quality embracing excellence
TRANSCRIPT
Janice Crenshaw, RN, MSNDirector of Quality Improvement
“Quality in a service is not what the supplier puts in. It is what the customer gets out and is willing to pay for. A service is not ‘quality’ because it is hard to do
or costs a lot of money, as providers typically believe. Customers pay only for what is of use to
them and gives them value. Nothing else constitutes quality.”
Peter DruckerManagement Theorist, Researcher and Consultant (1909 - 2005)
What is Quality?
Lakeside Memorial Hospital in Brooklyn, NY Earl K. Long Medical Center in Baton Rouge,
Louisiana Calhoun Hospital in Arlington, Ga. Renaissance Hospital in Terrell, Texas shut
down due to patient safety failures. Lee Memorial Regional Medical Center, in
Pennington Gap, Va. closed partly due to reimbursement cuts under the Patient Protection Affordable Care Act
Understand some of the challenges now facing healthcare & how it impacts the bottom line
Identify ways to address these challenges Learn how to communicate more effectively
to improve the patient experience Learn how to create a culture of
accountability that embraces excellence
PRO
CED
UR
ES
MISSION
PERFORMANCE STANDARDS
HER
OES
POLICIES
INFORMAL COMMUNICATION
ASSUMPTIONS
NORMS
EMO
TIONS FEELINGS
PREJUDICES
We exist first and foremost for those we serve. We exist to continue the healing ministry of St.
Francis of Assisi by providing care grounded in the ethical and philosophical beliefs of the church
We foster empowerment, respect and development of all employees
Denial Rationalization Blame “We/They” Unwillingness Not Skilled Lack of Accountability
The Best Co-Worker characteristics
The Worst Co-Worker characteristics
The day to day communication between supervisory managers and direct reports has more impact than any other single factor on employee productivity, quality, morale, and retention.
Bruce Tulgan, CEO RainmakerThinking Harvard Management Update, Mar 2003
A national study of 1,700 nurses, physicians, clinical staff, and administrators concluded that it is “common” for providers to say nothing when they observe “troubling” performance by colleagues.
62% of nurses see coworkers taking shortcuts that may endanger patient care, and 48% of nurses believe coworkers show poor clinical judgment; however, fewer than 10% of nurses, physicians, and other clinicians directly confront colleagues about performance concerns.
Silence Kills: The Seven Crucial Conversations for Healthcare, 2005, AACN and VitalSmarts
Procrastination
“Don’t have time” “Nothing can be done differently with
these types of patients” “We don’t need to” “We already are” We/they
More focus on staff retention & reward/recognition (i.e. employee rounding)
Service excellence departments Organizational Standards of Behavior Service excellence training for all staff More Senior Leadership transparency Higher levels of leader accountability Annual raises based on department
performance
Perception
=
Money!!!!!!!
Anger Unreasonable expectations Poor relationships with staff and physicians Perceptions that patient complaints are not taken
seriously Desire for substantial monetary settlement Perception that their actions are improving the
Healthcare system and positively influencing future patient care
In 2013 LA based Pacific Health Corp. closed all four of its hospitals in California – after the for-profit chain ran into Millions of dollars in law suits and legal fines.
Becker’s Hospital Review 2013
In 2011 Los Angeles, a team of attorneys that sued a Santa Barbara nursing home eventually uncovered five different versions of their client's chart. "Instead of providing the care, they're creating records – creating an illusion that care was there," said Michael Connors, a long-term care advocate for San Francisco-based CANHRR
Read more here: http://www.sacbee.com/news/investigations/article2573412.html#storylink=cpychart
The first step in taking ownership is looking in the
mirror and asking,
“How am I
contributing to the perception of
our work culture?”
Accountability A Paycheck
=
A clinician may conduct as many as 150,000 patient interviews during a typical career. If
viewed as a healthcare procedure, the patient interview is the most commonly used procedure that the clinician will employ. Yet communication
training for clinicians and other healthcare professionals historically has received far less attention throughout the training process than
have other clinical tasks
Institute for Healthcare Communication, July 2011
Smile and show passion
“Patients should never have to dig thru our biases, or be forced to misinterpret the presentation of care , trying to find our
passion”
The Heart & Soul of Rounding 2011 © Janice Crenshaw
Key words with passion = results Touch the heart and engage the
soul
Heart to Heart
ompassion
HH Hello, Greet & Hello, Greet & acknowledge acknowledge
EE Explanation, Explanation, explain explain reason for interaction, any reason for interaction, any test, procedures and test, procedures and durationduration
AA Assess the patient or Assess the patient or the situationthe situation
RR Respect the patient, Respect the patient, recognize familyrecognize family
TT Time you will return, Time you will return, Thank YouThank You
A Framework
for effectiveCommunication
Managers communicate clear expectations Hold staff and co-workers accountable to
behavior standards Focus on a behavior standard each month with
facility/department activities Role play in staff meetings Reward/recognize & manage up high performers Reward /recognize unit with highest patient
satisfaction results
Thank YouJanice Crenshaw, RN, MSNJanice Crenshaw, RN, MSN