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Platinum rule trumps the golden one for best patient experience, Dr. Kristin Christophersen says

Nov 1, 2019

Kristin Christophersen, DNP, RN, chief nursing officer at Fountain Valley (Calif.) Regional Hospital and Medical Center, discusses the importance of connection, changing staff behaviors and paying attention to patient preferences.

Editor's Note: Responses have been lightly edited for clarity and length.

Question: What is the most important lesson you have learned about delivering excellent patient experience?

Dr. Kristin Christophersen: The most important lesson is to see the patient as a person, not a disease. Excellent patient experience is about not only providing excellent clinical care, but it is about connection. Connection to the patient, their loved ones and to something unique and special in their personal life. All of us long for a connection and a relationship that is meaningful. The relationship between a caregiver and a patient or family member has to go deeper than the disease process to make impact.

Q: What are some common missteps hospitals make in their patient experience initiatives?

KC: I think I've seen every theme and flavor of the 'magic fix' for patient experience in my almost 30 years in healthcare. Hospitals go from the extreme of contests and rewards to harsh discipline. I've seen entire organizations focus on only the patient, completely forgetting the broken processes and systems the employees must deal with every day. Understanding the 'here and now' of the workforce is key to allowing them time to build relationships and connect with patients.

Q: What has been the most successful patient experience initiative at your organization?

KC: The most successful initiatives have been the same initiatives and focus for the last three years. The reason I mention this is healthcare demands change quickly, and many of the initiatives that are implemented take time to see results. After all, isn't it the saying that culture change takes three to five years? A change in patient perception is no different.

About three years ago, Tenet Healthcare [Fountain Valley Regional Hospital and Medical Center's parent] rolled out an initiative around what we titled the 'must haves.' This consisted of re-education, role-playing and consistent observation around key behaviors: bedside handoff, white board completion, nurse leader rounding, leader rounding and unit safety huddles. While most of these were already in place, we spent significant time reinforcing the behaviors, encouraging dialogue and reinforcing the benefits of these actions for every clinician.

Over the last three years, we have gone from a HCAHPS hospital overall rating of 65.2 to year-to-date 69.7.

Q: What excites you most about the future of your role?

KC: We recently engaged one of our patient towers in a Lean Six Sigma project related to patient experience. Their focus is going to be on the process for engaging the patient or loved one in conversation related to preferences. The intent behind this project is to assist employees in engaging conversations about the patient as a person.

During one of our Kaizen [short duration improvement project] events, one of our nurses told a story of a patient who had a traumatic injury which left them unable/unwilling to speak. The patient was becoming dehydrated, so she offered many different options to encourage the patient to drink. The patient chose milk. She found throughout the day that milk was the beverage of choice. She wrote it in the preferences section on the white board for the next shift. The next nurse followed the preferences to which the patient responded. The next nurse stated how valuable this information was and how they were able to connect with the patient through a simple task of learning a preference and writing on the white board.

This team has defined the steps, cues, tools, amenities, scripting, documentation, training and the ultimate outcome of building a therapeutic, compassionate relationship with our patients one caregiver at a time. We've thrown away the golden rule and adopted the platinum rule — treat others how they want to be treated. The only way to do this successfully is to transform our interactions.


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