Mini Session 2A Presenters: Amy Crowe, Kate …...Our patients and their loved ones • Want to be...
Transcript of Mini Session 2A Presenters: Amy Crowe, Kate …...Our patients and their loved ones • Want to be...
Mini Session 2A
Presenters:Amy Crowe, Kate Martin, Grace Jeremy
Making healthcare remarkable
Empathetic approaches to writing meaningful grievance lettersAmy Crowe, legal writer, patient services
Novant Health
About Novant Health
Empathetic approaches to writing meaningful grievance letters3
What we’ll cover today
Why our letters are important
The 4 foundations of a response
Putting it into practice
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Understanding the “why”
Why are our letters important for patients?
Our patients and their loved ones
• Want to be heard
• Seek answers
• Deserve a prompt and fair resolution
• Have a right to know about their care and receive it in a way they can understand
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Why are our letters important for our organizations?
• Can rebuild trust with our patients and families
• Shows we are honest and transparent about our care and services
• Conveys compassion and personalized care and services
• Can reduce potential litigation for our organization
• Meets compliance and regulatory guidelines
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The 4 foundations of a response
Empathy Apology
Health literacy
Customer service
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Empathy
What is empathy?
Empathetic approaches to writing meaningful grievance letters
Identifying or experiencing the thoughts, feelings or attitudes of another.
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What are our patients and their loved ones feeling?
Afraid
Anxious
Vulnerable
Helpless
Confused
Frustrated
Tired
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Relating to our patients and their loved ones
Ask yourself some questions:
– What would I be feeling in the same situation?
– Why is this so important to this person?
– Why is the person upset?
– How can I see what is at the heart of this person’s concern rather than just viewing it as a complaint?
– What were the patient’s expectations? How did those differ from what actually happened?
– What do I know about this person’s life story and his/her journey?
Use some acting skills
– If you’re having a hard time feeling empathetic, “act as if…”
– It can be difficult to relate in some situations, but get creative and dig deep.
Evaluate and eliminate inherent judgments or biases
– Ex. You are aware of the patient’s previous drug addiction. You assume they only want pain medication because of this.
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The results of empathy
Empathy creates compassion
Sees the person beyond their words
Identifying their feelings helps understand how to
meet their needs and respond
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Apology
Why apologize?
Reestablishes trust
Prevents litigation
It’s the right thing to do
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How to apologize appropriately
Always• Expectations• Experience• Communication• Behavior/attitude• Waiting
Sometimes• Gaps in clinical care• Disagreements with care plan• Adherence to policies and procedures
Never• Measures were taken for safety• When you’ve done the right thing
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Example
Patient: 1. I waited forever in
the ER. 2. Nobody gave me
anything for my pain.
3. An officer got involved for no reason.
Investigation:1. Patient did have a
long wait time because the ER was very busy that night.
2. Patient specifically requested IV Dilaudid, which was not medically indicated. He was offered Tylenol but refused.
3. He was very upset about this and became physically and verbally aggressive toward staff. Public safety was called to deescalate the situation.
Response:1. I apologize you waited
longer than expected in the ER.
2. In the ER, it is often not safe to give IV pain medication because it has increased risks. The safest way to take pain medications is by mouth. We’re sorry if this was not better explained at the time.
3. Keeping everyone safe at our facilities is important. We partner with public safety to make sure we’re providing a safe environment for all. We appreciate your cooperation in this effort.
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Tips for apologizing
• Don’t overly apologize. Keep it minimal to sound sincere.
• Balance the patient’s perspective with the organization’s reputation.
• Be apologetic without using “I’m sorry” or “I apologize”.
• Ex. We’re disheartened this was your experience and will use it as an opportunity to improve.
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Health literacy
What is health literacy?
Definition: Health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.
CMS requires our grievance letters to be written in a way that the patient or their representative understands.
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How to incorporate health literacy
Empathetic approaches to writing meaningful grievance letters
•Swelling vs. edema•Bruise vs. contusion
Use non-clinical language
•Doctor vs. physician•Short time vs. acute•Long time vs. chronic
Use lower-level vocabulary words
•Presented to the ER•Contraindicated•Received a workup
Avoid hospital lingo
•Our review was completed today, and we would like to share the results with you.
•Our review was completed today. We would like to share the results with you.
Use simple sentences
•Summarize instead of list in detail•Say it in as little words as possible•Generalize instead of restating verbatim
Reduce wordiness
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Reading level of your letter
Empathetic approaches to writing meaningful grievance letters
Goals for reading levels:
• Patient education materials – 3rd grade
• Grievance letters – 6th to 8th grade
• Realistically with grievance letters – below 10th grade
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Customer service
Two narratives
Questions we ask about our customer service
• Did we do the right thing?
• If not, how can we make it right for the patient/loved one?
• What is the appropriate response?
• How do we reestablish trust with this patient/loved one?
Questions patients/loved ones ask about their experience
• What happened while I was in the hospital?
• Why aren’t they trying to help me?
• How are they going to make this right with me?
• Why should I have to pay for care I disagree with?
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Balancing competing interests
• If there were opportunities for creating a better experience for the patient or their loved ones, what are your options?
• Service recovery
• Bill adjustment
• Compensation
• Meeting with the patient
• What is the patient/loved one asking for?• Identify the “ask” and address it.
• If denying a patient/loved ones’ “ask”, explain why.• Vaguely stating that a patient’s care was appropriate is not answering their
questions.
• Leaving the patient/loved ones without answers to their questions about their care does not reestablish trust.
• Our letters are a way to improve the customer relationship.
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Rebuilding trust and brand loyalty
Your letters can rebuild trust
Honesty & transparency
Giving dignity to the patient and their loved ones
Explain instead of blame
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Putting it into practice
Choosing language that matters
Acknowledge without having to understand
• “I can only imagine…”
• “I’m sure that was…”
• “I imagine this must have been…”
• “From what you’ve shared, it must have been…”
• *Only use words of emotion that the patient has provided. Don’t project emotion onto them.*
Add a personal touch
• If a patient has died, always start the letter with condolences.
• When referencing a loved one, use his or her first name if known.
• Congratulate mothers on the birth of their babies.
• The more personal we can make the letters, the more our patients feel we listened and see them as an individual.
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Choosing language that matters (cont.)
Sensitive language and word choice
Developing approved language for common responses
• Pain management
• Rude/dismissive behavior
• Wait times or delays
• Instructions and processes
Empathetic approaches to writing meaningful grievance letters
This… Instead of that…
“declined” “refused”
“Could not find support for…” or “no documentation to support”
“could not substantiate”
“patients with diabetes” “diabetic patients”
Explain (acknowledge) Don’t blame (accusing or perception)
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Gentle approaches and soft tone
Empathetic approaches to writing meaningful grievance letters
Redirecting emphasis
Use sentence structure (syntax) to soften your
approach
Patient says he didn’t receive a bath for 7
days. Documentation shows bath was refused when nurses attempted.
Instead of “You declined baths.” say
“Our offers for a bath were declined.”
Active voice
Use when the patient alleges we did not do
something that we should have.
Patient says her nurse didn’t respond to the call
bell for an hour when requesting more pain
medication.
Your nurse gave your pain medications as ordered.
The unit secretary responded to your call bell
and explained that your nurse would return when your next dose was due.
Passive voice
Use when the patient alleges we did
something that we shouldn’t have.
Patient claims we gave her the wrong
medication.
Your medication was changed by our doctor
based on your condition. The
medication you received was correct.
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There’s a person at the end of your letter
Keep in mind…
• We’re all human.
• You’re a person, and they’re a person.
• There is a story behind every concern.
• Feelings are real, and perception is reality.
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Q&A
References and addendum
References
"empathy". Dictionary.com Unabridged. Random House, Inc. 7 Mar. 2018. <Dictionary.com http://www.dictionary.com/browse/empathy>.
U.S. Department of Health and Human Services. 2000. Healthy People 2010. Washington, DC: U.S. Government Printing Office. Originally developed for Ratzan SC, Parker RM. 2000. Introduction. In National Library of Medicine Current Bibliographies in Medicine: Health Literacy. Selden CR, Zorn M, Ratzan SC, Parker RM, Editors. NLM Pub. No. CBM 2000-1. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services.
Susan Keane Baker and Leslie Bank. “I’m Sorry to Hear That…”: Real-Life Responses to Patients’ 101 Most Common Complaints About Healthcare.
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Steps for determine reading level
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Steps for determine reading level
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Steps for determine reading level
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Steps for determine reading level
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