Webinar Creating Diplomats For Hope SeriesMAKAREM S, SMITH M, MUDAMBI S, HUNT J. Why People Do Not Always Follow the Doctor's Orders: The Role of Hope and Perceived Control. Journal

THE

HopeEffect

Creating Diplomats For HopeWebinar

Series


Series

HOUSEKEEPING

AUDIO is available through your computer speakers or through dial-in. All lines are muted.

You can SUBMIT QUESTIONS/COMMENTS at any time. We will address all questions during the Q&A session at the end of today’s presentation.

Links to the slides and RECORDING will be made available and sent to all attendees via e-mail.


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ABOUT US

WE WORK WITH NATIONALLY-RECOGNIZED INSTITUTIONS:5 “Honor Roll” institutions5 out of the top 10 cancer programs3 out of the top 4 pediatric hospitals3 out of the top 10 cardiovascular programs

NATIONAL BENCHMARKING STUDIES:Patient experience managementMarketing practicesPhysician relations programsInternational programs

Ranked as one of top 50 Healthcare Consulting firms by Modern Healthcare

REPRESENTATIVE CLIENTS:Barnes-Jewish HospitalCleveland ClinicCincinnati Children’s HospitalDuke MedicineFroedtert HealthMayo ClinicMD Anderson Cancer CenterMemorial Sloan Kettering

Menninger ClinicTexas Children’s HospitalThe Ohio State University Medical Center University of Chicago MedicineUniversity of Colorado HealthUniversity of HoustonUniversity of Michigan Health System


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CAROL B. PACKARD

Senior Advisor & Strategist, Healthcare Performance Improvement

Carol Packard has a Ph.D. in organizational development, a master’s degree is in organizational psychology, and 20 years experience working in health care. Carol also has designed and implemented enterprise-wide Service Excellence programs, using patient satisfaction data to drive process improvements.


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JILL F. SECORD

Senior Advisor & Strategist, Healthcare Performance Improvement

Jill has 38 years of experience as a Registered Nurse with a Master's degree in business and expert skills in leadership, operations, managed care, and nursing education. She has clinical experience in critical care, orthopedics, home care, home infusion, managed care, contracting, provider relations, data analysis, new business development and strategic planning.

She is certified in Lean Quality Healthcare and has developed a system to integrate Lean techniques with Patient Experience Mapping and Family Focused Care initiatives. Jill has worked with a variety of healthcare organizations to create departments, streamline current processes, and develop new profitable programs.

Patient as Prisoner ?

Clothes taken AWAYASSIGNED a numberTurn OVER valuablesAllowed to see family on a LIMITED basisAssigned a STRANGER as a roommateDIFFERENT people in the room everydayInstitutional RULES and SCHEDULESSTERILE environmentGive up CONTROL

Does Any Of This Look Familiar?

Patient-Centered Health Care

Not only improves required HCAHPS patient satisfaction

measures, but also

IMPROVES CLINICAL OUTCOMES

REDUCES COSTS

The Psychology of Wait (January 20)

The Hope Effect (January 27)

Empathy & Lean (February 2)


Series

Today’s webinarTHE

HOPEEFFECT

THE ANTICIPATION OF GETTING & BEING WELL

Before we Start -

I’d like you to think about a few questions - First, consider this situation:

The Benefits of the migraine drug Maxalt (rizatriptan) increased when patients were told they received an effective drug for acute migraines. What happened when they were told they were actually given a placebo instead?

A. Patients reported less reductions in pain when they knew the pill was a placebo.

B. When labels of Maxalt tablets & placebo pills were switched, patients reported similar reductions in pain.

C. Patients reported more pain generally when they did not know whether they received Maxalt or a placebo.

Keep this question in mind as we go along…….

Before we Start - A Second Question

What percent of patients have cognitive impairment at time of discharge?

A - 10 - 25%B - 30 - 45 %C - 50 - 70%D - 75 - 85%

Keep these questions in mind as we go along…

Evidence

When patients receive CARE and ATTENTIONfrom people- THEY believe can help ease their suffering and distress

ENDORPHINS ARERELEASED

Evidence



STRESSISREDUCED

Evidence



STRESSISREDUCED

SENSE OF PAINIS REDUCED

Clinical Care + Positive Messaging

(Rami Burstein, and Ted Kaptchuk, ci Transl Med 8 January 2014: Vol. 6, Issue 218, p. 218ra5 Sci. Transl. Med.

Patients with severe migraines given either drug or placebo

Study drug labels 9 (Attack 1-6)

Two Attacks Two Attacks Two Attacks

Actual pillPlacebo

Actual pillPlacebo

Actual pillPlacebo

Actual pillMaxalt

Actual pillMaxalt

Actual pillMaxalt

Negative InformationPLACEBO LABELLING

Neutral InformationUNSPECIFIED LABELING

Positive InformationMAXALT LABELING

PLACEBO(nonactive)

MAXALT or PLACEBO(active) (nonactive)

MAXALT(active)

Envelope#1 – Study drug - Take pill 30 min after migraine onset - This envelope contains:

Clinical Care + Positive Messaging

(Rami Burstein, and Ted Kaptchuk, ci Transl Med 8 January 2014: Vol. 6, Issue 218, p. 218ra5 Sci. Transl. Med.

Patients with severe migraines given either drug or placebo

Important Take-Away!

HOPE

BOOSTED THE EFFICACYOF BOTH

THE ACTIVE MIGRAINE MEDICATION AND

THE INERT PLACEBO

Hope Increases Adherence to Medical Advice

FAITHINCAREGIVERS

MAKAREM S, SMITH M, MUDAMBI S, HUNT J. Why People Do Not Always Follow the Doctor's Orders: The Role of Hope and Perceived Control. Journal Of Consumer Affairs [serial online]. Fall2014 2014;48(3):457-485. Available from: Academic Search

Complete, Ipswich, MA. Accessed January 21, 2015

SELF-EFFICACY

HOPEADHERENCE TOTREATMENT

Patient-Centered Care

THE INTERACTIONSBETWEENHEALTHCARE PROVIDERS&A PATIENTOFTEN HAS A BIGGER IMPACT THANTHE “AGENT”(I.E. MEDICATION, SURGERY)WE TYPICALLY FOCUS ON!

Patients Feel more Hope

WHEN THEY SEE THEIR CAREGIVERS COLLABORATING

WHEN THEY ARE PART OF THE SOLUTION

Involving Patients in Bedside Shift Reports:

In 29 studies on effects of BSRs:

• 13 (44.8%) indicated increased patient satisfaction• 5 (17.2%) noted patient asked more questions • 4 (13.8%) patient said they felt safer after seeing nurses

changing shift• 10 (34.5%) noted increased patient safety• 10 (34.5%) mentioned increased communication with nurses• 5 (17.2%) noted patients demonstrated an increased

understanding of their care

What Does the EVIDENCE Say?

How many of you currently deliver

SHIFT REPORTS by the bedside?

Please answer using the textbox.

Concerns?

YES!Delivering bedside reportsis a skill to be developedTRAINING AND PRACTICEConfidentiality issuesin semi-private rooms

What do Nurses Think?

After implementing BSRs, • Average report time decreased from

45 to 29 min. • Nurse satisfaction increased 37% to 78% • White board adherence 25% to 98%.

Reasons for increased nurse satisfaction: • Receiving accurate handoff without distractions,

reducing time• Assessment of the patient & environment in real time

Implementation

Identify a model specific for your organization & patient populationsto ensure CONSISTENCY

Set & track MEASURABLE indicators

Support the ADOPTION by clinical nurses (training, incentives)

Adjust models as APPROPRIATE to attain and sustain use

A HEALING ENVIRONMENT ALSO ADDSTO THE HOPE EFFECT

Bright Rooms

Walch (2005) retrospective study:

Patients in the bright rooms required

22% LESS analgesic medications 21% DECREASE in medication costs

Walch JM, Rabin BS, Day R, Williams JN, Choi K, Kang JD Psychosom Med. 2005 Jan-Feb; 67(1):156-63.

Prospective environmental studies suggest

blood pressure typically declineswithin three minutes of viewing nature scenes

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2264925/

Nature Scenes

Hopeful Patient-Centered Care Lowers Readmission Rates

In samples of1798 hospitals for acute myocardial infarction2562 hospitals for pneumonia

HIGHER hospital-level patient satisfactionscores (overall and for discharge planning)both associated with LOWER 30-day readmission rates

(Am J Manag Care. 2011;17(1):41-48)

Meaningful Use Requirements

BUREAUCRATIC WASTE OF TIME OR HELPFUL?

30 - 50 % of patients have cognitive impairment at time of dischargeimpacting ability to COMPREHEND or REMEMBERdischarge instructions

(Boustani et al., 2010; Coleman et al., 2013; Lindquist et al., 2011).

IMPROVEDCLINICALOUTCOMES

ClearDischargeInstruction

PersonalEfficacy

Hope

Lots of evidence that the HOPE of improvement actually leads to improved outcomes!

And that leads to ENCHANTMENT!

The HOPE Effect

What Do you Do to Enhance HOPE ?



WHAT ARE THE HOPEFUL MOMENTS OF TRUTH FOR YOUR PATIENTS?

Care Coordination Communication

EXPECTED BEHAVIORS:How interactions

occur and are managed

SYSTEMS: Processes and technology

to increase efficiency

POSITIONING: Communications,

conversations, and messaging

What Stories will your Patients Tell?

PREVENT THE BAD ONESCAPTURE THE GOOD ONES

What Can you to Today?

Add pictures of NATURE SCENES and PLANTS in patient roomsand in waiting rooms

Review & Redesign - Discharge Instructions

SOURCE: As presented by Paasche-Orlow, 2014

Begin discussions on implementing a BEDSIDE REPORT PROTOCOL

Back To the Questions

Benefits of the migraine drug Maxalt (rizatriptan) increased when patients were told they received an effective drug for acute migraines. What happened when they were told they were actually given a placebo instead?





Benefits of the migraine drug Maxalt (rizatriptan) increased when patients were told they received an effective drug for acute migraines. What happened when they were told they were actually given a placebo instead?





What percent of patients have cognitive impairment at time of discharge? (Among general population)

A - 10 - 25%B - 30 - 45 %C - 50 - 70%D - 75 - 85%


What percent of patients have cognitive impairment at time of discharge? (Among general population)

A - 10 - 25%

B - 30 - 45 % (general population)C - 50 - 70% (elderly population)D - 75 - 85%

QUESTIONS ?

COMMENTS ?

• Have a representative contact you?• Have a representative come to speak at your

organization?• Want more information?

Would You Like To:

2700 Post Oak Blvd., Suite 1400Houston, TX 77056+1 713.877.8130www.endeavormgmt.com/healthcare

Contact Us

Carol [email protected]

Jill [email protected]

Thank you for participating!

Please join us next week on Tuesday, February 3 at 12:30 CT, 1:30 EST

Documents

Webinar Creating Diplomats For Hope SeriesMAKAREM S, SMITH M, MUDAMBI S, HUNT J. Why People Do Not Always Follow the Doctor's Orders: The Role of Hope and Perceived Control. Journal