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Reprinted from Spectrum, Society
for Healthcare Strategy and Market Development
View from the ICU: PR's Role
in Changing Bedside Behavior and Restoring Trust
Like most healthcare public relations professionals, when the recent high-profile
stories about medical errors broke, I spent my days responding to media inquiries
and trying to assure the public that it was safe to go to the hospital. In
the evenings, I'd visit my father in the ICU. He couldn't eat, breathe, talk
or walk without mechanical assistance since he entered the hospital to receive
a medical miracle. Instead, a medical error forced him to remain in hospitals
until his death ten months later.
The experiences of ten months and five hospitals
brought me face-to-face with the erosion of patient trust at
the bedside.
I experienced caregivers who lacked basic human
compassion, courtesy and respect for patient confidentiality.
I dealt with physicians who considered communications an obstacle
to medical treatment. I was denied access to the information
I needed to help my father make medical decisions.
On the surface, these problems are not in the purview
of the hospital public relations staff. However, they are communications
issues. I now believe healthcare communicators need to reexamine
their role in patient care and refuse to be relegated only to
traditional marketing and advertising activities.
Set the Standard of Caring
Communicators need to become passionate about encouraging
employees to treat patients with compassion. Fortunately, healthcare
naturally attracts caring people. But, even caring people become
distracted and busy. You can help remind staff through established
communication tools of how their actions and words are interpreted
by patients.
By becoming involved in training programs and educational
campaigns, you can help staff clearly understand that communicating
compassionately with patients is not a burden to care; it is
the definition of care.
- Study the tone of your
organization's publications. Are they clogged with business
terms that make employees think
they should act "cold" like a business? Strike words
like "customer," "profit," "growth," "efficiency" and "cost-effectiveness" from
your vocabulary and replace them with "patient," "compassion," "caring," and "concern." When
communicating financial and business decisions, put the story
in a "people-benefit" not "business-benefit" context
and frame every message you deliver in terms of how it affects
patients.
- Make heroes of staff members known for providing
compassionate care. Find ways to help recognize employees for
ordinary acts of kindness such as holding an anxious patient's
hand, taking a bed-bound patient on a rolling tour of the hospital
or walking an elderly woman to her car at night. These acts
help employees connect with patients by encouraging sensitivity
and a compassionate response to human suffering.
- Tell medical miracle stories by focusing on
the people involved, not the equipment or procedure. How did
the nurse feel about being part of the experience? How will
it change the patient's life? What does it mean to the family
members?
- Share letters from patients―not
just on a bulletin board in the nursing unit. Request permission
from
the patients to reprint them in your newsletters or place the
original letter in a scrapbook in the waiting room, where other
patients' family members can read it and feel better about
the people caring for their loved ones. Be sure to provide
appropriate recognition for the employees who are mentioned
in the letter.
Listen and Learn
If hospitals want to learn how to better serve
patients and rebuild trust, patients and family members need
to be given an open invitation and encouraged to discuss concerns.
- Make sure your patient
information materials solicit patient and family input and
let people know how to
give feedback: "Please let us know if there is anything we
can do better. Contact..."
- Find out what types of problems your patients
are experiencing by listening to conversations in the waiting
rooms. In particular, the ICU waiting room is where people
discuss malpractice and obstacles to care and compare notes
on physician behavior.
- Encourage leadership to
be visible and open to staff, patients and family members
and to spend time on
the "front line." They can invite a patient's family
to lunch or seek out patients and families that have been in
the hospital awhile, ask their opinions, complaints and accolades.
A follow-up thank-you note for the time would go a long way
toward building trust! As an added benefit, if employees see
top administrators listening with compassion to the needs of
patients, they will follow suit.
Create New Tools
Healthcare communicators must develop ways to help
families communicate with physicians.
E-mail is an obvious answer. Are your physicians
using it? If so, then promote it! Make a computer accessible
in the waiting room for family members to use. If your physicians
aren't using e-mail to communicate with patients, what are the
obstacles? Can they be removed?
I would have appreciated a patient/family-physician
communication center―someplace I could leave a note to
the physician and receive a response back. Hospitals could make
available special 'physician note' paper for families to use.
Physicians would know it was a message they need to read and,
hopefully, answer.
Communicators also should encourage physicians
to attend a physician-patient communication retreat or short
course. According to the American Medical Association (Jackson,
C. "The importance of doctor-patient communication." American
Medical News, May 21, 2001), physicians want to attend when
they learn they can avoid losing 20 to 25 percent of their patients
each year because of poor communications skills.
Share Information
Healthcare is like any other service - no one cares
how to buy it or use it until they need it. Unlike other services,
though, there is little information available to help patients
and family members become good consumers.
- Think about the information you'd need
if you didn't know anything about your facility or physicians.
You
would want more than standard brochure descriptions. You
would want to know about quality initiatives, the latest JCAHO
or
other accreditation survey results and outcome data. One
way to encourage the public to look at quality the way the
medical
community does is to report it. Reporting your own data―versus
allowing others to do it―is an excellent way to start
building credibility.
- Assess your organization's website. Does it
have basic information such as phone numbers, visiting
hours, facility maps, insurance plans, physician credentials
and office
information? Are you providing links to quality medical
information? Are you using the Web as a tool to educate patients
and families
about your billing procedures, provide admission and postoperative
information, describe the role of different physician specialties
and staff members and help patients make decisions about
their care?
- Why not put all this information in one location
in the hospital lobby where patients and family members
can find it? Give them access to computers for Internet searches
and e-mail. In addition, have a library of managed care
benefit
books, physician directories, quality indicators, hospital
maps and phone numbers and other resources families need
to navigate through the healthcare system.
Watch the Language of Action
Actions at the bedside build up to destroy trust.
For example, even with a hospital background, I couldn't tell
the nurses from the techs, aides or janitors. Titles were vague
and misleading. Many caregivers don't bother to wear nametags.
I rarely saw staff members wash their hands or use the disinfectant
mounted on the wall.
I was astonished as staff searched the room looking
for basic equipment like tissues, latex gloves, diapers and swabs.
Eventually, they would give up the search, go somewhere else
to find it, get distracted, and never come back. I watched physicians
and nurses shift through medical charts looking for orders or
trying to find test results and I wondered why medical care is
entrusted to paper and memory instead of computers.
- To examine how these details impact trust in
your organization, find a patient who will let you sit at their
bedside and observe the activity. How well does the room arrangement
work? Can staff find supplies? How loud are conversations at
the nurses' station? Are buzzers answered? You are sure to
come away with some commonsense ideas to share with other staff
members who can help solve problems.
- In addition, use every issue of your employee
newsletter to advocate on behalf of the patients. Stress the
importance of confidentiality, nametags and sanitation. Make
an organizational game of catching people in the act of hand
washing, wearing their nametags or improving bedside efficiency.
It may not be as exciting as the dedication of a new wing of
the hospital, but a new hospital wing doesn't build trust.
Change Behaviors
What I observed at my father's bedside has led
me to the conclusion that healthcare has lost the public's trust
by its own actions. At the core of the problem is not the quality
of the care our patients receive, but the quality of the communications.
In order to effect change and rebuild trust, hospital public
relations professionals must become healthcare communicators.
The future of our healthcare system and the lives of our patients
depend on it.
Written by
Barbara Long, APR
President, E-Savvy Communications
Jefferson City, MO
573.659.8568
e-mail: esavvy@blongesavvy.com
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