July 13, 2011 | | Comments 0
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Are you and your team on automatic pilot?

By Wendy Leebov, PhD

A couple of weeks ago, I was running a workshop on The Language of Caring and how to communicate in a way that builds trust and partnership with patients and families. As we worked our way through the seven skills, we reached the part where we examined what I consider to be one of the most important skills for patient-centered communication: “explaining positive intent.” This involves telling the patient (or other customer) how what you’re doing is for their sake. Often, we just engage in our activities with the patient without much explanation. We’re on automatic pilot and not thinking about how the patient or family member perceives what we’re doing. When we do explain, the explanation typically focuses on the activity: “Here’s what I’m doing.” Rarely, do we go beyond saying what we’re doing and articulate the benefit to the person with or on whom we’re doing it.

This is a problem because:

  • Patients and families DESERVE an explanation of why we do what we do to and for them
  • Patients and families need to know our purpose so they can be more engaged partners-so they can help us achieve these purposes, perhaps in a different or better way
  • We are not seen as the caring people we are unless we make it clear to people how well-intended we are-that our actions are driven by caring about them

Here are a few examples

No explanation: Handing the person a blanket while talking about something else.
An explanation of the action: “I brought you a blanket.”
An explanation of the positive intent behind the action: “I want you to be comfortable.”

No explanation: Taking vitals without commenting about what you’re doing.
An explanation of the action: “I’m here to take your vital signs.”
An explanation of the positive intent behind the action: “I want to make sure all is well with you all through the night.”

No explanation: Turning away from the patient to take notes in the computer.
An explanation of the action: “Please excuse me a moment. I want to make a few notes.”
An explanation of the positive intent behind the action: “I want to remember the important things you just shared with me.”

After illustrating the skill, I asked people to brainstorm a list of actions they take for and with patients, families, and coworkers every day. I then asked people to choose five actions that may not be pleasant or appreciated by the person on the receiving end-and to develop a one liner they could use to explain their positive intent to the person when they engage in that action.

I was stunned by how difficult this was. Clearly, members of our care and service teams engage in their actions with the intent to benefit the patient/customer, but they have a very tough time articulating their positive intent so the patient or other customer will be sure to feel their caring.

“How is what you are doing for my sake?”
I wish people would imagine that the patient or family member is constantly asking them, “How is what you’re doing for my sake?” And I wish the care/service provider would answer this question constantly-without having to be asked!

The action: Caregiver closes the curtain.
The imagined question: “How is this for my sake?”
The answer-positive intent explained: “I want to protect your privacy.”

The action: Appointment clerk says how long the appointment will take.
The imagined question: “How is this for my sake?
The answer-positive intent explained: “I want you to know what to expect, so you can plan for it.”

The action: Nurse gives patient’s family member a contact phone number.
The imagined question: “How is this for my sake?”
The answer-positive intent explained: “I want you to be able to call for an update whenever you want to.”Or, better yet: “I want you to rest easy, knowing that you can reach one of us at any time of the night or day to get an update on your mom.”

The action: Receptionist asks physician when he’ll be available to return patients’ calls.
The imagined question: “How is this for my sake?”
The answer-positive intent explained: “I want to alert patients for you, so they won’t be calling you over and over.”

The action: IT Help Desk person sets appointment with manager to look at computer problem.
The imagined question: “How is this for my sake?”
The answer-positive intent explained: “I want to be sure I understand this so I can solve it for you.”

The action: Physical therapist pushes resistant patient to get up and walk.
The imagined question: “How is this for my sake?”
The answer-positive intent explained: “I want to help you regain your strength, since I know you’re eager to go home.”

It’s time to help our teams stop in their tracks, develop, and use key words to explain how their actions benefit the people they serve. If they have trouble articulating the benefit, then engage the peer group in working on this together. I am talking simply about telling patients and families the positive patient-centered purpose behind our specific actions.

And, by the way, if we examine our actions and can’t find a benefit to the person we’re serving, it’s time to question those actions and stop engaging in them.

Click here for a worksheet you can use to engage your team in developing and delivering key words that make their patient/customer-centered positive intent clear to the people they serve.

To witness Explaining Positive Intent in action, preview the skill-builder video from The Language of Caring Skill Building System.

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Wendy Leebov About the Author: Wendy Leebov is a passionate advocate for creating healing environments for patients, families and the entire healthcare team. A mission-driven expert, Leebov provides outcomes-based consulting services, culture change strategies with healthcare organizations, training and tools for enhancing the patient and employee experience. With more than 30 years of experience and skills in communication, training design and delivery, she is known for making hard skills accessible and motivating people to stretch and apply skills which set them apart. Author of 12 books for healthcare, Wendy has produced two groundbreaking video-based skill building systems that educate and empower all staff to deliver the exceptional patient experience consistently by excelling at caring communication. Wendy writes a free monthly e-newsletter - HeartBeat on the Quality Patient Experience - packed with concrete tips and tools for managers who champion the great patient and employee experience. Visit Wendy’s website for more great tips and tools.

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