How Patient Advocates Can Help You And Your Company

Attention corporations! Consider having a skilled (independent) patient advocate on retainer for employees to use in health crisis. An emergency that puts the employee or a loved one in ICU. A new cancer diagnosis. Medical errors. Dementia care. The list is endless, and paying for this type of short term supportive service is a fabulous employee benefit! It also saves $ for the company. Consider a distressed employee’s “presenteeism”, yet what they’re really needing is expert care and guidance.

Patient Advocacy Is Vital to Our Health Care and Treatment

Tiffany Matthews, Healthcare and Patient Advocate

Healthcare in the U.S. is broken and only getting worse. Here are just a few examples of why:

  • Of the $3 trillion spent on healthcare annually, $1 trillion is wasted;
  • Many doctors are providing too much unnecessary treatment;
  • Providers are paid for quantity of care vs. quality of care;
  • Healthcare costs are through the roof for everyone; and
  • Many patients are not aware of their rights and responsibilities within their healthcare.

Many people settle for the care they get from their healthcare providers when they should not. If you ordered a cheeseburger and got a hamburger, wouldn’t you take it back? Do you use that same tactic in your healthcare? Maybe not. You’re not alone, most don’t.

Have you ever had an experience at a doctor or hospital that was uncomfortable or frustrating? Had errors on your bills? Left a doctor’s appointment feeling puzzled? Many experience this every day. I’m here to tell you that you don’t have to deal with poor treatment.

Advocacy is a patient-centered method that can address many of the ills of America’s healthcare delivery, spending waste and inefficiencies.

Being a social worker for 20 years in many areas of healthcare, I’ve seen plenty happen to people who were uninformed or didn’t know what to say, do, or ask. Many times, negative outcomes were preventable.

What is patient advocacy?

This means championing the cause of meeting a patient’s needs and desires during their healthcare journey. This could mean speaking with doctors on a patient’s behalf, facilitating communication between healthcare providers, supporting a patient’s end-of-life wishes, correcting an erroneous bill, helping with insurance claims and so many other things.

Advocates also have focuses such as billing, insurance claims and appeals, specific diseases (cancer, Alzheimer’s, stroke), or getting and keeping good care (like me). There are professionals such as hospital advocates, patient navigators and nurse navigators in healthcare facilities to assist patients with their needs while they are in the hospital.

If you hire a private advocate (one with no corporate/non-profit interests) and pay them directly, their job is to go to the mat for your best interests. If you want to know where the loyalty of any advocate is, find out where their paycheck comes from, and you will have your answer. It’s not always with the patient, unfortunately.

Insurance does not cover advocacy (so private advocates must be paid out-of-pocket), as the government has not regulated our profession. Anyone can say they are an advocate because of this, even my sixth-grader, no matter what their level of experience is. Make sure to check their education, skills and experience before hiring them. Ensure that they are the right fit for your specific needs.

In advocacy, intelligence is not a substitute for experience. Many very sharp people have called on my services because they didn’t know how to handle their healthcare situations, some after making matters worse. They alienated the healthcare providers or they were labeled as “troublemakers.” Communication shuts down between families and providers – which is an awful scenario that does not help the patient’s interests. Advocates can assist you in a situation such as this, and many others depending on their specialty.

Healthcare is a business and you are a consumer. Further, you are responsible for your own healthcare. Patients have to take care of themselves and yield to a provider’s orders, as they are the experts on healthcare. Yet, patients have the right to question any medication, test or procedure proposed to them. Patients must do their part to have good health, as they are the experts on themselves. One cannot drink and smoke heavily and expect a miracle cure for their body after abusing it.

Healthcare spending can decrease once patients learn to use the healthcare system correctly, and a good private advocate can show you how to do that while saving you time, money and frustration.

Not only individuals and families can benefit, but corporations and non-profits can save by enlisting an advocate’s services. It will show their employees (especially those that are caregivers or have chronic illnesses) that there is a more efficient way to experience healthcare treatment, and possibly solve problems which can increase productivity!

The benefits of hiring an advocate can be priceless. Let one assist you in handling the business of healthcare, while you concentrate on the most important role – being a patient.

Whole-Person Well-Being is the Goal!

Since starting my RN Patient Advocacy practice in 2010, the goal for my patient-clients is for holistic health, and whole-person well-being.  This always includes consideration for the mental, emotional, spiritual, environmental, social, and physical aspects of their lives.  I use holistic health assessment tools, and encourage my clients to use the self-assessment tool that I provide for them.
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How health and wellness transformed into well-being

Words matter. Over the past 60 years, we have changed the language describing our approach to health, wellness and well-being. At face value, this transition seems simple. We were first advised to seek “health” in the 1950s and then “wellness” in the ‘70s, ‘80s, and ‘90s. Now, we have moved on to “well-being.”

These terms evolved from the old notion of health as simply the absence of disease, to wellness as health and stress resilience. Ultimately, the term “well-being” now encompasses the broader social and environmental aspects of our lives.

It’s a nice story. But even in the late 1940s, the World Health Organization defined health as a state of complete physical, mental, and social well-being — not merely the absence of disease or infirmity. This includes various elements as peace, shelter, education, food, income, a stable eco-system, sustainable resources and social justice.

This sounds a lot like our modern definition of well-being.

As for the term “wellness,” Dr. Bill Hettler and the National Wellness Institute developed the idea of lifestyle dimensions in the 1970s, which had to be achieved in order to have true wellness. These dimensions included physical, emotional, spiritual, intellectual, environmental and social elements. Here and there, others tacked on other components such as relationship, finances or community.

See also: Uncertainty complicates addressing mental health issues

Again, like the term “health” before it, “wellness” was defined in the same very broad holistic way.

What’s odd about this chronology is how we keep re-writing history. For example, compare two quick internet searches: the difference between the terms health and wellness and the difference between the terms wellness and well-being.

Health and wellness are not synonyms. Health refers simply to a physical body being free from diseases, but wellness is an overall balance of your physical, social, spiritual, emotional, intellectual, environmental and occupational well-being.

Likewise, wellness and well-being are not the same thing. Well-being refers to a more holistic whole-of-life experience, whereas wellness refers just to physical health.

It’s like the film “Groundhog Day.” Health, wellness and well-being are all defined pretty much the same way. But every 30 years or so we trash the prior term as too limiting, adopt a new one that looks just like the old one and feel rejuvenated.
How can we make sense of this?

The changes that have occurred over time are actually meaningful. In the 1950s and 1960s, even though the definition of health was expansive and inclusive, the approach was nevertheless constrained. Companies weren’t concerned about how employees felt, just whether they were sick or not. In other words, there was a difference between the theoretical definition of health and its practical application.

This is likely the reason that practitioners wanted to broaden what they saw as an overly narrow approach. Because the definition did not square with what was actually being practiced, it seemed that there needed to be an entirely new framework to rejuvenate the tired and incomplete approach.

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So, new wellness wine was put into old bottles, and health became wellness.

The perception was that wellness was a new idea that broke from the past, moving beyond the idea that health represents just the absence of disease. This re-framing worked to popularize its more holistic aspects: the importance of stress, resiliency and better time management.

Today, the same transitional cycle is happening again as the new buzzword, well-being, takes the baton from wellness. Well-being is said to include the social, financial, and environmental elements that wellness lacked. But those who advocate turning from wellness to well-being make the same mistake as their predecessors did 40 years ago.

This kind of linguistic rebirth seems to be necessary to create a renewed sense of purpose and possibility. Yes, it’s self-delusional about its own history, but the new term nevertheless results in fresh elements added into the cultural conversation; that process has helped us to approach the original intent of “health” almost 70 years ago.

In the end, the answer to the original question about “semantics vs. substance” is that it is both, as language pushes the culture to realize the promise of its original nature. The semantics, in this case, help create substance.

#1 Soft Skill for Workplace Communication and Collaboration

Building empathy in the workplace is my number one goal when colleagues and I use improvisational theater tools in on-site, face-to-face workshops.  It’s not about performing or comedy; it’s about broadening the soft skills of emotional intelligence.  Developing verbal and non-verbal behavior, supporting our partners, and engaging in face-to-face conversation.  A solution for building empathy in communication and collaboration.

 

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The Science Behind What Really Drives Performance (It’s Going to Surprise You)

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Imagine you could have a skill where–in any given conversation with colleagues, clients, or subordinates–you could be keenly aware of, and even experience, their feelings and thoughts.

Sounds like some X-Men-like psychic superpower right? Well, what if I told you that anyone can have this uncanny ability and use its strength and charm to have successful conversations?

Well, you can. The superpower I refer to is called empathy.

But this skill–and it is a learned skill available to anyone–is often misunderstood because there are variations of it. I’ll get to the science of it shortly.

How Do You Define Empathy?

To better grasp what people mean when they talk about empathy, the most common uses for empathy fall in these categories:

1. The type of empathy where we directly feel what others feel.

2. The type of empathy where you imagine yourself in others’ shoes.

3. The type of empathy where you imagine the world, or a situation, from someone else’s point of view rather than your own.

4. The type of empathy that researchers sometimes call “mind reading.” It involves being good at reading others’ emotions and body language.

Where do you fit in?

The Research Behind This Superpower

If you’re skeptical that this is touchy-feely campfire nonsense with no business value in a transactional world, consider the research.

Global training giant Development Dimensions International (DDI) has studied leadership for 46 years. They believe that the essence of optimal leadership can be boiled down to having dozens of “fruitful conversations” with others, inside and outside your organization.

Expanding on this belief, they assessed over 15,000 leaders from more than 300 organizations across 20 industries and 18 countries to determine which conversational skills have the highest impact on overall performance.

The findings, published in their High Resolution Leadership report, are revealing. While skills such as “encouraging involvement of others” and “recognizing accomplishments” are important, empathy--yes, empathy–rose to the top as the most critical driver of overall performance.

Specifically, the ability to listen and respond with empathy (see graph below).

Ray Krznaric, author of Empathy: Why It Matters, and How to Get It, sums it up nicely:

Empathy in the modern workplace is not just about being able to see things from another perspective. It’s the cornerstone of teamwork, good innovative design, and smart leadership. It’s about helping others feel heard and understood.

This whole premise does have an air of genius about it, considering that when you take on the perspective of those you are talking with, it engages people on the spot. This can be a difference maker. That’s the good news.

The Bad News

The DDI report reveals a dire need for leaders with the skill of empathy. Only four out of 10 frontline leaders assessed in their massive study were proficient or strong on empathy.

Richard S. Wellins, senior vice president of DDI and one of the authors of the High-Resolution Leadership report, had this to say in a Forbes interview a year ago:

We feel [empathy] is in serious decline. More concerning, a study of college students by University of Michigan researchers showed a 34 percent to 48 percent decline in empathic skills over an eight-year period. These students are our future leaders!

We feel there are two reasons that account for this decline. Organizations have heaped more and more on the plates of leaders, forcing them to limit face-to-face conversations. Again, DDI research revealed that leaders spend more time managing than they do “interacting.” They wish they could double their time spent interacting with others. The second reason falls squarely on the shoulders of technology, especially mobile smart devices. These devices have become the de rigueur for human interactions. Sherry Turkle, in her book, Reclaiming Conversation, calls them “sips of conversations.”

Final Thoughts

Keep in mind that empathy shows up in different ways, as I mentioned at the beginning. It’s not just “feeling.” Think how it can translate to both verbal and non-verbal behavior so the person hearing you will feel your empathic nature. And, it goes without saying, people see right through you if your empathy is not expressed in a sincere and authentic way.

Don’t underestimate for a second its true potential. Begin developing leaders to learn this relational skill for competitive advantage.

Your ability to empathize, as a leader, will make a difference in the performance of others. And it is critical to good teamwork.

Resilience and Self-Care

Resilience isn’t just for dealing with the tough times.  We can learn and build new ways of facing personal and professional challenges.  Consider these strategies…
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How to Build a Stronger Work Life: Reconsider Resilience

Dr. Marla Gottschalk

I’ve often wondered why building resilience isn’t a key business imperative. Because being human, is often at odds with work life. Our work can routinely bring stress, negativity, setbacks and outright failures — and we are challenged to employ strategies to combat the effects.

We often frame our conversations about resilience with stories of extreme hardship or extenuating circumstances. However, resilience could serve as an ever-present, daily mentor — helping us to rebound from the collected pressures of work life. Most of us forge on, taking little note of the collected toll.

This can be a serious mistake.

Through all of the trials and tribulations, we rarely notice that our psychological resources are waning.We muddle on. We develop idiosyncratic mechanisms to bolster our mood and maintain motivation. However, the damage can accumulate and we become less able to bounce back. Months later, we may realize that we still lament the project that has been cut, laid off co-workers or failing to land an important client contract and our energy levels are affected. When the next event unfolds, we find ourselves essentially bankrupt. Devoid of the necessary resources to meet the challenge.

There have been a number of discussions on the topic, including protecting ourselves from overload, banking positive currency and practicing self-compassion. However, what if we could take resilience one step further? Could we effectively build our skills (and our team’s skills) in this area — just as we challenge our muscles in the gym?

Can we learn to think and act more “resiliently”?

Well — yes. There is evidence that resilience can be learned. The work of Dr. FredLuthens (who explores the construct of Psychological Capital) has completed research examining this area which could be fostered by organizations and shared with their employees. Supporting research completed completed by Ann Masten also provides foundational elements. This includes addressing 1) asset factors (elements that enhance our resilience, such as a stable home life or a healthy way to examine failure), 2) lowering risk factors (for example, a lack of a mentor) and 3) altering our perceptions concerning the potential to influence work life circumstances.

Here are a just few ways to apply this knowledge to our daily lives:

  • Facilitate network building. Building long-term asset factors, provides a stable foundation to help us deal with stressful work situations when they do arise. Consider losing a job for example; stronger networks can help employees move on more effectively by providing access to critical information concerning roles and growth needs.
  • Clarify strategy and goals. Reducing risk factors — elements which weaken our psychological safety net, is also vital. For example, knowing “why” we are completing a task and how our role contributes to outcomes is critical. If we fail to believe that our actions have meaning, we are less likely to forge on.
  • Utilize the “staunch reality” viewpoint. One scenario that quickly depletes psychological resources, is sticking to a game plan that is simply not working. Understanding that we have the ability to influence outcomes by embracing realistic assessments of workplace situations — can help us to prepare. This honest view is necessary to review history, properly identify setbacks, evaluate potential impact and brainstorm possible responses before they occur.
  • Aggressively focus on strengths as a “vaccine”. We can mitigate the negative after effects of stressful events, with a focus on positive elements. This includes the identification and utilization of an individual’s stronger vs. weaker skill sets. A focus on the latter, can quickly deplete our psychological reserves.
  • Explore the sources of “drain”. The elements that drain our psychological reserves can be varied (and often surprising). Consider the sources that affect you and meet with your team to determine where the leaks are occurring. Brainstorm actions to stem the tide.

How do you build (and protect) resilience for yourself or your team? Share your strategies.

Employee Engagement Also Applies to Employer Engagement

Too often I’ve seen executives not engaging in the “soft skills” of leadership, and missing the importance of leading by example.  They expect company managers to “know” how to do what they’re being directed to do.  How is your company helping to build leadership?

 

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3 must-do strategies for executive leaders to permanently improve employee engagement

Vicki Hess

Every executive leader in healthcare has a vested interest in improving employee engagement – whether he or she acknowledges it or not.

Unfortunately, many senior leaders think HR should manage engagement or they are looking for a magic formula when it comes to sustained improvement. Of course one doesn’t exist.

First, the problem. Here’s what I typically hear in my conversations with hospitals and health systems across the country. Employee engagement survey results come in and senior leaders talk about how important engagement is with their manager group. They share their desire for front line leaders to create department level action plans to transform engagement.

The action plans are created and quite often recorded in online monitoring systems for “accountability”. Most leaders – at all levels – understand that engagement is a key lever for productivity, creativity, safety and patient satisfaction so these actions make sense. Too often, the actions center around what the organization and leader need to do to impact engagement and they leave off the personal responsibility of the employees – but that’s another article.

For a month or two, there’s a focus on improving engagement. Then a new priority comes along and the front line leader’s attention is drawn to a new concern. The front line leader’s “one-up” manager stops asking about engagement. It moves to the back burner and all of the sudden it’s 9 months later and time for a new survey and whole cycle starts again.

If you want to stop this vicious cycle, try these 3 strategies.

Have an Engagement Champion at the executive level
Ideally, everyone on the senior leadership team would feel completely committed to engagement, but I know that’s not always going to happen. To quote Peter Drucker, “Whenever anything is being accomplished, it is being done, I have learned, by a monomaniac with a mission.” This doesn’t mean that some leaders can let engagement slide off their dashboards; it does mean that you need a champion.

Who is yours? Who on your senior leadership team feels most passionately about employee engagement and is willing to lead a consistent, well thought out campaign to keep engagement on the front burner? Without this level of commitment, engagement might improve in some departments but won’t improve overall. Ideally, the president or CEO is driving the conversations and actions over time. Having a senior level person championing engagement makes a strategic difference.

Provide tools for improvement that are distributed on a regular basis
When a system or process improves it’s usually because of a consistent focus with tools to back it up over time…think Lean Daily Management or traditional Performance Improvement practices. Because employee engagement is often seen as a “soft skill” with hard to measure results, it’s easy to fall into the trap of thinking that leaders will just know what to do.

In my work with clients, I have found the opposite of this to be true. Front line leaders are hungry for high impact, easy to implement ideas and tools to use. From one-on-one meeting agendas to rounding questions to team meeting ideas, many leaders struggle to know what to say and do. Having a working process to “drip” tools and strategies over time makes a difference. How are you providing consistent, realistic tools for your front line leaders to positively impact engagement?

Build in an accountability system starting with executive leaders
Traditional engagement action plans place the accountability on the front line leader. In many nursing settings, these leaders have upwards of 50 direct reports and many other priorities. How do you keep the accountability alive for engagement?

One idea goes back to involvement from the executive leadership team. When senior leaders are interested in the engagement level of their direct reports, they show a level of concern that models what directors and managers should offer to the supervisors who report to them, etc. Think about this. If you are a front line manager and your boss never asks about your own level of engagement, how important are you going to think it is?

Having a system with routine reminders including prompted questions for senior leaders helps to keep the focus present over time. Your Engagement Champion can also make sure that engagement shows up on meeting agendas and strategic planning conversations.

What Now?
In our world of healthcare, uncertain times lie ahead. Uncertainty breeds disengagement when unchecked. Disengagement leads to turnover which leads to time and money spent on re-hiring…and the cycle continues. A revolving door of staff leads to patient dissatisfaction which leads to poor financial performance. None of it is what you want.

The only way to deliver on the promises you are making to your customers & stakeholders is to continually provide an environment where employees are engaged. Now is the time for your senior leadership team to adopt these 3 must do strategies so you can improve engagement for good.

Vicki Hess, RN, is your go-to resource for transforming employee engagement at the individual, department or organization-wide level. As the author of four books, creator of the Engagement Excelerator Virtual Coaching Program, Certified Speaking Professional (CSP), trainer and consultant; Vicki inspires healthcare leaders to take action in a real-world, relatable way. Organizations that implement Vicki’s ideas experience increased engagement, productivity, safety, quality, retention, patient satisfaction, creativity and more. Access free tools and resources when you visit www.EngagementExcelerator.com.

Improv Skills to Boost Workplace Communication, Teamwork and Resiliency

“…improvisers are taught that confidence, agreement, attentive listening and authenticity are the backbone of a solid performance.” Medical Improv is one of the featured areas at Duke University.  It’s not about comedy or stage performance, but it’s a heck of a lot of fun for employees to engage and learn more about communication and collaboration.

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Taking Improv from the Stage to the Workplace

April Dudash

At improvisational comedy theaters such as Chicago’s The Second City and The iO Theater, improvisers are taught that confidence, agreement, attentive listening and authenticity are the backbone of a solid performance.

These same skills can be practiced in the workplace.

As Fortune 500 companies and universities use improvisation for professional development, some Duke units are providing improv workshops to teach adaptability during conversations and how to establish trust, teamwork and listening skills among colleagues.

“Improv gives you the ability to adapt and embrace change,” said Bob Kulhan, an improviser and adjunct professor at Duke’s Fuqua School of Business who teaches a “Business Improvisation” class. “The benefit of it can be absolutely tremendous in your life, personally and professionally.”

Here are improv tips to strengthen conversations:

Specifics are best

In improv, performers act out scenes on the spot without a script. The audience can provide a word or phrase for inspiration and then the performers provide strong details to each other and work together to create a scene.

In the workplace, sharing details can move a project forward or clarify expectations.

Dan Sipp, an improviser and standardized patient trainer at Duke, leads an improv workshop for the School of Medicine. He said sharing specifics, especially while talking with patients, could help bring issues into sharp focus.

“Specifics help us connect with a person and help us connect with a story,” Sipp said. “When you’re not specific, you cause people to make assumptions.”

Be accepting of new ideas

Considered the main mantra of improv, “Yes, and…” is always on improvisers’ minds during a performance.

On stage, “Yes, and…” means unconditionally accepting information presented by a scene partner and adding useful information, said Kulhan, the Fuqua adjunct professor. If a performer says, “I need to take my dog to the vet,” her scene partner could respond with, “Yes, and I will drive us there in my Subaru.” “Yes, and…” moves the intent and action forward.

In the workplace, “Yes, and…” means keeping an open mind during conversations and considering all presented ideas.

“’Yes, and…’ is a bridge to thoughtfulness and connection and empathy and engagement,” Kulhan said.

Be resilient in the face of ‘No’

In improv, a performer must present information on the fly to flesh out a scene, and scene partners accept ideas to move a performance forward.