Paradigm shifts, scores jump in Lutheran’s Emergency Department
That’s a lot of movement. At the start of summer in Lutheran’s Emergency Department, physician and quality leaders launched a new framework for engaging with patients at the bedside with the goal of strengthening the connection between clinicians and patients.
It’s working. In the last quarter, Doctor Communication scores have increased 10 Top Box points, month over month. The Top Box score indicates how often patients select the most positive response category when asked about their hospital experience. The higher a hospital's Top Box score, the higher it ranks among other hospitals in the Press Ganey database.
The new initiative rolled out in Lutheran’s ER is referred to as the Five Care Behaviors and offers a structured approach to how clinicians enter a patient room, engage in conversation and exit the interaction in the most optimal, patient-centered manner.
“We recognized that coming out of the pandemic, we needed to reinvigorate the clinician-patient connection,” said Scott Miner, MD, medical director of Lutheran’s Emergency Department. “This program achieves that by elevating ‘connection’ as an essential component of the standard of care. As such, the act of establishing a connection with our patients is now structured, standardized, measurable and coachable, and comes with a training module.”
Five Care Behaviors
Upon entering a patient room, all emergency physicians and advanced practice providers:
Sit at the bedside.
Listen to the patient and family tell their story for 60 seconds before asking any questions or discussing the plan of care.
Seek opportunities to feel and share empathy. (see screen shot below)
Ask if the patient and family have any questions before rising out of the chair.
Express thanks at the end of the interaction. Miner says many clinicians choose to leave a business card.
Miner attributes the increase in patient experience scores in part to the successful launch of this program. All emergency clinicians have completed the module, and reminders and tipsheets are posted throughout the department.
Screen shot of one of the steps in the 5 Care Behaviors module
He also credits the initial strong results to the beginning of a shift in culture – a shared understanding that mindful engagement with patients, following a structured approach, is the expectation of all clinicians and that it will yield benefits to patient care and everyone’s experience.
“Our intention is to further develop and codify this program so what’s new and shifting right now becomes sustainable and continuous and, in time, anchors our communication and solidifies our connection with our patients,” said Miner.
According to Miner, Homi Kapadia, MD, Dave Leventhal, MD, Mandy Kao, MD, and Dave Rutherford, DO, have been essential and greatly appreciated for the development, rollout and success of the program.
Next steps include real-time observation, coaching and feedback to optimize every clinician-patient interaction. Miner and other physician leaders currently are in training to become coaches.
Physicians with questions about the program can reach out to Miner or Jean Corban, Lutheran’s director of Service Excellence.