Making Healthcare Human Again to Improve Patient Experience
Do you understand why you're here?
What are your greatest fears about being here?
What can we do to make you feel more comfortable?
|Dr. Steve Pu
These are the questions nurses at Twin Rivers Regional Medical Center in Kennett, Mo., ask patients upon admission. The physicians and staff at Twin Rivers wanted to create a different experience for patients than the typical experience of having vitals checked and answering questions about allergies and insurance upon admission. To create a more personal and empathetic interaction with patients, leaders at the hospital developed an initiative called Sacred Moments — a period in which nurses ask patients meaningful questions about their personal concerns and comfort.
"We're trying to reconnect people," says Steve Pu, DO, medical director at Twin Rivers. "We're making healthcare a human experience where people care about each other."The epiphany that led to Sacred Moments
The Sacred Moments initiative grew out of focus groups of medical staff members, other hospital employees and patients' families who brainstormed how to improve patient experience. The chief of staff of the obstetrics/gynecology department identified a need to ask patients things that truly matter to them. An orthopedic surgeon took that idea and developed a set of questions nurses can ask patients to form a personal relationship before beginning clinical care, according to Dr. Pu.
When nurses first bring patients to their room, they ask them about their fears, concerns, comfort and support system, and provide information about the care team and the process of care. After roughly 20 minutes of this "sacred moment," another provider visits the patient to ask purely clinical questions. The personal information coupled with clinical information create a holistic image of the patient that can help inform the patient's individual care, says Dr. Pu.
Transforming hospital culture
Although Sacred Moments is a simple and low-cost intervention, it has sparked a cultural transformation in the hospital, according to Dr. Pu. Since launching the program in January 2012, the hospital has increased its Hospital Consumer Assessment of Healthcare Providers and Systems top box scores by 25 percent. "It doesn't initially cost any money, it doesn't add any time; it simply reminds us to pause and emphasizes being empathetic with patients," says Steve Jackson, vice president of ExperiaHealth, which worked with Twin Rivers to improve patient experience.
Nurses' satisfaction has also increased through the Sacred Moments program. "Our nursing staff is asked to do more and more — more documentation and reports; it depersonalizes and dehumanizes the patient experience," Dr. Pu says. "[Sacred Moments] gives them the opportunity to reconnect on a personal basis with their patients and ultimately, it makes them remember why they got in healthcare in the first place: to care for people." Providing nurses the opportunity to connect with patients on a human level changes their attitudes about the workplace, which in turn creates a more nurturing environment for both patients and employees. "It creates a transformation of culture, where people feel engaged, supported and that their work has meaning," Mr. Jackson says.
In addition to increased patient and nurse satisfaction, the cultural transformation triggered by Sacred Moments is evidenced in physician engagement and leadership in improvement initiatives, according to Dr. Pu. For example, Twin Rivers hosted a town hall meeting before launching Sacred Moments to learn physicians' and front-line workers' top concerns and frustrations. Afterward, a group of physicians worked together to address these issues, which included leadership and accountability, among others. Furthermore, some members of one of the focus groups created their own group, which they named the "No Excuse Team." The team meets weekly to identify and take opportunities for quality improvement.
"I've been here since 1984. I've never seen this sort of cultural transformation at [the] hospital," Dr. Pu says.Continuing down the road of improvement
While Twin Rivers has already seen improvements in HCAHPS scores and nurse satisfaction and the beginnings of a cultural transformation, it is only at the start of its path to improved quality and patient experience. To continue improving, Twin Rivers will maintain its Sacred Moments program and implement other initiatives to boost patient experience and nurture a patient-centered culture. For example, hospital leaders are focusing on recognizing employees for superior performance, such as when a physician or nurse receives a thank you note from a patient.
"We understand that the long journey has only begun," Dr. Pu remarks. "We're very optimistic about moving forward."
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