modules and Habit-Building in Work Teams Phased Learning: Ten Modules Developed by Wendy Leebov, Ed.D., best-selling author and patient experience expert 1. Introducing The Language of Caring 2. Heart-Head-Heart Communication 3. The Practice of Presence 4. Acknowledging Feelings 5. Showing Caring Nonverbally 6. Explaining Positive Intent 7. The Blameless Apology 8. The Gift of Appreciation 9. Say It Again with HEART 10. The Language of Caring: From Good to GREAT Features z Managers lead! z One skill at a time z Short team sessions under 30 minutes z Compelling videos shot on location at Banner Health z Built-in feedback and habit-building z CEU-ready z Web access to all resources on the Language of Caring Client Portal Achieving an unparalleled patient experience and a culture of caring through exceptional communication!

Watch the introductory video and learn more by visiting: http://languageofcaring.com/programs/language-of-caring-for-staff/ The Language of Caring for Staff z Creates alignment by developing a common language and skill set for caring communication z Mobilizes employees as engaged contributors who together create a community of caring z Makes other initiatives, like rounding, pain management and reducing readmissions, more effective z Encourages empathic communication, engagement and partnership the keys to patient and familycentered care z Leads to improved safety, better outcomes and higher CAHPS scores Spoken from the Heart We re seeing that our associates are engaging patients. They re thinking about what they re doing and saying. They re practicing the skills over and over. Our scores? We ve seen steady incremental improvement month after month since we started the Language of Caring. Rob Gould, CEO Banner Desert Medical Center; Mesa, AZ Language of Caring is a game-changer. The Language of Caring has helped PeaceHealth ensure that our organizational vision Every person receives safe, compassionate care; every time, every touch is an intention and a reality. Mary Lockhart, PhD, System Program Manager for Patient Experience PeaceHealth Among Language of Caring Clients Hospitals and Health Systems z Banner Health multiple states z Fox Chase Cancer Center, PA z Humility of Mary Health Partners, OH z Johns Hopkins Medicine; MD z MD Anderson Cancer Center, TX z Memorial Hermann Health System, TX z Providence Health and Services multiple states z St. Joseph Regional Medical Center, ID z St. Mary s Hospital and Regional Medical Center, CO z WellSpan Health, PA Medical Groups z Harvard University Health Services z Children s Hospital of Philadelphia Care Network z New England Quality Care Alliance z Mount Auburn Cambridge Independent Providers Association z PeaceHealth St. John Medical Center Physicians z Safety Net Institute - 15 Clinics, CA Connect with us! Jill Golde, Partner 314-571-9607 jgolde@languageofcaring.com Dorothy Sisneros, Partner 602-615-1192 dsisneros@languageofcaring.com languageofcaring.com

Language of Caring for Physicians empower physicians to deliver on the promise of patient-centered care Realities 1. Anxious, vulnerable patients and families 2. Penalties for static CAHPS scores 3. Consumer scrutiny and the social media grapevine 4. Fierce competition 5. Preventable malpractice claims 6. Job stress and time pressure Strengthen physician communication and everyone benefits. languageofcaring.com Improved Outcomes Higher Scores Coworker Support Patient Respect and Loyalty More Fulfilling Work Higher Earnings Personal Growth Improved patient and family experience Phased Learning: Eight Modules Developed by Wendy Leebov, EdD and Carla Rotering, MD; grounded in evidence-based best practices 1. The Communication Solution 2. Mindful Practice 3. Collaboration and Teamwork 4. Effective Openings and Closings 5. Engaging Patients and Families as Partners 6. Communicating with Empathy 7. Effective Explanations 8. Hard Conversations Groundbreaking Physician Engagement and Development Program z Strengthens communication competencies essential to effective care and physician satisfaction z Blended learning joins the best aspects of face-toface with video and web-based tools z Language of Caring coaches help you tailor the optimal implementation plan z Eight compelling videos filmed with staff at MD Anderson Cancer Center Achieving an unparalleled patient experience and a culture of caring through exceptional communication!

Watch the introductory video and learn more by visiting: http://languageofcaring.com/programs/language-of-caring-for-physicians/ The Language of Caring for Physicians z Engages physicians as partners in providing the remarkable patient and family experience z Improves team communication and collaboration z Improves CAHPS scores, clinical outcomes, patient loyalty, and pay-for-performance z Promotes physician satisfaction and fulfillment z Respects physicians significant time constraints z CEU-ready Comprehensive Resources Spoken from the Heart The Language of Caring has already helped me improve my ability to convey empathy in my conversations with patients, clinicians and hospital staff. It would have been nice to have this course 20 years ago when I was in residency Douglas Cutler, MD Medical Director, Care Coordination Banner Thunderbird Medical Center The Language of Caring is like having my own personal guide teaching me the art of medicine. My patients and even their family members are thanking me for the care and attention I have provided them even though the amount of time I spend with them hasn t changed. This should be made a mandatory course in every medical school curriculum. Dr. Thomas Corson Emergency Physician, Banner McKee Medical Center Among Language of Caring Clients z MD Anderson Cancer Center (TX) z St. Rita s Medical Center (OH) z Truman Medical Centers (MO) z Providence Regional Medical Center Everett (WA) z WellSpan Health (PA) z St. James Healthcare z Banner Health (AZ, CO, WY, AK) z Cardon Children s Hospital (AZ) z PeaceHealth (WA, OR, AK) z Valley Health (VA) Connect with us! Jill Golde, Partner 314-571-9607 jgolde@languageofcaring.com Dorothy Sisneros, Partner 602-615-1192 dsisneros@languageofcaring.com languageofcaring.com

Company Overview: Language of Caring, LLC Who is Language of Caring? Language of Caring is a healthcare consulting firm owned by partners Wendy Leebov, Jill Golde and Dorothy Sisneros. This powerhouse trio shares a passion for reshaping healthcare organizations to become communities of caring that ensure an exceptional patient, family and team experience. We ve served as healthcare leaders, organization development professionals, instructional designers, strategists, and coaches. And, we ve enlisted and certified a talented, committed team of physician and nurse leaders, trainers and team-builders who serve our clients as coaches, strategy partners and facilitators. What We Do We effectively engage physicians, nurses, and everyone on the healthcare team in mastering and using Language of Caring s concrete communication skill set to achieve: z Patient engagement and patient and family-centered care z Exemplary CAHPS scores and a reputation as provider of choice z Optimal reimbursement under Value-Based Purchasing z Greater alignment, inspiration, collaboration and engagement among the entire healthcare team z And improved patient outcomes We develop healthcare teams who speak the Language of Caring and deal effectively not only with patients medical needs, but also with their anxieties, fears, and concerns. We help organizations breathe new life into existing strategies and move performance to a breakthrough level. languageofcaring.com It has been an absolute pleasure to work with the Language of Caring team in two different healthcare systems to create a differentiating culture of compassion. The training content is fabulous simple to understand and extremely effective with patients and coworkers. The Language of Caring team exemplifies service excellence by partnering with us to address our unique needs. They have provided inspirational training and assistance as we work to create unsurpassed customer/ employee-centered service. Tracy Tannenbaum VP, Service Excellence We engage hearts and minds, and the results are palpable. Achieving an unparalleled patient experience and a culture of caring through exceptional communication!

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