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Givers Make the World Go Round

I was introduced to Adam Grant (not in person, just though his amazing book, Give and Take:Why Helping Others Drives Our Success) a year or so ago in an MBA class. His book captivated me, showing through research and real life examples many intuitive things I have  felt but had no idea how to put into words.  Not only does he articulate these deep seeded intuitions, he always backs it up with research and data.

His research is work spreading.  Check it out!

 

 

Empathy Transforms…Us.

I am researching topics to include in a class I am developing entitled “Keeping Healthcare Human”.  I was inspired to create this class because this is what I see as the biggest deficit in healthcare today: the inability for caregivers to engage with those they care for in a compassionate and humane way.

There are many reasons this happens. I would say if I had to pinpoint one main reason it would be this: we are overwhelmed. And although I haven’t done any scientific research on it, my intuition drives me to suspect that when we are overwhelmed, our brain seeks to simply and compartmentalize, reducing humans to more manageable objects to be dealt with rather than fellow human beings to be entered into relationship with.

My research led me to empathy…again. And this time I found this awesome TEDx talk by Paul Parkin. His talk took me deeper into empathy and how it works than I have ever thought of it before. There were a couple of things that were truly insightful about his talk, but the most eye-opening  for me was this: ultimately, empathy changes us.

He says, “Empathy forges communication that is inquisitive, that is non judgmental, that is validating and compassionate. And when we start to communicate in that way, the primary thing that it does is it changes us. It softens us. We see people in our lives differently. We re-write the narratives that we tell ourselves about others in the kindest ways possible.”

Oh how this is needed in healthcare today!

Empathy transforms not only the situation for the person receiving empathy, it also has the power to transform the giver of empathy. Hello, light bulb!!!

Listen, and be changed.

 

 

 

Patient and Family Advisory Councils: What to Look for When Recruiting Members

Patient and Family Advisory Councils, otherwise known as a “PFAC”, are an ideal way to foster partnerships and solution based dialogue between the healthcare team and the community. As part of my series on Patient and Family Advisory Councils, I wanted to talk about ideal traits to look for when recruiting community members to be a part of your PFAC.

There are six different attributes that are key when looking to see if someone is a good candidate to be a part of your PFAC:

  • Have they had previous healthcare experience?

It seems like stating the obvious, but you want to make sure whoever you are recruiting has had relatively significant personal healthcare experience. They may have been a close family member, or in some cases a close friend, of someone who has had experiences in healthcare. They will need this point of reference to draw from in order to promote meaningful dialogue as well as cultivate ideas for improvement.

  • Are they able to see outside of their own experience for the greater good?

Some community members may not be at a point where they can see past their own experiences in order to see the bigger picture and how others are affected in similar or different  ways. It’s important that you recruit members who can draw on their own experiences but also see how their experiences fit into a much bigger picture.

  • Are they able to look at issues beyond what they may have experienced personally? 

Members who can draw on their own personal experience while at the same time are interested and passionate about improving many different aspects of healthcare–whether they have personally experienced them or not–are the people you will want to recruit. If they only are interested in fixing “their” problem, and are not willing and able to look at other issues as well, you’ll want to pass.

  • Do they have a broad reach and influence in the community?

This is a wonderful opportunity to build a link between your organization and the community. By recruiting members who are actively involved in the community in other aspects, they will be able to bring a greater knowledge of issues as well as represent and speak to dialogue and improvements coming out of the PFAC. Not everyone has to be a prominent community member, but having those that are dispersed on your PFAC is a huge bonus to foster a relationship with the community.

  • Can they commit?

From the beginning, you’ll want the time commitment to be explicitly discussed and agreed upon. Whether your PFAC meets monthly or quarterly, whether the term is 1 or 3 years, you’ll want your members to know the commitment and be willing to dedicate the time in order to be a valued member on the council.

  • Are they comfortable sharing their honest thoughts and opinions in a group setting with a wide variety of people?

PFACs will consist of a wide range of individuals with broad background and experience levels. Members will need to be comfortable sharing their insights and thoughts in a productive and solution oriented way to a group including other members, doctors, nurses, administration, and others. You’ll want to look for people who have the skills to be able to communicate effectively in a group setting.

 

Patient and Family Advisory Councils: Increasing Community Engagement to Improve Care

Patient and Family Advisory Councils are rapidly becoming a standard across hospitals nation wide. The patient’s voice is now stronger than ever due to the fact  re-reimbursement and loyalty has become more and more tied to their personal experience within the healthcare system.  Patient and family advisory councils (PFAC) are one way hospitals are reaching out to partner with the people they serve in order to improve.

A patient and family advisory council provides a forum for patients and families to partner with members of the healthcare team in order to offer insight and perspective on what it takes to create an exceptional patient experience. Through the council, patients and families are given the opportunity to serve on other hospital committees, eventually becoming completely integrated into the fabric of the organization.

Patients and families who are a part of a PFAC ensure that the consumer perspective and point of view is heard and valued alongside clinicians’ and administrators’. They work with the entire healthcare team to bring to light the nuances of what creates an exceptional experience.

There are many benefits to incorporating a PFAC into your organization:

  • Increased listening, understanding and cooperation between the community and the healthcare team.
  • Efficient planning of new projects to ensure consumer needs and priorities are met from the start.
  • A forum for cost-effective and innovative solutions to challenges.
  • A forum to test ideas before implementation.
  • A link between the organization and the community it serves.
  • Promotes respectful and effective partnerships between patients, families, and the healthcare team.

In the next couple of weeks, I’ll be diving in to what it takes to begin a patient and family advisory council, explore more of the benefits, talk about the barriers as well as who are good candidates for membership. We’ll also discuss readiness and resources, both financial and staffing, that you’ll need in order to get started. Stay tuned!

 

A Letter that Reminds Us What is at Stake

A while ago I came across a letter that was floating around social media from the New York Times. The letter was written by Peter DeMarco after his young wife, just 34 years old, passed away due to a massive asthma attack.  He recollects all of the kind, humane ways in which the care team treated his wife, her family, and him during her final seven days in the hospital.

He touches on all of the seemingly “little” ways the doctors, nurses, and staff treated them with empathy and ultimately love. Blankets when they were cold, special visitor requests granted, endless coffee and water, a chair when needed, a shower, a question answered, an explanation given with patience and compassion, and “sadness in [their] eyes”.  His letter shows the depth of compassion and kindness that surrounded this family during the hardest time of their lives.

You have to read it to the end though. I haven’t cried like that for a stranger’s situation in a really long time. He not only  captures beautifully the essence of what it means to compassionately care for those who desperately need it, he also captures the delicate fragility of life and what it’s like to lose someone you love.

The letter not only serves as a well deserved thank you to all the caregivers who cared for his wife and their family, it also reminds me of the depth of what is at stake in the everyday moments of our lives, as rushed and routine as they can become.

Read it here.

 

 

Practicing Mindful Communication

I spent the last week in Orlando, Florida at the Press Ganey National Client Conference. There were so many highlights, including having the opportunity to listen to Condoleezza Rice as well as a plethora of others doing their best to leave this world better for them having been in it. What inspires me the most is their unswerving dedication, despite having seen so much opposition, to continue to fight to improve our lives, whether it be in the realm of security, or healthcare.

One of the most insightful and inspiring sessions I attended was titled, “Activating Physician Culture with Physician Coaching in Relationship Centered Care.” The session was led by three doctors who have instituted a training program at Texas Children’s Hospital for doctors to improve the skills it takes to build relationships with patients that foster meaningful communication. They spoke of the directionally correlated relationship between good communication and quality of care outcomes.

One of the distinctions they made was the emphasis on relationship centered care–not “doctor centered” or even “patient centered”–but relationship centered. They spoke of the lack of communication training that physicians–but in reality all caregivers–receive, and yet, they said, communicating is one of the most common “procedures” a physician will do. Yet so many do it so incompetently: they stated studies have shown a physician will typically interrupt their patient in the first 14 seconds of a conversation. I would say that is not necessarily only a physician problem, but a human problem.

In the training one focus is on the importance of listening. To demonstrate they had us participate in a listening activity they do in their trainings with the physicians. The concept was simple: in pairs, one participant would share with the other a challenge they were having at work, while the other would listen. The game rules were that the listener would not interrupt, but rather they would let the other’s story unfold. Once the speaker was done, the listener would then try to restate  what they think they had heard, specifically listening for the other to confirm by saying something like, “Yes, that’s right.”

I have to admit I did an inner eye roll when they said we were going to have to do this activity. I think I’ve done something similar at some point, and I’ve always considered myself a good listener. In this particular case, I was the speaker. I let my story unfold. My listener, a stranger, leaned in, gave me all of her attention. She didn’t interrupt me, and when I was done, she tried to repeat in her own words, the meaning behind what I was saying.

She was a good listener. In less than two minutes, I felt like she knew me, she connected with me. And I realized how rare this type of communication is. I realized how rarely I am a good listener, because I am mostly hearing in order to know how to respond.

I realized I’ve been missing out on the stories I could have let unfold. On understanding and connecting with others and letting conversations flow and travel down their own paths, paths to new meaning and new understanding, vs me taking control and guiding the conversation to at best a familiar path, and at worst (how many times have I done this?) to a screeching halt.

Today I tried to listen to understand. I tried to get the meaning of the stories behind what people were talking to me about and I was cautious of injecting my own experience, insight, or whatever. Because what I saw in a new way through this particular session was the importance and significance of others’ experiences, not just my own.

**In my video I mention one of the doctors was from John Hopkins. When I went back to confirm I realized that was not correct. The speakers were Laura Cooley, PhD, Executive Director, American Academy on Communication in Healthcare (AACH); Larry H. Hollier, Jr. MD, FACS, FAAP, Chief, Division of Plastic Surgery, Texas Children’s Hospital; and Calvin Chou, MD, PhD, FAACH, Vice President for External Education, AACH; Professor of Clinical Medicine, UCSF.

 

 

Caring for the Caregivers: Schwartz Rounds

After six years in healthcare I still have so much to learn, but one thing is certain: patients aren’t the only ones who suffer in hospitals. Caregivers can also experience a significant amount of suffering, not the least of which is the emotional and psychological effects of the situations they find themselves thrown into while caring for patients and their families.

It’s this emotional side of healthcare that rarely gets addressed. There are too many tasks to perform and protocols to follow to spend any time focusing on the emotional impact the work may be having, for good or for bad. With healthcare burn out on the rise and retention a hot topic for any healthcare leader, healthcare administrators are looking for solutions to these very real, very sensitive topics.

Enter Schwartz Rounds. Schwartz Rounds are all about caring for the caregiver and are one way to help with burn out and retention.  Usually when “rounds” are spoken of in a hospital setting they refer to checking in on the status of patients. Schwartz Rounds, conversely, check in on the status of the caregivers themselves.

“Schwartz Rounds are a place where people who don’t usually talk about the heart of the work are willing to share their vulnerability, to question themselves. The program provides an opportunity for dialogue that doesn’t happen anywhere else in the hospital.” – Participant
  The Schwartz Center for Compassionate Healthcare

Schwartz Rounds create an open forum for anyone who cares for patients–clinical or non–can come together to discuss the social and emotional issues that arise in caring for patients.

Here is how it works:

 

Prior to the forum, a case is chosen. There is great care in choosing the cases; it has to have had a significant impact on caregivers. It doesn’t necessarily have to be a hard or sad case, although I would say a majority of them probably are.  Often overlooked in healthcare is the necessity to talk about the positive emotional impact of the work.

Once a case is chosen, a panelist is chosen to present the case. There are facilitators to help the group process through and talk about the different emotional and social aspects the particular situation brought up for them. Caregivers who may not have been directly involved in the particular case can comment and participate by drawing on similar past experiences.

What’s cool is that everyone is invited, and it’s a way for the different teams of doctors, nurses, environmental staff, techs and anyone else involved in the care of a patient to come together, to share stories, to laugh and cry and leave strengthened.

According to The Schwartz Center for Compassionate Healthcare website, participants in Schwartz Rounds reported:

  • Increased insight into the social and emotional aspects of patient care; increased feelings of compassion toward patients; and increased readiness to respond to patients’ and families’ needs.
  • Improved teamwork, interdisciplinary communication, and appreciation for the roles and contributions of colleagues from different disciplines.
  • Decreased feelings of stress and isolation, and more openness to giving and receiving support.

Addressing the needs of caregivers is paramount to providing the best care for the patients they serve. It is also paramount to decrease burnout and help retain compassionate and skilled caregivers.  Schwartz Rounds is one way to help caregivers process through some of the suffering and some of the joy they experience while taking care of the people and the communities they serve everyday.