and Department of Education and Training Patient and Staff Experience Training San Francisco Department of Public Health

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1 and Department of Education and Training Service Excellence Patient and Staff Experience Training San Francisco Department of Public Health Service Excellence is a copyright of Enspiron and SFDPH

2 CULTURAL UNDERSTANDING RESOURCES CLAS/ Cultural Linguistic Competency Policy The San Francisco Department of Public Health is committed to developing and maintaining health services that are culturally competent, consumer-guided and community-based. Cultural competence is an essential requirement for health care providers to provide effective services to our diverse populations through CLAS Standards and following the policy. The LEARN Model A report explaining methods used in eliminating disparities in the health status of people of diverse racial, ethnic, & cultural backgrounds. Think Cultural Health This Office of Minority Health website is dedicated to advancing health equity at every point of contact. With growing concerns about health inequities and the need for health care systems to reach increasingly diverse patient populations, cultural competence has become more and more a matter of national concern. HHS Action Plan to Reduce Racial and Ethnic Health Disparities The Health and Human Services (HHS) Action Plan to Reduce Racial and Ethnic Health Disparities outlines goals and actions HHS will take to reduce health disparities among racial and ethnic minorities. A Gardener's Tale This website has both the article and video of Dr. Camara Jones, MPH, PhD, the author, discussing this now-classic tale. Health Matters in San Francisco The Health Matters in San Francisco website was developed by the Building a Healthier San Francisco coalition (BHSF) and the Healthy Communities Institute. Culture Vision CultureVision is the first comprehensive, user-friendly database that gives healthcare professionals access to culturally competent patient care. For more information, resources, tools and handouts, contact the Department of Education and Training

3 MOST COMMON COMPLAINTS Mark if the complaint is for patients, staff or both. They don t listen to them I m not sure what I should be doing? They don t feel appreciated Lack of empathy You have no choice; no one else will see you. Ignore input We don t seem interested in them I don t know where to go? No time to ask questions Pushy and demanding The construction is so loud! Lack of sympathy and understanding It takes too long to get an appointment! Complaint Patient Staff Both Discourteous and disrespectful Arguing with or in the presence of someone who is arguing What does this appointment slip mean? Failure to admit when wrong I need an interpreter. Criticizing system or other employees Not dependable or does not follow through I wish these elevators would work! Feel embarrassed Inconsistent service or quality of care delivered I feel like a third class citizen Insensitive to the needs of someone Why will no one help me? Expecting someone to be fair or logical Becoming angry or frustrated I feel like I m wasting time! I feel rushed when we meet. For more information, resources, tools and handouts, contact the Department of Education and Training

4 SERVICIDE Servicide Definition: The service we provide which offends and frustrates our patients, guests, and coworkers. Examples include: Apathy: An I don t care attitude Blame: Blaming others, making excuses Coldness: Being callous and indifferent Disrespect: Failure to respect others Demanding: Forcing people to comply Ignoring: Treating people as insignificant Plastic: Being fake or disingenuous Rule Book: Rules that supersede needs For more information, resources, tools and handouts, contact the Department of Education and Training

5 SEVEN STANDARDS Standard One Make Positive First Impressions Purpose: To create a positive, friendly atmosphere within SFDPH. Standard Two Treat Others as Guests Purpose: To make others feel respected and important. Standard Three Develop Service Recovery Purpose: Turn negative situations into positive experiences. Standard Four Communicate Effectively Purpose: To simplify communication with others. Standard Five Create a Team Spirit Purpose: To focus on serving others as a team. Standard Six Project a Positive Attitude Purpose: To create a positive, productive environment. Standard Seven Be Passionate About Excellence Purpose: To challenge each person to strive for excellence. For more information, resources, tools and handouts, contact the Department of Education and Training

6 STANDARD ONE Make Positive First Impressions Ten Foot Rule Definition: Apply the Ten Foot Rule any time you come within ten feet of a patient, guest, visitor, vendor, student, volunteer or coworker; Initiate the Interaction. First encounters typically set the tone for a guests visit, positive or negative. Welcome each guest. Use small talk and compliment. Ask, May I help you? Escort them to their destination. Create positive first impressions. Tips Three Simple Ways to Counteract Ignoring Others Smile Give good eye contact (when appropriate) Speak to them For more information, resources, tools and handouts, contact the Department of Education and Training

7 STANDARD ONE Make Positive First Impressions F.A.C.E Definition: One way to connect with patients and staff is with using F.A.C.E. You are the F.A.C.E of SFDPH. F-Friendly: it creates a positive tone and gives you personality. A-Attitude: the operative word is to be positive. C-Connect with everyone you meet; let each person know they are important. E-be Excellent: never settle for good or getting by always give your best. Tips Personalize Your Service Use their surname. Mr./Ms. last name until you have permission to use otherwise. Use your first name. First names help to break down barriers between us. Involve the family. Remember, the family is a direct extension of the patient. Anticipate their needs. Be proactive; help them resolve issues in advance. Go the extra mile. Doing the little extras lets them know you genuinely care. For more information, resources, tools and handouts, contact the Department of Education and Training

8 STANDARD ONE Make Positive First Impressions Greetings Phone Greetings Your phone is one way to create a positive or negative first impression of SFDPH. Always add personality and energy to your voice and follow these steps. Step One: Give a positive greeting; Good Morning Afternoon Evening. Step Two: Identify your clinic, hospital or department. Step Three: Introduce yourself using your first name or title (Dylan or Dr. Green). Step Four: Ask how may I help you or assist you today? Tips Remember to: 1. Put a smile in your voice. 2. Speak slowly and clearly. 3. Answer by the third ring. 4. Ask for permission before placing the caller on hold or transferring the call. 5. Check voic regularly. 6. Return calls promptly. In Person Greetings Step One: Introduce yourself using your first name or title. Step Two: Share your title/role. Step Three: Identify your department, clinic, or hospital. Step Four: Share you experience (length of time) with SFDPH or time in field. Step Five: Thank you for choosing SFGH, COPC, or LHH. For more information, resources, tools and handouts, contact the Department of Education and Training

9 STANDARD TWO Treat Others as Guests I C.A.R.E Definition: Apply to everything you do. We are the hosts of SFDPH and it is our job to make others feel at home. I: be Involved. Keep guests informed and included. o Communicate clearly with patients, family members and coworkers; Explain what is being done and what they can expect; Ensure that patients and family are included in the decisions. C: be Courteous. Add personality and be friendly. o Positive Impressions begin with a friendly smile and eye contact; Courtesy = Respect: the words we use, our attitudes and actions; Be Professional, stop the blame and excuses that stifle growth. A: be Attentive. Listen, stay focused, be interested. o Give your undivided attention, never brush people off; Strive to be caring, kind and compassionate with everyone; Acknowledge patient requests and answer call lights quickly. R: be Responsible. Take pride in all you do. o When there is a problem, you be accountable to resolve it; Have integrity and always do what you say you will do; Offer options and solutions to resolve every complaint. E: be Excellent. Go above and beyond what is expected. o Ask to determine expectations and to anticipate their needs; Be proactive, solve problems, take people to their destination; Be exceptional and go the extra mile, little things differentiate us. For more information, resources, tools and handouts, contact the Department of Education and Training

10 STANDARD THREE Develop Service Recovery Service Recovery Definition: Having a system in place to turn negative situations into positive experiences. Step 1, listen: Allow upset people to vent their frustration. Step 2, empathize: Let them know you understand the situation. Step 3, apologize: By saying, I m sorry does not admit guilt. Step 4, resolve: Your job is to fix the problem ASAP. Step 5, normalize: Your objective is to get back to neutral. Ten Minute Rule Definition: You own the problem for the first ten minutes. One: For the first ten minutes, do everything you can to solve the problem. Two: After ten minutes, you can turn it over to a coworker or your boss. Three: Follow up because you still own the problem. Tips Remember to stay in control, keep a calm voice, you own the problem, and you must resolve it or ask for help. For more information, resources, tools and handouts, contact the Department of Education and Training

11 STANDARD FOUR Communicate Effectively Communication Definition: Communication includes words, actions, body language, attitude, and messaging. Communication is most effective when it is simple and clear. Goal: Patient centered communication has a powerful impact on not only to HCAHPS or CG CAHPS performance improvements, but also patient satisfaction in the inpatient, outpatient, and emergency environments. Within communication, there are common assumptions. If we set expectations with the patient, communication is automatically improved. Common Assumptions*: 1. Assume that the patient of family member understands what is being communicated. 2. Assume the patient agrees with what is shared. 3. Assume the patient cares about our message and understands its importance. 4. Assume the patient will take appropriate action on the information provided. These common assumptions negatively impact: 1. Our ability to effectively communicate with the patient and family; 2. The patient s compliance with the plan of care and discharge instructions; 3. The patient s safety, quality and total experience while under SFDPH IDS care. *Crossland and Clarke. (2008). The Leader s voice: How Your Communication Can Inspire Action and Get Results! New York: SelectBooks, Inc. Tips Use the K.I.S.S Principle: Keep It Short and Simple! For more information, resources, tools and handouts, contact the Department of Education and Training

12 STANDARD FOUR Communicate Effectively Communication Solutions Start thinking about ways in which you can set expectations improving the staff and patient experience by setting expectations to improve communication. Example #1 (Hospital) Question: During this hospital stay, how often was the area around your room quiet at night? Solution: Have physicians and nurses communicate with patients to the night shift s commitment to a quiet environment. Set expectations for the patients sharing the reality that there may be some minimal noises and interruptions. Inform the patients that they can contact their nurse to notify them of any disruptive noise. If the noise cannot be eliminated or reduced, be open with the patient and let them know why there is a temporary disturbance. In the morning, use patient rounding to validate staff communication with the patients about how quiet it was at night. This also allows hospital staff to understand the patients perceptions of actual quiet at night and give managers and physicians chances to reward staff and recognize opportunities to problem solve for improvement. For more information, resources, tools and handouts, contact the Department of Education and Training

13 STANDARD FOUR Communicate Effectively Communication Solutions Start thinking about ways in which you can set expectations improving the staff and patient experience by setting expectations to improve communication. Example #1 (Clinic) Question: Clerks and Receptionists courteous and respectful? Solution: Have clerks and receptionist communicate with patients and the medical staff about wait time expectations. Set expectations for the patients sharing the reality of wait times, that the schedule is behind or you are short staffed today. Inform the patients that they can contact anyone at the front desk to ask any questions, when they will be seen or if they would like to reschedule. If the delay to be seen by the provider will be long, be open with the patient and let them know why there is a delay. When the patient is placed in the exam room, validate staff communication with the patients about how long it took to be seen. Use a team approach with incorporating the MEA, RN, PA, NP, MD, etc. to ask how the patients wait was; apologize if needed. This also allows clinic staff to understand the patients perceptions of actual wait times and give managers and physicians chances to reward staff and recognize opportunities to problem solve for improvement. For more information, resources, tools and handouts, contact the Department of Education and Training

14 STANDARD FOUR Communicate Effectively Communication Solutions Try this three step approach to care to improve communication. This allows you to integrate setting expectations into your regular routine. Example #2 (Hospital) Question: Staff Responsiveness, Three Step Approach Solution: Example: Step One Admission: Upon admission, set expectations. Step Two Patient Rounding: Check in with patient about their expectations. Step Three Discharge: Ask the patient if the staff met the expectations. HCAHPS Question-After you pressed your call button, how often did you get help as soon as you wanted it? Step One Admission: Let me show you how to use our call button. Our staff wants to get to you as soon as you need help. Typically it takes 3-5 minutes for a nurse to get to your room after the button is pressed. Can you test out the call button for me? Thank you. Step Two Admission: Have you used the call button? Are we getting to you as soon as you need us? Remember it normally takes us 3-5 minutes to get to you. Step Three Discharge: Did our staff get you as soon as you needed us? We are happy we met your expectations! We apologize if you we did not get to you in time. Change Point: A nurse may think of a call as a task that interrupts their work. If we look at it from the view of the patient, it is a wonderful opportunity for nurses to improve the patient safety and experience. For more information, resources, tools and handouts, contact the Department of Education and Training

15 STANDARD FOUR Communicate Effectively Communication Solutions Try this three step approach to care to improve communication. This allows you to integrate setting expectations into your regular routine. Example #2 (Clinic) Question: Helpful, Courteous, and Respectful Office Staff, Three Step Approach Solution: Example: Step One Registration: Upon patient arrival to clinic, set expectations. Step Two Exam Room: Check in with patient about their wait expectations when placed in the exam room. Use your team (MEA, RN, MD, PA, etc.) to check in with the patient. Step Three Follow Up Appointment: Ask the patient if the staff met the wait expectations. CG CAHPS Question-Clerks and Receptionists courteous and respectful? Step One Registration: Welcome to our clinic. Please fill out the following forms. If you have any questions or need forms in a different language, please let me know. Once you complete the forms, please return them to this desk; anyone at the desk can assist you. Typically it takes about minutes to get you registered then someone from our team will call your name. Thank you. Your provider is behind schedule today so your wait will be XX, please let me know if we need to reschedule you. We appreciate your patience. You are important to us and the schedule does not affect the amount of time you have with your provider. Step Two Exam Room: Did you wait long? Was our clerk/receptionist helpful? Remember it normally takes us minutes to get to you. Thank you for your patience today, please know you are important to us what are your concerns today? Step Three Follow Up Appointment: Did our staff get you as soon as you needed us? How was your appointment today? We are happy we met your expectations! We apologize if you we did not get to you in time. The provider would like to schedule a follow up appointment with you in XX days/weeks/months, what time works best for you? This follow up appointment will be at San Francisco General Hospital, do you know where that is they will call to schedule the appointment/procedure with you. Anything else I can help you with today? Thank you for choosing our clinic for your care. Have a great day! Change Point: A clerk or receptionist may think of spending more time setting expectations with the patient as a priority task will interrupt their work. If we look at it from the view of the patient, it is a great opportunity for clerks and receptionist to improve the patient experience from the waiting room to the exam room. For more information, resources, tools and handouts, contact the Department of Education and Training

16 STANDARD FIVE Create a Team Spirit Teamwork: Keys to a Winning Team Definition: We are more effective when we serve others as a team. This is achieved through reducing territorialism between departments, hospitals and clinics and helping coworkers focus on supporting and building up the team. Plan and buy into the plan to win. Possess a winning attitude. Continually focus on improving. Help their teammates succeed. Tips Become a Service Excellence Champion. Attend a professional development workshop on teamwork. Ask if you can assist your coworker with a project or patient. Show your supervisor that you are a team player by using the Keys to a Winning Team. For more information, resources, tools and handouts, contact the Department of Education and Training

17 STANDARD SIX Project a Positive Attitude Tips Attitudes make the difference. Work at being a positive person in all that you do. In order to start your day off right remember to: Smile Be Positive Be Accepting Communicate Be Encouraging Self Care Contact Schwartz Center Rounds Blue Walcer, MPH Fair and Just Culture Jeff Critchfield, MD Critical Incident Response Team (CIRT) Troy Williams, RN, MSN Employee Assistance Program (EAP) or Wellness Center Community Wellness Center Department of Education and Training (DET) Currin Carlisle Learning Center For more information, resources, tools and handouts, contact the Department of Education and Training

18 STANDARD SIX Project a Positive Attitude Attitude The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than success, than what other people think or say or do. It is more important than appearance, giftedness or skill. It will make or break a company, an individual or a home. The remarkable thing is we have a choice everyday regarding the attitude we will embrace for that day. We cannot change our past...we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude... I am convinced that life is 10% what happens to me and 90% how I react to it. And so it is with you... -Charles Swindoll For more information, resources, tools and handouts, contact the Department of Education and Training

19 STANDARD SEVEN Be Passionate About Excellence What are Your Best Practices? Tips Ten Likeable Qualities 1. Being a genuinely nice, friendly and caring person. 2. Projecting a positive, optimistic, can do attitude. 3. Putting others and their interests before your own. 4. Being personable, having a cheerful disposition. 5. Being tactful and considerate of others feelings. 6. Being a good listener and effective communicator. 7. Being helpful, supportive and getting along with others. 8. Using common courtesies that demonstrate respect to others. 9. Being an encourager and one who builds others up. 10. Outgoing, good eye contact and having an infectious smile. For more information, resources, tools and handouts, contact the Department of Education and Training