Excellence in the
Emergency Department:
How to Get Results
Indiana Rural Health Association
Stephanie Baker, RN, MBA, CEN
March 3, 2011
Why is this Important?
What does improved results mean to:
Patients/Families
Physician
Employees
Community
Emergency Department
Hospital
What Do Improved Results mean to Patients
and Families?
Pain is being managed
Call lights are being responded to in a timely manner
Patient needs are met “proactively”
Patients are kept informed and actively involved in
their plan of care
Improved communication with families
Patients understand their home care instructions
Patients feel like we care, not like an inconvenience
What Do Improved Results mean to
Physicians?
Less turnover of staff
Better working systems
Better relationships with referring hospitals
Decreased complications and complaints
Decreased litigation
Greater peace of mind
Increased fulfillment of physician mission to provide
better patient care
What Do Improved Results mean to
Employees?
Know and feel better about where they work- pride
in workplace
More effective and efficient team when work force is
stable
Feel systems and processes work better
Tools and equipment to do the job
Ability to consistently perform core responsibilities
More specific reward and recognition
Renewed passion for their work
Better work-life balance
What Do Improved Results Mean to the
Community?
Better access to care for patients
Better place to work for employees
Healthier community
Better place for physicians to practice medicine
High quality care at a competitive cost
What do improved results mean to the ED
and the Hospital?
Improved Clinical Quality Outcomes
Reduced litigation and risk
More positive community representation
Increased volumes / revenue
Improved Market Share
Positioned well for Pay for Performance
Allows for survival -- accountable for metrics
Healthcare Flywheel®
Bottom Line
Results
Prescriptive
To Do’s
(Transparency and
Accountability)
Purpose,
worthwhile work
and making
a difference
SelfMotivation
WHY
®
Execution Framework
Evidence-Based LeadershipSM
Foundation
STUDER GROUP®:
Objective
Evaluation
System
Leader
Development
Aligned Goals
Implement an
organizationwide
staff/leadership
evaluation
system to
hardwire
objective
accountability
(Must Haves®)
Create
process to
assist leaders
in developing
skills and
leadership
competencies
necessary to
attain desired
results
Must
Haves®
Performance
Gap
Aligned Behavior
Agreed upon
tactics and
behaviors to
achieve goals
Re-recruit high
and middle
performers
Move low
performers up
or out
Standardization Accelerators
Aligned Process
Processes that
are consistent
and
standardized
throughout the
company
Software
“Vision without execution is h a l l u c i n a t i o n .” Thomas Edison
Top Ten Challenges in Execution
1. Leaders / Others
underperforming and still
receiving a good evaluation
(Accountability)
2. Change not connected to why
(Alignment)
3. Lack of necessary urgency
(Alignment)
4. Leaders do not have the skills to
assure a solid implementation.
(Action)
5. Too many changes -- too soon
(Action)
6. Push Back by leaders, staff
and physicians
(Accountability)
7. Not familiar with what “right”
looks like
(Action)
8. Lack of frequency
(Action)
9. Inability to transfer best
practices
(Action)
10. Poor processes
(Action)
Key Evidence
Evidence - Defined
ev·i·dence
/ˈɛv ɪ dəns / Show Spelled [ev-i-duh ns] noun,
verb, -denced, -denc·ing.
–noun
1. that which tends to prove or disprove something;
ground for belief; proof.
2. something that makes plain or clear; an indication
or sign
Studer Group Partners Outperform the Nation by an
Average of 20 Percentile Points across HCAHPS
Measures
Percentile Rank Comparison: Studer Group Partners vs. Non‐Partners
Patients who gave a rating of 9 or 10 (high)
Yes, patients would definitely recommend the hospital
23%
22%
Source: The graph above shows a comparison of the average percentile rank for Studer Group Partners that have received EBL coaching since Oct 2007 and non‐partners for each composite; updated 10.11.10
Our Partners Outpace Peers in HCAHPS Improvements
at a Speed Nearly Three Times Faster Than the Nation.
Source: The graph compares the change In one year in “top box” results achieved by Studer Group partners vs. non‐partners. Change is from Jan‐Dec 2008 to Jan‐Dec 2009.
As Hospital’s ED Percentile Ranking Increases,
So Does Its HCAHPS “Overall” Percentile Ranking
Studer Group Partners Perform Better Than
the Nation in All Core Measures
Studer Group Partners vs. National Average in Compliance with Evidence‐Based Clinical Core Processes
100%
93.9%
90%
96.1%
94.5%
93.5%
91.4%
90.0%
89.0%
87.6%
83.3%
78.6%
80%
70%
Children's Asthma
Heart Attack or Chest Pain
National Average
Heart Failure
Pneumonia
Surgical Care Improvement Project
SG Avg (EBL Since Oct 2007)
Why is The Focus On the ED?
45-80% of
hospital
admissions
come
through the
ED
Why is this important? #1 - Reimbursement
“Here you go…
thought you
might like this”
#2 Workforce Shortage - Nurses
Physician Workforce Shortage
www.aamc.org/workforce
Reason #3 - Malpractice
Relationship between patient satisfaction,
complaints and lawsuits
Physicians with lower patient satisfaction results are more
likely to have patient complaints (RR 1.79;95% CI 1.38-2.33; p<.001)
Each one point decrement in patient satisfaction scores is
associated with a –
6% increase in complaints (RR 1.06, 95% CI 1.03 – 1.08;p<.0001)
5% increase in risk management episodes (RR 1.05, 95% CcI
1.01 – 1.09;p< .008)
Lower performing physicians were at greater risks for lawsuits
(RR = 2.10;p 95% CI 1.13 – 3.90; p<.019)
75% of complaints were related to communication issues
Stelfox HT, et al, The American Journal of Medicine 2005; 118: 1126 – 1133
Reason #4 - The Transparent Environment –Quality
On-Line
Pay for Performance . . . Coming Soon to
Your Neighborhood
Value-Based Purchasing (VBP)
= a specified percentage of hospital payment would
be conditional on performance
– Reimbursement currently: 100% public reporting
– Reimbursement FY 2013: 50% performance
50%public reporting
– Reimbursement FY 2014: 100% performance
Calculating Reimbursement
– Will need to either be at 50%ile or show improvement
from previous score to earn points for that dimension
Reason #5 –
Communication = Compliance = Quality
Physician communication correlates STRONGLY
with adherence rates by patients in acute and
chronic disease. There are now over 100
observational and 20+ experimental studies
published demonstrating the correlation of
communication (patient satisfaction) with
compliance. Compliance with treatment regiments
has significant influence on quality measures in
chronic disease and outcomes.
Medical Care: August 2009 - Volume 47 - Issue 8
- pp 826
Quality/Service/Efficiency
Relationship Between Employee Turnover
and Patient Care
Mortality Index = Clinical Quality
Employee Turnover = Service Excellence
LOS = Operational Efficiency
It’s Getting Harder to be Great
The Best Definition of Madness is
To keep doing things
the same way
and expect different
results . . .
How Are You Feeling About All of This?
How We Need to Feel
CHANGE
Patient Safety, Satisfaction, and Quality All
Depends on Patient Flow
Quality and Safety
Source: Studer Group and CEP
ED Revenue Potential with a 1 Hour reduction
in Throughput with Unmet Demand…
40,000 ED Visits X 1 Hr LOS reduction= 40,000 Hrs of
↑ED Capacity/ Year
2-3 Hours/Visit = 20,000-13,000 potential new visits
20,000 new visits X $100/Visit = $2,000,000 in new
revenue for the group
20,000 new visits x $400/Visit = $8,000,000 in new revenue
for the hospital
This potential revenue increase does not include the
increase in inpatient revenue at $3,000-$7500 per
admission
Walkaways- LWBS’s and AMAs:
The Financial Implications of Throughput Improvements
Average $100 MD income for every walkaway
Average $400 in hospital income for every
walkaway
For a 50,000 visit ED= $50,000 in new MD
revenue (no increased overhead) for every 1%
reduction in LWBS/LWBTs
A 1% reduction in walkaways = $200,000 in new
outpatient hospital revenue
Hospital Admissions and Your ED
20 admissions per day x
$5,000/admission (on average)=
$36,500,000/year coming in
through your ED
What if you increased
admissions by 5% = what
increase would this have on
revenue?
30 admissions/day x
$5,000/admission (on average)=
$54,750,000/year coming in
through your ED
1 more admission per day (365)
X $3,000-$7500/ patient
admission
Go ahead, find out your numbers
and then do the math for your
facility…
(AHRQ-only 6.2% of admissions
through the ED are uninsured)
=$1,095,00-$2,737,500/year
Thinking About ED Patient Flow
Optimizing Patient Intake and
Throughput:
Segmenting Patient Flow Into Incoming
Patient Streams…
The Life Cycle of a Patient Visit
Arrival
Triage
Input (Patient Intake)
Bed assigned
Physician
contact
Throughput
Disposition
Output (Departure)
Admit
Discharge
The view from the gurney up:
“Vertical” vs. “Horizontal” Patients
Vertical Patients
Ambulatory
Arrive by Triage
Well
Younger
Perceived urgency or
convenience factor
Value (Starbucks or
McDonalds)
– Speed
– Convenience
– Financial
– Other non-medical
factors
Horizontal Patients
Stretcher bound
Ambulance Arrival
Sick
Older
Perceived serious or lifethreatening Condition
Value (Traditional
Healthcare)
– Speed
– Safety
– Preservation of Life/Limb
Segment Your ED’s Patient Flow into
Incoming Patient Streams
Triage
Brief RN Assessment:
ESI Evaluation / Evaluation of Acuity
Low Acuity
Pathway
ESI Levels 5, 4,
+ some 3s
Moderate Acuity
Pathway
Most ESI Level 3s
High Acuity
Pathway
ESI Levels 1 + 2
Keeping Your Vertical Patients Vertical
and Moving
Treat and
Release
Patient
Intake
Area
Results
Waiting
Area
Patients enter
intake area
-Focused
Evaluation and
Treatment
-Move to results
waiting area.
-Triage Orders
-Dx/Rx Protocols
-MLP in Triage
-MD in Triage
-Super-Track
-Fast-Track
-Team Triage
-Results Back
-Treatment
Complete
-Discharge
Bed Turns and Results Waiting
6 Hour ALOS=4 patients per
bed per day
4 Hour ALOS=6 patients per
bed per day
A key rate limiting server
A key component of care
A key “member” of your team
…Park bench… or MVP?
ED Patient Flow is Predictable:
Classic ED Patient Flow Curves
Emergency Department Admission Times : 1 Hour Increments
400
350
300
250
Number
200
Of Pts
150
100
50
0
0:00 1:00
2:00 3:00
FY2004 Q- 1
154
149
120
81
4:00 5:00
83
79
6:00 7:00 8:00
99
153
166
9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00
269
253
277
235
260
274
268
294
307
332
352
345
299
278
211
FY2005 Q- 1
160
119
107
83
71
76
85
106
156
208
226
230
260
243
260
260
304
286
302
333
287
270
260
198
[Trend-Star Data : Q-1 FY04 & 05
Volume Variation by Day of Week
Volume varies significantly by day
of week – 10%+ variation between
heavy and light days
Saturday, Sunday and Monday are
heavier days
When matching capacity with
demand, varying staffing by day of
week is essential
Our
Emergency Departments
are the
ultimate reality show…
We can do this…
Must Haves to
Hardwire a Culture of
Safety and Service
Why Do We Want To Do This?
….because this could be hard…..
Service is Married to Quality,
Safety and Flow
HCAHPS – Hospital Consumer Assessment of Healthcare
Providers and Systems
What is HCAHPS
A standardized survey tool to measure the patient’s perception of quality care provided during their experience while a patient at an acute‐care hospital.
The patient perception of care will be publicly reported Why is it with other quality metrics on the Hospital Compare important? website. www.hospitalcompare.hhs.gov
The information will be used to provide meaningful data How will it for improvement efforts as well as provide comparisons be used? between hospitals to help consumers choose a hospital.
HCAHPS Questions
Composite Nursing Communication
Doctor Communication
Responsiveness of Staff
Pain Management
Communication of Medications
Discharge Information
NA
NA
Question Summary
Response Scale
Nurse courtesy and respect
Nurses listen carefully
Nurse explanations are clear
Doctor courtesy and respect
Doctors listen carefully
Doctor explanations are clear
Did you need help in getting to bathroom? 2
Staff helped with bathroom needs
Call button answered
Did you need medicine for pain? 2
Pain well controlled
Staff helped patient with pain
Were you given any new meds? 2
Staff explained medicine
ALWAYS, Usually, Sometimes, Never
ALWAYS, Usually, Sometimes, Never
ALWAYS, Usually, Sometimes, Never
ALWAYS, Usually, Sometimes, Never
ALWAYS, Usually, Sometimes, Never
ALWAYS, Usually, Sometimes, Never
Yes No (screening question)
ALWAYS, Usually, Sometimes, Never
ALWAYS, Usually, Sometimes, Never
Yes, No (screening question)
ALWAYS, Usually, Sometimes, Never
ALWAYS, Usually, Sometimes, Never
Yes, No (screening question)
ALWAYS, Usually, Sometimes, Never
Staff clearly described side effects
Did you go home, someone else’s home, or to another facility? 2
Staff discussed help need after discharge
Written symptom/health info provided ALWAYS, Usually, Sometimes, Never
Own home, Someone else’s home, Another facility (screening question)
YES, No
YES, No
Area around room kept quiet at night ALWAYS, Usually, Sometimes, Never
Room and bathroom kept clean
NA
Willingness to Recommend
ALWAYS, Usually, Sometimes, Never
DEFINITELY YES, Probably Yes, Probably No, Definitely No
NA
Hospital Rating Question 0 to 10 point scale (percent 9 and 10 reported)
Always
Never
Sometimes
Usually
Always
Research
Patients’ rating of quality is more predicted by their rating of the quality of communication than technical care. * Annals of Internal Medicine
75% of patients admitted to the hospital were unable to name a single doctor assigned to their care. *Archives of Internal Medicine
91% of patients want to be addressed by name and 78% of patients wanted their physician to shake hands YET physicians use the patients’ name less than 50% of the time. * Annals of Internal Medicine * Mayo Clinic Proceedings
Nursing Communication:
The Most Bang for Your Buck
The Nursing Communication Composite is the one most highly correlated with overall hospital rating.
1. During this hospital stay, how often did nurses
treat you with courtesy and respect?
2. During this hospital stay, how often did nurses
listen carefully to you?
3. During this hospital stay, how often did nurses
explain things in a way you could understand?
Key Tactics: What You Must Know to
Improve Your HCAHPS Results
Rounding for Outcomes
On staff and providers
On patients
Hourly Rounding
Rounding in Reception Area
Post Visit Phone Calls
AIDETSM
Chapter Two: HCAHPS Handbook; The Fundamentals: What You Must Know to Improve Your HCAHPS Scores; pgs 23‐44
Leader Rounding
on Providers and
Staff
What All Types of Rounding Have in
Common
Proactively engaging, listening to,
communicating with and supporting our most
important customers (family, staff, doctors,
patients, partners, and other departments)
The exact opposite of an open door policy
Engagement: The 12 Items That Matter
Q12.
Q11.
Q10.
Q09.
Q08.
Q07.
Q06.
Q05.
Q04.
Q03.
Q02.
Q01.
This last year, I have had opportunities at work to learn and grow.
In the last six months, someone at work has talked to me about
my progress.
I have a best friend at work.
My associates or fellow employees are committed to doing quality work.
The mission or purpose of my company makes me feel my job
is important.
At work, my opinions seem to count.
There is someone at work who encourages my development.
My supervisor, or someone at work cares about me as a person.
In the last seven days, I have received recognition for doing
good work.
At work, I have the opportunity to do what I do best every day.
I have the materials and equipment I need to do my work right.
I know what is expected of me at work.
Total Number of Hours Absent by
Engagement Levels
Work force with higher levels of engagement were absent for
fewer hours than less engagement employees
Percentage of Hand Hygiene Incidents by
Workgroup Engagement Levels
Departments with higher levels of engagement also have a
higher % of acceptable hand-hygiene incidents than lesser
engaged departments
Annual Department Patient Satisfaction
Percentile Ranks by Engagement Levels
Departments with higher engagement levels also had higher
annual Patient Satisfaction Percentile Ranks
Rounding for Outcomes – Staff and
Providers
Concern and Care
Align Questions
to Fit Desired
Outcomes of the
Organization
What is Working Well
People to Recognize
Systems to Improve
(hit those Q12!)
Tools and Equipment
Follow-up
Be Prepared
Round on high performers first!
Have data with you, data speaks louder than
opinions
Know how you will answer tough questions
Assure that rounding stays positive!
Use a log for validation to be sure you do not forget
important things, note trends, and validate
rounding was done
Validation:
Staff / MD Rounding Log
What is working well?
Staff / doctors to recognize?
Any systems need improvement?
Do you have the tools and equipment to do the job?
Anything else I can do for you right now?
Rounding for Outcomes
www.studergroup.com
Stop Light Report
Impact of Rounding on Willingness to Recommend as a Place to Work
Oregon Integrated Health System; 8700
employees
Better
Leaders Rounding on Staff
and Physicians
* Results are one year following implementation of Leader Rounding on Staff
and Physicians; Staff and physicians rounded on at least monthly had the
highest satisfaction levels.
Leader Rounding
on Patients
Leader Rounding on Patients
Best way to validate behaviors for an “Always”
culture.
Are we do doing it effectively?
Are we doing it consistently?
Are we focused on the right outcomes?
Are the tactics truly hardwired?
Nurse and Physician Leader Rounding is the single best
way to connect with patients to reinforce care, verify
nursing behaviors, and recognize staff members.
Rounding with Patients and Families
Set expectations/validate Behavior
Identify patient and family needs
Align Questions
to Fit Desired
Outcomes of
the
Organization
Document needs
Give instructions on what to do if
they do not get the care they expect
Explain any post visit calls or
surveys
Recognize and Coach Staff
Leader Rounding on Patients (Clinical)
Four Goals of Leader
Rounding on Patients:
1. Manage the patient's
expectations
2. Service Recovery
3. Harvest Recognition/Manage/Up
4. Gather information for
coaching/Manage Staff
Performance
Leader Rounding on Patients (Clinical)
Two key questions:
1. What have I learned?
2. What must I do with that
information?
Question: What do we do with the
information we get from patient rounding?
Nothing
Fix it for them
Yell and scream
Coach and mentor
Service recovery and reassurance
How to Ensure Consistent Behaviors
Rounding : the continuous feedback loop
Round on Patient and Family
Patient
and Family
Round on Staff
www.studergroup.com
EMCA-551
Leader Rounding on Patients
“Did a Nurse Manager Visit You During Your Stay?”
n= 561
n= 604
n= 601
n= 608
Tactic and Tool Implemented:
• Leader Rounding on Patient
n= 106
n= 104
n= 105
n= 96
Source: Arizona Hospital, Total beds = 355, Employees = 4,000, Admissions = 10,188; updated 2Q2010
Leader Rounding on Patients – ED
Round vs. No Round
100
98.6
97.7
90
96.8
88.5
84
96.2
93.2
95.7
80
% Excellent Rank
70
60.2
60
48.3
50
Yes
36.9
40
No
30
20
10
11.8
9.2
8.6
1.3
6.7
0
4Q08
1Q09
2Q09
3Q09
4Q09
Source: Southwest Washington Medical Center; ED visits = 81,799 1Q10
3Q10 4Q10TD
Leader Rounding on Patients
HOW MANY OF YOU HAVE EVER LEFT A
DISTRACTED SPOUSE TO BABYSIT?
Did you round on him??
Did you round on his “patients”???
Leader Rounding on Patients
Leader Rounding on Patients
Reception Area Rounding
Best Practice- Hourly- Keep a log
Owned by triage nurse but others can assist
Goal is to keep patients informed
Use “Close the Gap” behaviors
Keep it simple!
Reception Area Rounding
Decreased Patients Leaving without Medical Advice
5
Tactic and Tool Implemented:
% of patients leaving
without medical advice
3.9
Leader Rounding on Patients
Hourly Rounding (reception and treatment
areas) with IPC
4
3
1.9
2
Implemented
April 2007
0.9
0.9
1
0
FY 06
FY07
FY08
FY 09 (YTD)
Source: Miami Hospital, Total beds = 584, Employees > 1,500 employees, Admissions = 32,522
Reception Area Rounding
Reduced Left Without Being Seen
•
•
•
•
10
% LWOBS
9
7.5
8
7
ROI: $2,206,336 reduction (2008 – 2009)
Annual Adult visits = 64,000
Average net revenue = $1567
LWOBS reduced from 5.2% to 3.0%
7
5.2
6
5
3.06
4
3
Tactic and Tool Implemented:
2
Leader Rounding on Patients
1
Hourly Rounding (reception and
treatment areas) with IPC
0
FY 06
FY07
FY08
FY09 YTD
Source: Miami Hospital, Total beds = 584, Employees > 1,500 employees, Admissions = 32,522
Emergency Department Satisfaction
Emergency Department Satisfaction
84
70
Percentile
60
50
Tactic and Tool Implemented:
40
Hourly Rounding (reception and
treatment areas) with IPC
Leader Rounding on Patients
40
30
20
8
11
10
0
FY06
FY07
FY08
FY09 YTD
Source: Miami Hospital, Total beds = 584, Employees > 1,500 employees, Admissions = 32,522
AIDET
Advantages of AIDET
SM
Decrease anxiety with increased compliance
Decreased
Anxiety
+
Increased
Compliance
=
Improved clinical
outcomes and
increased patient
and physician
satisfaction
AIDET – Emergency Department Outcome
Source: Hazel Hawkins Emergency Department; discharge date
Impact on Safety and Quality
Better
Change in Percentile Ranks
Ease of obtaining test results (60.0%)
CP instructions for follow‐up care (80.0%)
CP information about medications (73.5%)
CP efforts to include in decisions (73.3%)
CP concern for prob/condition (84.2%)
Access to care (46.5%)
Overall Patient Satisfaction (53.0%)
Post AIDET
Pre AIDET
0
10
20
30 40 50 60
Percentile Rank
70
80
90 100
Source: Oklahoma University; OUP Hematology/Oncology Clinic & Infusion Center; 10 providers & 22 staff, take care of 15,000 clinic
visits & 10,000 chemotherapy infusions per year
Post AIDET Results- Major Hospital- EmCare
Qualitick Patient Satisfaction Results- Jan 2011
Were you kept informed of your wait time?
Yes: 76%, No: 7%, Did not wait: 17%
Would you recommend the ED to provide care to your family or friends?
Yes: 97% No: 3%
“AIDET allowed us to improve the interpersonal relationships between
doctors and nurses and all other staff members, as well as our patients.
It has brought a much higher level of camraderie and helps the entire
organization work toward a common purpose. We now move as one”.
Chris Loman, ED Medical Director
Major Hospital, Shelbyville, IN
Post AIDET/Hourly Rounding Results- Logansport
Memorial- EmCare
Qualitick Patient Satisfaction Results- 2010
Kept informed of your wait time?
Yes: 85%, No: 5%, Did not wait: 10%
Would you recommend the ED to provide care to your family or friends?
Yes: 96% No: 4%
Explanations and Instructions given?
Very Satisfied: 68%, Satisfied: 26%
“You can provide outstanding care, but if they didn’t feel communicated
with, it didn’t matter”.
Jeanette Huntoon, Chief Executive Nurse
Studer Group Five Fundamentals
AIDETSM
Focus on the “A & I” to show courtesy and respect by all physicians, nurses and staff.
Focus on the “E” to explain medications and diagnosis.
A
Acknowledge
I
Introduce
D
Duration
E
Explanation
T
Thank You
Communication and Malpractice Claims
Risk of most malpractice suits is predicted by practitioners’
inability to communicate well with their patients
Specific physician behaviors that significantly increased the
likelihood of malpractice suits include:
Lack of respect
Not listening to the patient
Not providing adequate feedback
Hickson, GB, et al. NC Med.J 2007: 68:362-364
Levinson W, et al. JAMA 1997; 277: 553 – 559
Acknowledge
A
Acknowledge
Key message: You are important
Eye Contact
Acknowledge everyone with patient
Smile, look like you love what you are
doing
The importance of the Greeting
78.1% of patients wanted their physicians to shake
hands
91.3% of patients wanted to be addressed by their
name
Makoul G, Zick A, Green M,
Annuals of Internal Medicine 2007;167: 1172 – 1178
Introduce
I
Introduce
First Generation
Name
Title
Patients name
Next Generation
Your role in the team of
care givers
Your years of experience,
credentials
Other information to
MANAGE UP
Manage Up!
Duration
D
Duration
Key Message: I anticipate your
concerns
How long will the visit take?
How long will the test, procedure, wait
actually be?
How long will it take to get the results?
How long to see the doctor?
Explanation
E
Explanation
Listen to the patient’s story
Active Listening
Clarifying questions
Empathy
Explain the treatment plan
Using language that patients can understand
Use key words
“Do you need more explanation”?
Thank You
T
Thank You
Key Message: I appreciate the opportunity to
care for you
Closing key words
Thank you for choosing Fairview Park.
Thank you for waiting.
Thank you for trusting us to care for you.
What other questions do you have?
Validation of AIDET
Key Words for Push Back
“What about this is not right for our patients?”
“It’s a new day”
“I hear you …..”
It always seems impossible until it is done.” Nelson Mandela
Never Underestimate
the Difference You Can
Make
~ Quint Studer ~
Thank You !
[email protected]
Stephanie Baker, RN,MBA, CEN
[email protected]
619-977-2579
www.studergroup.com