Journey to EXCEL-lence

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Journey to EXCEL-lence


EXCEL-lence

Distinction

Quality

SuperiorityBrilliance

GreatnessCaliberEminence


Key Words and Key Times / AIDET® How to coach for results Rounding for Outcomes

Journey to EXCEL-lence

COPYRIGHT © STUDER GROUPPlease do not quote or disseminate without Studer Group authorizationSlide 4

Key Words at Key Times – AIDET®


Links: Words + Behaviors @ Key Times

Ensures the patient / customer interpretation isn’t left up to chance

Positively impacts outcomes

Defined by:What does our patient / customer want to know?What do we need our patient / customer to know?How can we communicate that consistently,

always?

Key Words at Key Times


Hopefully Usually Probably Try Pretty Quick / A few minutes/ ASAP / As soon as

we can

Never Words


Five Objectives in Communication


Decrease anxiety with increased compliance

Advantages of AIDET®

=Decreased Anxiety

Increased Compliance+

Improved outcomes and

increased patient

physician and employee

satisfaction


A Acknowledge

In person, with your body: Smile! Make eye contact Acknowledge everyone in the

room Use open body language 10/5 Rule:

“Good morning Mr. Warner…”


First Generation

NameDepartment

“Hello Mr. Warner. My name is Jackie and I am Dr.

Smith’s medical assistant….”

“Hello Mr. Warner. I’m Jackie, and I am Dr. Smith’s

medical assistant. I have worked with Dr. Smith for 5

years and he is a very sought after internist! He is one of our best providers in

dealing with your condition…”

Next GenerationSelf, Skill Set, Experience and CertificationCo-workersOther DepartmentsPhysicians

I Introduce


SELF COWORKERSOTHER

DEPARTMENTS AND PROVIDERS

Reduces patient anxiety

Improves compliance

Improves clinical outcomes

Increases patient perception of care

Reduces complaints

Patient feels better about their next care giver

The patient feels more at ease with the handoff, thus their coordination of care

Coworker has a head start in winning confidence

Reduces Complaints

Reinforces coordination of care and teamwork

Positions other department well so they don’t have to win the patient over

Decreases patient anxiety and concern

Reduces complaints

Advantages of Managing Up


How long will the wait for ____be?

How long will the patient need to wait before they can return to work…?

When should patient/customer expect results or a returned phone call?

When should the patient schedule their next appointment?

D DurationRounding in Reception “It may be 15 minutes before we call you to

back to see Dr. Smith. I will update you if it is

later than that….”“ Your test results will

be posted on your personal patient

website in 3 days. Someone from my

office or I will also call you when we review the

results?”“ I would like to see you

back for a f/u in 6 months.”


Why are we doing this? What will happen and

what should you expect? What questions do you

have? USE

UNDERSTANDABLE LANGUAGE

E Explanation

“Let me explain some more about the MRI I

ordered….”

(Explain the why for ordering the test, what will happen and what

patient should expect, including

understanding of side effects, and answer

any questions.)


T Thank you

Show appreciation Provides a positive closing Thank patients for trusting us

with their care

“Thank you for choosing us

….Thank you for waiting … Thank you for coming in

today…What other questions do you

have?”


Engagement

Active listening Non-multi tasking Eye contact Tone and speed of voice Appropriate / therapeutic touch Appropriate use of humor / emotion Physical position Energy mirrors need


Every Interaction, emphasizing and repeating parts as necessary

Defines the five objectives to be met in context of your interaction with others.

Not Order-Specific Works in All Departments and Disciplines - Not

just a CLINICAL communication tool Patient Communication (White) Boards: Standards of Behavior

Tips for knowing when and how to use AIDET®:


Coaching for Improvement


Being a leader in healthcare today is

like continuously walking up a down

escalator. If one stands still

they go backwards.

Leadership in Healthcare


Clarity about the purpose and the goals Guidance with best practices along the way Assure consistency and standard practice Empower employees and promote accountability An effective coach will get employees to go

outside of their comfort zone- promote change and work with staff to embrace the change.

Why Do We Need to Coach?


Phases of Competency and Change


Consistency Reliability

Accountability

Execution Triangle


It’s not about pulling the weeds…

Coaching

It’s about fertilizing theGarden…


Inspires employees to reach their highest potential Encouraging, Challenging, Modeling- leads by example Frequent and Consistent (knows what you are doing and

provides regular feedback) Knows their employees and the culture of their

department/organization Tells you why you are doing something and takes time to explain

how Allows you to learn from your mistakes Listens without being judgmental and sets aside personal biases Provides feedback – positive and negative, in a constructive

manner

Leader Must Haves when coaching employees


observe

reinforce

response

coachcommit

Validate

recognize

Building Competency Model

trust

Training


Observe Leader assesses the employee’s skill (after a practice

period) by witnessing it firsthand and documenting findings on a standardized competency assessment form.

Reinforce Real-time feedback is provided by the leader to the

employee immediately following the observation and starts with the most positive elements of performance. What gets recognized gets repeated.

observe reinforce


Response from employee What do you think you did well? Was there anything you felt you could have done better?

Coach Choose 1 or 2 opportunities for improvement Give clear examples of “what right looks like” Direct them to additional resources on the Studer website

(i.e. Learning Lab, webinars, etc.).

Commit Summarize WINS Ask employee to commit to improvements Set a time expectation for improvement

response

coach

commit


Validate Reassess the employee’s performance for

improvements in the agreed-upon development area at the agreed-upon deadline (data and observation)

Recognize Manage up progress Use specific examples of how they improved You may establish a certificate of achievement

program for those who achieve full competency

validate recognize


Teach to the test – this isn’t about “gotcha” Have a plan/tool/form to outline the process and behaviors being

evaluated Be prepared to provide feedback on every step of the process and

every behavior Summarize with what is the one thing to focus on for improvement Ensure your feedback is aligned with the performance of the

person being observed- A work vs. C work Improve your observation assessment skills with practice,

practice, practice Don’t be too general

How to give feedback


Resistance may occur- continue to reinforce the why and connect to the mission.

Built on the level of Trust in the Department–Trust is enhanced by employee rounding–Go back to the WHY

What about Resistance?


–Time–It will make staff feel uncomfortable–It will make the leader feel uncomfortable–It will make them think we don’t trust them–The leader thinks the staff already do the skill

well enough–Patients report in rounds the staff are “doing it” –

are we asking the right questions?

–Coaching behaviors is personal and subjective

Barriers to effective coaching in the workplace


Clearly communicate the why of observation and validation before you formally observe staff performance

Share the standardized competency assessment form you will use during the observation to help them prepare

Explain the benefit of building competency to the employee and your commitment to their development

Let staff observe you first Create a skills lab

Setting the stage for a safe environment


During employee rounding, talk with the staff about AIDET®- “when you used AIDET® this week, what was the impact on the patient? Or How did the patient respond when you used AIDET®?”

Patient Rounding, ”Are staff introducing themselves? Are they providing good explanations and answers to your questions?”

HCAHPS Results and patient comments Direct observations Post visit calls During your monthly meeting with your one up- give report on number validations

complete and what you are hearing and seeing as a result of AIDET® being used.

On-going AIDET® Validation

32

HCAHPS DOMAINS A I D E T

Nursing Communication

Doctor Communication Responsiveness of Staff Pain Management

Communication of Medications

Discharge Information Cleanliness and Quietness of Hospital Environment


AIDET Accountability and Validation Cycle

General Orientation

Dept Orientation

Individual Coaching

Validation

Accountability

Consistency

Regular teaching, coaching and validation is key to hardwiring AIDET


When you know you have a solution to a

problem that is causing pain for someone – you have a human

responsibility to act, and to do so with all

urgency.

~ Quint Studer

Human Responsibility

High Middle Low or EAL Conversations

Aligning Behavior with Outcomes

EAL Conversations

Where do EAL Conversations fit?

• Pillar Goals are established and department goals are outlined in LEM

• Behavior Standards are in place

• Rounding is hardwired to assure that everyone has tools and equipment to take care of patients

• Critical Conversations and Coffee Cup Conversations help leaders have conversations in real time regarding goals and behaviors

• EAL Conversations are structured coaching and performance conversations that are based on patterns of behavior

Why EAL Conversations

Positive Outcomes

Re-recruit/Retain excelling performers

Coach achieving performers

Manage lagging performers; up or out

Support RetentionBuild RelationshipsClarify Expectations

EAL Conversations - How

• Conducted annually• Training held for leaders• Cascades from the top• Tools and resources provides at the time

of roll out

Questions - Comments

Thank you!

• Tools and Resources– OU Medicine Excel Website– Excel Tools 2014 – OUMC Intranet– Studer Group Website

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