The Magic of Storytelling to Improve the PatientExperience
Healthcare Ethics Consortium 2016 Annual ConferenceMarch 17 – 18, 2016MichelleClements,BSN, RNClinical Manager, Neonatal Intensive Care Unit andWellBabyNursery
Not-for-profitAcuteCareCommunityHospital –660bedsFounded in 1894
UNC REX HealthcareNeonatal Intensive Care Unit15BedLevelIV
The “Magic” of the Patient Story
Helps the healthcare team identify opportunities to improvethecareprovidedNurtures the patient and family-centered care experiencethroughunderstanding the patient’s perception of careprovidedSupports quality and safetygoalsEngages emotions – touches the heart of both patientand caregiver
Some reasonswhystoriesare effective in healthcaredelivery
A storyis mentally richer than simpleinstructionsA storymotivates and inspires acceptance,action,andcomplianceA storyhas the power to engage and involve thepatientA storyignites empathy andimaginationA storyis more likely to be remembered andretoldA storyopens the door to conversation and better two-waycommunicationsA storytransfers knowledge and can changebehavior
In 2011, PRC KeyDriver#1 – Nurses’ Communication with Patient/Family 58.2% Excellent with an Inpatient NICU/PICUPercentExcellent Rank of15Parent Verbatim: “Communication needs to be improved. It’s a scary time and communication can be better about what’s going on.”We reachedout to parentsthathad a baby in theSCN2010 or 2011and askedthem toparticipate inafocus group.
Rose colored glasses– recognizingthe value of data on the parent experience and recognizing the value of the “parent voice”Unclear ownership of the parent experienceLackof healthcare team facilitation skills in communicating with parents regarding their experienceTeam “uneasiness” in hearing opportunities for improvement directly from parentsWhat to do with the information received from parents …. where do we begin?
Honoring the Journey……
Portraits and Gardens
The Power of Vulnerability
Who’s going to take me where I’ve neverbeen before?
Silence has subtle but lastingconsequences!
Empathy versus Sympathy?Makinga connection to the patientexperience
FourDefiningAttributesofEmpathyTobe able to see the world as others see itTobe nonjudgmentalTounderstand another person’s feelingsTocommunicate your understanding of that person’s feelings
Theresa Wiseman – Nursing Scholar
Forget Me Not
Does empathy require us to push aside our own feelingsand experiences to focus on someone else?
Focus Groupof “Alumni” NICU parents:We asked only one question.“Wouldyou tell us about yourexperience?”
Hearing the Parent Voices…….
I would like to have more opportunity to bathe mybaby.I feel “in the way” of theNurse.I don’t like feeling that I have to ask permission to touch or kiss mybaby.Could I have the same nurse sometimes?When I come to the hospital to breast feed my baby, it’s the one thing “I” can do for my baby. I’ve arrived before to find my baby already fed. I then had to go pump and missed feeding my baby.Nurses spend a lot of time on the computer instead of caring for thebaby.Can I hold my baby more often?It felt terrible to go home and leave my baby in the NICU. Other Moms were being wheeled out holding their baby and I left with empty arms.I really wish I could have experienced a wheel chair ride out on the day of my baby’s discharge – just like the Moms with well babies.
Start with Makinga Personal Connection
First, you must know your “own” storyAskthe patient what name you should call themExpress to the patient that you have time to be with themHelp create an environment of comfortand caringLook fornuancesBe prepared for how to respond to interruptions from outside demands on your time.
Reflect on your assumptionsand stereotypesReflect on what matters toyour patientReview the patient’s chartAsk open-endedquestionsDo notinterruptMake a connection to the patient’s lifeBe aware of your bodylanguageAsk the patient for their perception of the plan ofcareSummarize “actionable” concerns with thepatientExpress gratitude for the time spenttogetherSoothe emotionsIntegrate key aspects of the patient story into the careprovidedFollowthrough
Facilitating aPatient Story
Is it about the score?You decide.....