Case Management & Crucial Communication

1. Case Management & Crucial Communication

2. Objectives • Identify the elements of a crucial conversation. • Identify different styles of communication. • Learn generational differences and how that knowledge can improve your communication.

3. “We know that communication is a problem, but the company is not going to discuss it with employees.” - Supervisor, Fortune 100 Company

4. Definition of aCrucial Conversation A discussion between two or more people where: • Stakes are high • Opinions vary • Emotions run strong

5. Why Increase Your Focus on Communication?

6. Improved Communication • Increases customer satisfaction scores. • Decreases patient mortality. • Improves staff perception of: • Unit conflict management. • Collaboration amongst the team. • Staff quality. • Overall quality of patient care.

7. The Static of Communication

8. What causes the static? Communication that is being delivered is not the same as, or connected with, the message being received.

9. Causes of Static Communication • Ambiguity • Confusion • Inconsistency • Conflict • Distrust

10. What contributes to the static? Technology that was meant to improve and ease communication has inadvertently created miscommunication.

11. Barriers to crucial conversation • PDAs (i.e. Blackberries) used in meetings. • Personal conversations in public areas. • Speaker phones in public areas. • Ringing cell phones. • Co-workers behaviors (loud talking). • Micro-managing. • Public reprimands. • BEING SPOKEN TO IN A CONDESCENDING MANNER.

12. Communicating Through Technology

13. Communicating Through Technology • Email • Use of all capitals can be misinterpreted as being angry. • Misuse of exclamation points • Misspellings - No use of spell check • Font size • Text Messaging • Use of abbreviated words • Misspellings

14. Communicating Through Technology • Voicemail • No out of office message. • Message too lengthy. • No information about how to reach for emergency. • Cell Phones • Weak cell phone signals. • Dropped calls. • Pagers • No response. Is that deliberate or did the page go through?

15. Communication is a two-way process

16. We need to think of communication as an outcome. At a minimum, our objective should be for others to understand ours.

17. Communication in a Caring Context

18. Communication Using Caring Behaviors • Warmth • Respect • Empathy • Genuineness • Trust

19. Communication Using Caring Behaviors (Cont’d) • Essential to the practice of healthcare. • Are team members focused? • Does not involve more time. • Promotes health.

20. Communication Using Caring Behaviors (Cont’d) • Need to cultivate a sensitivity to one’s self and others. • Builds relationships of trust.

21. Communication Styles • Passive • Aggressive • Assertive

22. Passive Style of Communication

23. Passive Style • Stems from fear, timidity, inhibition, feelings of helplessness. • Stems from fear of rejection. • Leads to internalized anger and tension.

24. Passive Style (Cont’d) • Can lead to internalized anger and tension. • Problems are not faced or solved. • Suppresses feelings.

25. Aggressive Communication

26. Aggressive Style • Can take unfair advantage of others. • Can be used to intimidate. • May be used when angry and thus could be construed to be anger.

27. Assertive Communication

28. Assertive Style (Cont’d) • Communication is direct when there is a problem. • Builds trust. • Does not infringe on anyone else’s rights • Creates a win-win outcome. • Values self and others.

29. Negative Outcomes of “Out of Control Conflict” • Relationships are damaged. • Discourages cooperation. • Results in defensiveness and hidden agendas. • Wastes time, money, and human resources.

30. Negative Outcomes of “Out of Control Conflict” (Cont’d) • Focuses on fault finding and blaming others. • Creates enemies, hard feelings, and hostility. • Is frustrating, stress producing, and energy draining.

31. Negative Outcomes of “Out of Control Conflict” (Cont’d) • Is often loud, hostile, and chaotic. • Leads to burn-out. • Leads to lack of collaboration. • Results in poor quality patient care. • Encourages gossip. • Impedes professional growth.

32. Negative Outcomes of “Out of Control Conflict” (Cont’d) • Can lead to destructive behaviors. • Can lead to frequent job changes. • Can lead to mistrust within the team. • Staff leave.

33. Words to Live By • Incorporate a sense of humor. • Always assume the posture of warmth, respect, empathy, and genuineness. • Treat others as you want to be treated.

34. Understanding Generational Diversity and It’s Impact on Communication

35. The Age Cohorts • The Veterans… 1939-1945 • Baby Boomers… 1946-1959 • Cuspers… 1960-1965 • Generation X… 1965-1975 • Generation Y… 1975-1981

36. Key Events in the Lives of Veterans Current Ages: 61- 86 • Great Depression • World War II • Korean War • Military and National Pride

37. Communicating with Veterans • Build trust through inclusive language. • A leader’s word is their bond, focus more on words than body language. • Face-to-face or written is received best. • Use more formal language. • Don’t waste their time, they have a job to do. • Don’t expect them to share their innermost thoughts immediately.

38. Key Events in the life of Baby Boomers Current Ages: 42-60 • Television • Rock and Roll • Era of affluence, credit cards • Racial unrest • Vietnam War • Assassinations • Space Exploration • Scientific and Medical Advances

39. Communicating with Boomers • Boomers are the ‘show me’ generation, so use body language to communicate. • Speak in an open and direct style. • Answer questions thoroughly, and expect to be pressed for details. • Avoid controlling or manipulative language. • Present options to show flexibility in your thinking. • Use face-to-face or electronic communication to reach out to them.

40. Key Events in the life ofGeneration X Current Ages: 26 -41 • End of Cold War, Soviet Union collapse. • Introduction of Personal Computers. • Portable CD players. • Video games, microwaves, cordless phones. • AIDS. • Economic instability. • Single parent families.

41. Communicating with Gen X • Learn their language and speak it. • Use e-mail as a primary communication tool. • Talk in short sound bytes to keep their attention. • Present the facts and use straight talk. • Ask them for their feedback. • Share information with them immediately and often. • Use an informal communication style. • Listen! You just might learn something!

42. Key Events in the life ofGeneration Y Current Ages: 7-27 • Terrorism • Environmental Concerns • Global political realignment • Multiculturalism • Era of high technology

43. Communication with Gen Y • Let your language paint visible pictures. • Use action verbs to challenge them. • Don’t talk down to them, they will resent it. • Show respect through your language, and they will respect you. • Use e-mail and voice mail as primary communication tools.

44. Communication with Gen Y (Cont’d) • Use visual communication to motivate them and keep them focused. • Constantly seek their feedback. • Use humor, reassure them that you don’t take yourself too seriously. • Encourage them to break the rules and explore new paths or options.

45. Generations at WorkManaging the Clash of Veterans, Boomer’s, Xer’s, and Yer’s

46. ASSETS Stable Detail-oriented Thorough Loyal Hard working LIABILITIES Inept with ambiguity and change Reluctant to buck the system Uncomfortable with conflict Reticent when they disagree Veterans …On the job…

47. ASSETS Service oriented Driven Willing to ‘go the extra mile’ Good at relationships Want to please Good team players LIABILITIES Not naturally ‘budget minded.’ Uncomfortable with conflict. Reluctant to go against peers. May put process ahead of result. Overly sensitive to feedback. Judgmental of those who see things differently. Self-centered Boomers…On the job…

48. ASSETS Adaptable Techno literate Independent Unintimidated by authority Creative LIABILITIES Impatient Poor people skills Inexperienced Cynical Job hoppers Bore easily Gen Xer’s…On the Job…

49. ASSETS Collective action Optimism Tenacity Heroic Spirit Multitasking capabilities Technologically savvy LIABILITIES Need for supervision and structure. Inexperience, particularly with handling difficult people issues. Gen Yer’s…On the Job…

50. Where do I go from here? • Know that generational differences are real! • When working with doctors, nurses, patients, families, and other team members, using this information can make a difference in getting to the outcome you want. • Try to think how the generation you are speaking to thinks. • Take the time to learn more about this subject – its FASCINATING…and rewarding.