How health systems can build patient confidence and trust through collaboration
Wellstar West Georgia Medical Center (WWGMC) leveraged an NRC Health correlation tool using quantitative data to discover confidence and trust in nurses and physicians are the two metrics most aligned with a positive patient recommendation.
“It takes a lot of work by everyone, and that work must start from the very top with our senior leaders, and then that must trickle back down to our frontline. The voice of our frontline staff must then move back up to our senior leaders to help us determine the best directions to elevate the voices of our customers,” says 2022 NRC Health Symposium speaker Julia Cox-Pearson, BSN, MBB, Director of Lean and Patient Experience, at WWGMC.
WWGMC, an employer of 1,400 with 247 beds, built processes and behaviors to improve confidence in nurses and physicians independently and mutually by tracking measures with inpatient, outpatient, emergency department, and ambulatory surgery, and their ‘Overall Would Recommend” grew from 71.1 to 76.8 in the past three years.
Driving Improvement through Collaboration
Tammy Lynch, Director of Acute Care, WWGMC, said they had worked for years to improve this patient experience in general and acute care using observations, hourly rounds, trials, and new implementations, but with inconsistent results. “We had consultants. We pulled all our leaders together. We just weren’t getting there, Lynch explained. “Our CNO said, ‘Hey, let’s just try something simple. Let’s just ask the staff. Let’s ask every team member, ‘What are they having to say I’m sorry for?’ We’re like, ‘Okay, we can do this. This is easy.’”
Every unit decided, on the same day, to start in their huddle and just ask every team member at the huddle what they had to apologize for. “It was a great eye-opening learning experience,” Lynch says. “Our new team members got to learn from the more experienced team members that it was okay to say, ‘I’m sorry,’ to start with. You didn’t have to own what went wrong or that experience, but you could say you are sorry. You could acknowledge it. They also learned how to handle it. Once you say, ‘I’m sorry,’ you are not done. You’ve got to keep going, and you’ve got to fix it for them, or at least try to fix it for them. It was a lot of sharing back and forth. It was very collaborative,” she said.
Initiatives to Improve Confidence and Trust in Nurses & Doctors
Lynch said creating standard work for charge and discharge nurses helped by taking feedback that we’re learning from huddles and integrating it into the everyday work that was already in place. When they implemented these changes, they saw their improvements impacted the patient experience and subsequent survey scores. This process taught them about identifying barriers to success and helped drive long-term improvements.
4 Steps to Identify Trends in Care through Rounding:
- Round by assignment: Round with the nurse first, ask focused questions to learn about behaviors
- Use focus questions: Choose focused-patient rounding questions aligned with your strategic lanes
- Provide feedback and coaching: Provide team members with feedback that encourages growth
- Identify and share trends: Reflect on what you learned and share insights during huddles
Lynch explains that when a standard is not met, it’s important to re-educate the team member about the standard and follow up with the team member by the end of the shift.
WWGMC uses coaching to help leaders understand their leadership should be intentional, and words have weight. “We always use recognition,” Lynch says. “We reflect on what we’ve learned. We start every huddle with something positive. We’ll go from team member to team member and say, ‘Tell me something positive about today. What brought you joy today in your work? Who would you like to recognize?’”
Lynch says they are sharing everything that the patients have shared. “Elevate your team members. It’s very important to us that feedback. That feedback closes that loop. It’s coaching to take them to the next level. It’s developing and investing in our team members to grow and develop themselves.”
Recognition for WWGMC includes a program that acknowledges values in action with a quarterly award for the hospitalist of the quarter with the highest “confidence in doctor” score using a minimum number of surveys. The hospitalist is recognized in a newsletter, at the Department of Medicine, Given a favorite treat in the Doctor’s lounge and a plaque at the end of the year.
Ultimately, WWGMC uses intentional leadership to reinforce an integrated strategy with interprofessional collaboration to create measurable outcomes—and it shows,
“I feel confidence and trust in physicians has helped move so many things because it’s helped them to find their identity and their worth, and the value in their practice,” Cox-Pearson says. “We work very hard to ensure that our goals are measurable, achievable, and transparent at all levels. We know what we’re working on, and our leaders are committed to helping move those metrics.”