We have many opportunities to work with physicians. It may be in caring for a specific patient or group of patients, or we may work with them on a project or team. Working with physicians to achieve accountability is no different from working with anyone else. We want to get physicians to do what they say they are going to do. We want them to make commitments and keep their commitments, as explained in the video below.
We can use the same tools used in all accountability situations, and one which is to frame the conversation.
Framing an accountability conversation is how you “set the stage” for what is expected. Often, you don’t achieve the results you desire because the expectations were not clear or each party had different expectations. Framing allows you to define what you expect.
Framing is when you ask the physician to listen and process in a positive way. It creates the listening opportunity for you to speak into. It creates one common mindset in the conversation and enables participants to do the correct work.
You can easily fix the random mindset in a conversation or meeting by asking people to be a certain way, to do a specific kind of work, and to be open to the possibility of accountability. In a group, framing sounds like this:
- I ask us to focus on our vision of improving our patient satisfaction scores by five percentage points in six months
- I ask us to listen to the presentation for opportunities we can pursue to make progress on our goal
- Please be prepared to make commitments at the end
You can do the same thing in a one-on-one conversation with a physician. For example, let’s say you are caring for a patient in pain. You contact the physician and use the SBAR technique (situation background assessment recommendation) to communicate the patient’s condition. You confer with the physician about how reasonable pain control can be achieved, and the physician gives you an order for pain medicine. You commit to the physician that you will give the medication as ordered and you will call the physician in three hours if the patient’s pain has not improved (pain level < 5) for further orders. The physician agrees with the plan.
Everyone wants to do the right work and to contribute. All we have to do is ask!
What methods have you used to gain commitments from physicians at your facility?
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