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The audacity of reclaiming hours in healthcare: Proactive tips to improve your leadership

Over the last few decades of healthcare, leaders and staff have asked themselves how best to juggle it all. After COVID-19 turned healthcare upside down, the question remains—how can we reclaim hours?

Jill Ellis, Solutions Expert, Magnet and Nursing Leadership, recently addressed this topic in a webinar that offered five methods to reclaim hours in healthcare. With 40 years of nursing to her credit, Ellis is very familiar with the nuances of the ever-changing world of healthcare.

“I think of the anxiety,” she says. “Even when it’s the best change in the world, I always say ‘yes,’ and then I get anxious, right? I may go through fear, guilt, depression—like, ‘Oh my gosh, I have to do this now?’ While last year was phrased as the Great Resignation, there have been many shifts, and those people are starting to come back, so the year 2022 will be the year of people.”

Ellis advises leaders not to be “terminally unique” when considering new strategies to save time, pointing out that when we hear about new strategies and say, Well, I just…, then we’re already shut down. “You put up a wall, and you’re not going to look at it the same way,” she says. “So try to think of yourself as being whole. You’re not just a pediatric facility. You’re not just an oncology unit. You’re not just a medical practice. Try to think of it more as a relationship to healthcare, and try not to compare.”

Rounding: Ellis advises rounding not just on patients, but also on employees, physicians, and internal customers. And start with something positive. “To change a habit, you only have to get 1% better every day—just 1%,” she says. “When you start with something positive, everybody is winning, and it builds teamwork.”

She adds that getting ahead of the game and being proactive, instead of always working in a reactionary phase, can be difficult. “That’s a hard place to be, too,” she says. “I think it goes back to an emotional standpoint of fight or flight. I think that puts us to some degree in fight mode when we’re always reacting to what’s happening, or playing Whac-A-Mole to put out the fires here and there and everywhere.”

To close the loop and find out what everyone wants and needs, you can save time by conducting 10-minute one-on-one conversations around what’s going well, building teamwork with recognition, asking about the problems of today and tomorrow, communicating back to the team, and recognizing staff.

Communication Strategies: It is challenging to show patients that you care just using eye contact, when wearing a mask. AIDET is a great example to make your communication strategies more thorough.

“One way to demonstrate AIDET is to say something like, ‘I’m Jill. I’m your registered nurse today. I’m going to have you for the next 12 hours.’ That’s a good way to do it,” Ellis says. “Day two, I’m going to say, ‘I’m Jill again. I’m your registered nurse.’ On day three, I will say, ‘Who am I?’ So you can find ways to do it that make it meaningful, and it’s not so robotic in itself. To end the conversation, show gratitude where you can. “AIDET is just one example, so whichever acronym you have in place, just do it more thoroughly,” Ellis says.

“In one organization in Indianapolis, we rolled it out, and a physician was the CEO of the hospital. He didn’t say very much, but he listened to what we said, and he thought, ‘Well, I’m just going to do one thing. I’m just going to use the Thank you. I do everything else pretty well.’

“The first time he used Thank you in his practice, the patient hugged him. He thought, ‘Well, this is very different. So let me try it again.’ The second time he did it, the patient was just overwhelmingly thrilled and said, ‘Well, thank you.’ Then it became a thank-you fest between them both. By the end of his day, he felt so much better about the day than he had the day before. So he continued to use it—his 1% was just to say thank you, and he found a way to do it even better.”

Improving communication is a way to reduce anxiety and build compliance. Ellis advises making strategic communication a thorough process, practicing all the time, validating the plan, and using recognition in huddles and staff meetings to get the word out.

Role Modeling: Ellis notes that when you point your finger at staff to tell them to do something, three are always pointing back at you—so don’t forget that when it comes to role modeling.

“Everybody wants to change the world, but nobody wants to change,” she laughs. “Some changes are easy, and some changes are hard, but as a leader, role-modeling behaviors is just non-negotiable.”

For example, she says that if you want your staff to smile while they work, and you need to role-model it, role-play it at home and in front of the mirror, role-model it with your family, do it in the car on your way to work, and every time, think about what you’ll do at work. And when you walk up to someone, “just introduce yourself,” she says. “They may know you, but you know what? They may not, so make sure that they know who you are.

“Each day, if you continue to practice and do it better yourself as you round and communicate, then you’ll master it,” she adds. “And it’ll become a habit for you to continue to build every day.”

Patient Communication Boards: Ellis says patient communication boards can function as duplicates of the nurses, but only if staff use them as intended.

“Rounding on your employees saves you time,” she says. “It creates a proactive versus reactive mindset. Communication strategies save you time, because if you communicate thoroughly, the patient doesn’t have questions at the end, which take more time to answer. Role-modeling saves you time, because you’re going to live out loud, which you’re expecting others to do. [Similarly, the] board is very powerful in itself.

“I used to tell nurses all the time—they’d say, ‘Oh my gosh, I’m so busy,’” she adds. “I’m like, ‘Well, you’re working harder than you have to. Why not use the board to communicate? It is communicating to the patient the whole time you’re not in the room about what’s going to happen for the day.’”

Discharge Process

Ellis says that in general, you just want to find a way to automate the process if possible. She says NRC Health uses an automated process to make calls to 100% of patients. If there’s anything that a patient answers that would flag the call, alerts go to the nurses, so you’re only calling back patients who need to talk to you as soon as you can—which should alleviate a patient phone calls about the discharge process in the evening.

She gives a personal illustration to show how important the discharge process is. Her daughter, at 20, was diagnosed with juvenile diabetes. “It was a very sudden determination that she had diabetes at 2 p.m.,” she says. “By 6 p.m. we were in an ICU with her getting care, and then 24 hours later we were sent home. I was a pediatric nurse for many, many years, but I was overwhelmed. I was overwhelmed with the care, the medications, the information.

“They called me 24 hours later, and I asked questions,” she continues. “I talked about calculations. We talked about our food, and the nurse assured me that I was doing everything just the right way, which made me feel so much better about the care I was delivering. I must have sounded like I needed more help, because she said, ‘You know what? I’m going to call you back tomorrow as well. We’ll make sure you’re on the right path.’ And I so appreciated that. It was so helpful to get an extra phone call and for her to make such a difference for me.”

Watch Ellis’s webinar on-demand to understand strategies to give time back to a nurse leader or staff member, helping you proactively carve out time for positivity, compassion, and safer care.