HEART to Heart Service Recovery Initiative

1. HEART to Heart Service Recovery Initiative March 2009

2. Baton Rouge General Strategy Map Our map displays the fact that everything we do is for the benefit and purpose of serving our patients.

3. 96% of unhappy customers do not complain Unhappy customers tell 8 to 10 people A score of “Good” isn’t good enough to create loyalty! How do Patients Feel About Their Experience? Only when a patient gives a score of 5 have they truly become an advocate and believer in us!

4. Your Caring Earns Our Score Patients are randomly selected to receive a survey at their home within one week of discharge. For each question, they rate our care on a scale of 1 – 5. There are questions for almost every part of their experience.

5. Trust in the organization Empowerment to talk about needs Control over experience Safe outcomes What’s in it for the Patient & Family • Feel emotionally cared for • Feel affirmed and understood • Feel important • Peace of mind “Your kind, gentle way of treating patients made my stay at BR General so much more bearable.” - Patient, February 2009

6. Job Security Job Satisfaction Better interactions w/patients and families Patients choose us Someone you know may be our patient Pride for BRG Potential for Profit Sharing Recognition of excellence by your peers What’s in it for You “Hospital staff can make a huge difference in the patient experience!” - Employee, March 2009

7. HEART to Heart A planned approach to help every employee identify and immediately upgrade service when service excellence standards are not met or fall short of expectations, causing disappointment for patients and their families. Patients provide a service score from “1 = very poor to 5 = very good” which is posted on the dry erase board by staff. Throughout the stay all staff communicate with patients and families and partner to raise the score.

8. The first caregiver that interacts with the patient describes our service focus. “Welcome, Ms. Smith, I’m Beth, your nurse today. I want to make sure that you have a very good experience while here. Throughout your stay we’ll track how we’re doing, and want your feedback to know what we can do to make your stay better. To do this, we would like you to rate your experience so far, on a scale of 1- 5. 1 is “very poor”, 2 is “poor”, 3 is “fair”, 4 is “good” and 5 is “very good”. This score is written on the top corner of the board along with nurse name and date. “When staff come into your room, they will ask you about your score and if there is anything they can help with. Please let us know at any time is there is anything you need.” HEART to Heart

9. When entering a patient room, you may find that there is no score on the board. Check to see if they would like to participate. “Hello, I’m Diane, your respiratory therapist here for your treatment today. How are you? I see that there isn’t a service score on your dry erase board, do you know about our service focus?” Have fun with your patients that give us a 4 or 5. We want them to feel comfortable and happy about our interest in their experience. If you patient gives a score of 3 “fair”, you’ll need to use the HEART method to address their needs. If your patient gives a score of 2 or 1 “poor” or “very poor”, you’ll need to use the HEART method and involve a leader as quickly as possible. HEART to Heart

10. Hear Empathize Apologize Recover Track HEART to Heart

11. Offer your full attention Limit interruptions Actively listen Paraphrase Reflect feelings Non-Verbal Communication Eye contact Body language Verbal Supportive language Tone, volume, rate Hear • “It sounds like you’re upset. I want to help.” • “Let me see if I understand, you asked for a salad plate, but got a regular tray instead?”

12. Listening with your ears, your eyes and your heart. Listen to the words that are said Observe body language Validate feelings Put yourself in their shoes Express understanding for how they feel Empathize • “That sounds uncomfortable, you felt pain?” • “If you were expecting to speak to the doctor, and didn’t get to, I can understand that you feel frustrated.”

13. A “Blameless Apology” does not take responsibility for the experience or say that you are at fault. Apologize • “I apologize for the noise in the hallway. I understand why it startled you.” • “I am sorry your food is cold. I would be happy to warm it for you.” • “I apologize that we did not meet your expectations. What can I do right now to make the situation better?” • “We want to provide you with very good care. I am very sorry we have not met your expectations. I will be happy to look into this for you.”

14. The quotes used as examples for HEART are scripts. Use them as provided, or customize them to make your communication more personal. Scripts provide employees with a consistent, easy method of addressing needs Scripts ensure that the message Baton Rouge General wants to convey is being conveyed Scripts are a wonderful resource for those whom “warm and fuzzy” does not come naturally Note: Employees should feel comfortable delivering the message so that it does not sound rehearsed. Words that Work - Scripts

15. Immediate Recovery Promptly investigate Promptly act to amend and atone Show appreciation for bringing the issue to your attention Promptly communicate what has been done to resolve this issue Ask if there is anything else you can do and do it Recover – For A Patient Score of 3, 4 & 5 Examples • Bring blanket • Ice water • Empty trash • Get nurse to answer question • Promptly answer call light • Address alarm

16. Follow-up Recovery: Staff calls the operator and has manager text paged to come to the room for a service recovery concern Manager visits patient w/in one hour, or by phone if across town, and sets meeting time If manager cannot meet patient or make call with in one hour, manager follows chain of command arranges for higher level leader to meet with patient with in one hour Operator provides DON with report of calls scoring a 1 or 2 each day Be transparent with organizational problems and get all staff involved in service Immediate Recovery Promptly investigate Promptly act to amend and atone Show appreciation for bringing issue to your attention Promptly communicate what has been done to resolve this issue Ask if there is anything else you can do and do it Recover – for Patient Score of 1 or 2 Anytime a patient gives a score of 1 or 2, attempt to assist, then follow up with having a leader speak with them.

17. Real time patient feedback and response gives us the constant opportunity to see how our patients are feeling, and address their needs to improve our scores. Operator provides DON with report of calls scoring a 1 or 2 each day Analyze for trends At the unit level At the department level At the organizational level Track

18. Organizational commitment to serving our patients Our recovery skills and HEART Process Apology/Apology notes Gift Bags with Children’s Art Stationary Located in house supervisor offices at BB & MC Only to be used once issue is completely resolved and patient/family is satisfied Tool Kit

19. Your E4 Card is a good place to commit to being HEART to Heart with your patients!

20. “Super User”/Mentor Training - Completed Kick-off training Sessions – This Week All staff Bring awareness Motivate Educate Make it fun New-hire orientation Once our pilot at BB is successful On-going training sessions Current staff Rejuvenate and refresh Quarterly Report Out Celebrations Training

21. Examples/Role Play/Don’t Do… Thanks for coming!