webinar creating diplomats for hope seriesmakarem s, smith m, mudambi s, hunt j. why people do not...
TRANSCRIPT
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THE
HopeEffect
Creating Diplomats For HopeWebinar
Series
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Creating Diplomats For HopeWebinar
Series
HOUSEKEEPING
AUDIO is available through your computer speakers or through dial-in. All lines are muted.
You can SUBMIT QUESTIONS/COMMENTS at any time. We will address all questions during the Q&A session at the end of today’s presentation.
Links to the slides and RECORDING will be made available and sent to all attendees via e-mail.
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Creating Diplomats For HopeWebinar
Series
ABOUT US
WE WORK WITH NATIONALLY-RECOGNIZED INSTITUTIONS:5 “Honor Roll” institutions5 out of the top 10 cancer programs3 out of the top 4 pediatric hospitals3 out of the top 10 cardiovascular programs
NATIONAL BENCHMARKING STUDIES:Patient experience managementMarketing practicesPhysician relations programsInternational programs
Ranked as one of top 50 Healthcare Consulting firms by Modern Healthcare
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REPRESENTATIVE CLIENTS:Barnes-Jewish HospitalCleveland ClinicCincinnati Children’s HospitalDuke MedicineFroedtert HealthMayo ClinicMD Anderson Cancer CenterMemorial Sloan Kettering
Menninger ClinicTexas Children’s HospitalThe Ohio State University Medical Center University of Chicago MedicineUniversity of Colorado HealthUniversity of HoustonUniversity of Michigan Health System
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Creating Diplomats For HopeWebinar
Series
CAROL B. PACKARD
Senior Advisor & Strategist, Healthcare Performance Improvement
Carol Packard has a Ph.D. in organizational development, a master’s degree is in organizational psychology, and 20 years experience working in health care. Carol also has designed and implemented enterprise-wide Service Excellence programs, using patient satisfaction data to drive process improvements.
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Creating Diplomats For HopeWebinar
Series
JILL F. SECORD
Senior Advisor & Strategist, Healthcare Performance Improvement
Jill has 38 years of experience as a Registered Nurse with a Master's degree in business and expert skills in leadership, operations, managed care, and nursing education. She has clinical experience in critical care, orthopedics, home care, home infusion, managed care, contracting, provider relations, data analysis, new business development and strategic planning.
She is certified in Lean Quality Healthcare and has developed a system to integrate Lean techniques with Patient Experience Mapping and Family Focused Care initiatives. Jill has worked with a variety of healthcare organizations to create departments, streamline current processes, and develop new profitable programs.
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Patient as Prisoner ?
Clothes taken AWAYASSIGNED a numberTurn OVER valuablesAllowed to see family on a LIMITED basisAssigned a STRANGER as a roommateDIFFERENT people in the room everydayInstitutional RULES and SCHEDULESSTERILE environmentGive up CONTROL
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Does Any Of This Look Familiar?
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Patient-Centered Health Care
Not only improves required HCAHPS patient satisfaction
measures, but also
IMPROVES CLINICAL OUTCOMES
REDUCES COSTS
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The Psychology of Wait (January 20)
The Hope Effect (January 27)
Empathy & Lean (February 2)
Creating Diplomats For HopeWebinar
Series
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Today’s webinarTHE
HOPEEFFECT
THE ANTICIPATION OF GETTING & BEING WELL
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Before we Start -
I’d like you to think about a few questions - First, consider this situation:
The Benefits of the migraine drug Maxalt (rizatriptan) increased when patients were told they received an effective drug for acute migraines. What happened when they were told they were actually given a placebo instead?
A. Patients reported less reductions in pain when they knew the pill was a placebo.
B. When labels of Maxalt tablets & placebo pills were switched, patients reported similar reductions in pain.
C. Patients reported more pain generally when they did not know whether they received Maxalt or a placebo.
Keep this question in mind as we go along…….
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Before we Start - A Second Question
What percent of patients have cognitive impairment at time of discharge?
A - 10 - 25%B - 30 - 45 %C - 50 - 70%D - 75 - 85%
Keep these questions in mind as we go along…
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Evidence
When patients receive CARE and ATTENTIONfrom people- THEY believe can help ease their suffering and distress
ENDORPHINS ARERELEASED
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Evidence
When patients receive CARE and ATTENTIONfrom people- THEY believe can help ease their suffering and distress
ENDORPHINS ARERELEASED
STRESSISREDUCED
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Evidence
When patients receive CARE and ATTENTIONfrom people- THEY believe can help ease their suffering and distress
ENDORPHINS ARERELEASED
STRESSISREDUCED
SENSE OF PAINIS REDUCED
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Clinical Care + Positive Messaging
(Rami Burstein, and Ted Kaptchuk, ci Transl Med 8 January 2014: Vol. 6, Issue 218, p. 218ra5 Sci. Transl. Med.
Patients with severe migraines given either drug or placebo
Study drug labels 9 (Attack 1-6)
Two Attacks Two Attacks Two Attacks
Actual pillPlacebo
Actual pillPlacebo
Actual pillPlacebo
Actual pillMaxalt
Actual pillMaxalt
Actual pillMaxalt
Negative InformationPLACEBO LABELLING
Neutral InformationUNSPECIFIED LABELING
Positive InformationMAXALT LABELING
PLACEBO(nonactive)
MAXALT or PLACEBO(active) (nonactive)
MAXALT(active)
Envelope#1 – Study drug - Take pill 30 min after migraine onset - This envelope contains:
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Clinical Care + Positive Messaging
(Rami Burstein, and Ted Kaptchuk, ci Transl Med 8 January 2014: Vol. 6, Issue 218, p. 218ra5 Sci. Transl. Med.
Patients with severe migraines given either drug or placebo
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Important Take-Away!
HOPE
BOOSTED THE EFFICACYOF BOTH
THE ACTIVE MIGRAINE MEDICATION AND
THE INERT PLACEBO
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Hope Increases Adherence to Medical Advice
FAITHINCAREGIVERS
MAKAREM S, SMITH M, MUDAMBI S, HUNT J. Why People Do Not Always Follow the Doctor's Orders: The Role of Hope and Perceived Control. Journal Of Consumer Affairs [serial online]. Fall2014 2014;48(3):457-485. Available from: Academic Search
Complete, Ipswich, MA. Accessed January 21, 2015
SELF-EFFICACY
HOPEADHERENCE TOTREATMENT
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Patient-Centered Care
THE INTERACTIONSBETWEENHEALTHCARE PROVIDERS&A PATIENTOFTEN HAS A BIGGER IMPACT THANTHE “AGENT”(I.E. MEDICATION, SURGERY)WE TYPICALLY FOCUS ON!
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Patients Feel more Hope
WHEN THEY SEE THEIR CAREGIVERS COLLABORATING
WHEN THEY ARE PART OF THE SOLUTION
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Involving Patients in Bedside Shift Reports:
In 29 studies on effects of BSRs:
• 13 (44.8%) indicated increased patient satisfaction• 5 (17.2%) noted patient asked more questions • 4 (13.8%) patient said they felt safer after seeing nurses
changing shift• 10 (34.5%) noted increased patient safety• 10 (34.5%) mentioned increased communication with nurses• 5 (17.2%) noted patients demonstrated an increased
understanding of their care
What Does the EVIDENCE Say?
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How many of you currently deliver
SHIFT REPORTS by the bedside?
Please answer using the textbox.
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Concerns?
YES!Delivering bedside reportsis a skill to be developedTRAINING AND PRACTICEConfidentiality issuesin semi-private rooms
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What do Nurses Think?
After implementing BSRs, • Average report time decreased from
45 to 29 min. • Nurse satisfaction increased 37% to 78% • White board adherence 25% to 98%.
Reasons for increased nurse satisfaction: • Receiving accurate handoff without distractions,
reducing time• Assessment of the patient & environment in real time
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Implementation
Identify a model specific for your organization & patient populationsto ensure CONSISTENCY
Set & track MEASURABLE indicators
Support the ADOPTION by clinical nurses (training, incentives)
Adjust models as APPROPRIATE to attain and sustain use
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A HEALING ENVIRONMENT ALSO ADDSTO THE HOPE EFFECT
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Bright Rooms
Walch (2005) retrospective study:
Patients in the bright rooms required
22% LESS analgesic medications 21% DECREASE in medication costs
Walch JM, Rabin BS, Day R, Williams JN, Choi K, Kang JD Psychosom Med. 2005 Jan-Feb; 67(1):156-63.
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Prospective environmental studies suggest
blood pressure typically declineswithin three minutes of viewing nature scenes
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2264925/
Nature Scenes
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Hopeful Patient-Centered Care Lowers Readmission Rates
In samples of1798 hospitals for acute myocardial infarction2562 hospitals for pneumonia
HIGHER hospital-level patient satisfactionscores (overall and for discharge planning)both associated with LOWER 30-day readmission rates
(Am J Manag Care. 2011;17(1):41-48)
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Meaningful Use Requirements
BUREAUCRATIC WASTE OF TIME OR HELPFUL?
30 - 50 % of patients have cognitive impairment at time of dischargeimpacting ability to COMPREHEND or REMEMBERdischarge instructions
(Boustani et al., 2010; Coleman et al., 2013; Lindquist et al., 2011).
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IMPROVEDCLINICALOUTCOMES
ClearDischargeInstruction
PersonalEfficacy
Hope
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Lots of evidence that the HOPE of improvement actually leads to improved outcomes!
And that leads to ENCHANTMENT!
The HOPE Effect
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What Do you Do to Enhance HOPE ?
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What Do you Do to Enhance HOPE ?
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What Do you Do to Enhance HOPE ?
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WHAT ARE THE HOPEFUL MOMENTS OF TRUTH FOR YOUR PATIENTS?
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Care Coordination Communication
EXPECTED BEHAVIORS:How interactions
occur and are managed
SYSTEMS: Processes and technology
to increase efficiency
POSITIONING: Communications,
conversations, and messaging
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What Stories will your Patients Tell?
PREVENT THE BAD ONESCAPTURE THE GOOD ONES
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What Can you to Today?
Add pictures of NATURE SCENES and PLANTS in patient roomsand in waiting rooms
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Review & Redesign - Discharge Instructions
SOURCE: As presented by Paasche-Orlow, 2014
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Begin discussions on implementing a BEDSIDE REPORT PROTOCOL
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Back To the Questions
Benefits of the migraine drug Maxalt (rizatriptan) increased when patients were told they received an effective drug for acute migraines. What happened when they were told they were actually given a placebo instead?
A. Patients reported less reductions in pain when they knew the pill was a placebo.
B. When labels of Maxalt tablets & placebo pills were switched, patients reported similar reductions in pain.
C. Patients reported more pain generally when they did not know whether they received Maxalt or a placebo.
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Back To the Questions
Benefits of the migraine drug Maxalt (rizatriptan) increased when patients were told they received an effective drug for acute migraines. What happened when they were told they were actually given a placebo instead?
A. Patients reported less reductions in pain when they knew the pill was a placebo.
B. When labels of Maxalt tablets & placebo pills were switched, patients reported similar reductions in pain.
C. Patients reported more pain generally when they did not know whether they received Maxalt or a placebo.
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Back To the Questions
What percent of patients have cognitive impairment at time of discharge? (Among general population)
A - 10 - 25%B - 30 - 45 %C - 50 - 70%D - 75 - 85%
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Back To the Questions
What percent of patients have cognitive impairment at time of discharge? (Among general population)
A - 10 - 25%
B - 30 - 45 % (general population)C - 50 - 70% (elderly population)D - 75 - 85%
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QUESTIONS ?
COMMENTS ?
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• Have a representative contact you?• Have a representative come to speak at your
organization?• Want more information?
Would You Like To:
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2700 Post Oak Blvd., Suite 1400Houston, TX 77056+1 713.877.8130www.endeavormgmt.com/healthcare
Contact Us
Carol [email protected]
Jill [email protected]
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Thank you for participating!
Please join us next week on Tuesday, February 3 at 12:30 CT, 1:30 EST