Prior Aefina Partner blogs have addressed How to Improve Physician Communication and Infrastructure for Success in Physician Communication.
Moving to action is the next step. Work with executives, physicians, and teams have shown us that work in three levels is required to successfully improve partnerships between patients, physicians, and team members. This framework illustrates levels of action for meaningful impact and sustained gains that tap into team members’ motivation and ability (head and heart) in three areas:
• Within the team
• And within the organization
Each level puts patient partnerships in context – they remind each individual of their internal motivation and emphasizes understanding care through the eyes of patients and families.
The nested circles include:
· The patient-practitioner connection
· The care environment – clinic or department
· The organization – responsible for effective supportive infrastructure
The visual helps all team members see where changes are needed. It also efficiently focuses actions that improve care experience for all involved – great experiences of care as well as improved physician and team member engagement.
Let’s review actions at each level. The actions can be implemented at all levels at the same time as long as they reinforce and support the core: the patient-practitioner connection.
Patient – Practitioner
The focus here is on specific evidence-based behaviors that every practitioner commits to demonstrate in all interactions with patients. Using an experience based, co-designed process involving practitioners and patients, this level identifies what each practitioner brings to every encounter that builds the partnership over time, leads to better outcomes, and achieves better experiences for both parties.
Examples of minimal foundational commitments include: Start Strong (introduce self; acknowledge and welcome family); Connect on a Personal Level (be prepared by reviewing record; ask “what are you most worried about?” then listen); Ensure Understanding (slow pace; use lay terms; assure shared decision making); and Finish Strong (“what questions can I answer?”; review next steps to achieve mutual agreement). Adding projects or tactics solely at this level results in random actions rather than developing an integrated system. Random actions too often over-burden practitioners and team members.
The care environment applies to all team members who are have contact with patients and families or provide support services that impact the experience. A poor encounter prior to connecting with the provider may disrupt the experience before the first visit.
Using a similar experience based, co-design approach, team members identify their own commitments to the patient experience and identify systems issues that are barriers to an excellent experience. Sample minimal commitments include Welcome Warmly (how patients are greeted by phone or in person); Accept Ownership (own the problem until it’s resolved or transferred to someone who can); Finish Strong (assure understanding of next steps; thank them). Systems issues may include ease of access (in person or via technology), waits and delays, and ease of referrals.
Organizational leaders are accountable for assuring effective systems support an excellent patient experience and engaged team members. Examples include systems that work (HIT); human resources infrastructure (embedding the commitments in hiring, development, and evaluation); fast problem-solving to remove barriers for team members; and meaningful and useful data.
The Framework is guided by principles –
- Experience based, co-design – team members have some control over care setting as they participate in design at all 3 levels, in partnership with patients and others
- Workload – “stop stuff”; gain time by doing work that matters, supported by effective systems
- Community – Partnership by everyone is seen through patient and family eyes rather than solely a professional or organizational view
- Values – assure that the individual and organizational values are aligned
- Skill development – physician, leaders and staff skill development is required
We welcome your comments, insights, and discoveries.