Improve Patient Experience in Two Sentences

Making a personal connection with a patient doesn't take much time, technology, or investment, but it can pay off big when it comes to improving patient outcomes and satisfaction.

Barbara Jacobs, RN, MSN, would like you to know she has the two cutest grandchildren in the United States.

"It's a fact," the CNO at Anne Arundel Medical Center in Annapolis, MD, told me. "Other people think they do, but I actually do. I actually have them."

Her adoration for these two little boys is not exactly a well-kept secret. 

"Everyone here has heard about my grandchildren," she laughs.

Why, you may wonder, should we as healthcare providers care about her love for these little guys? Well, because she does.

"If I say that to a caregiver and then another caregiver comes in and says, 'Hey, Mrs. Jacobs, I hear you have two cutest grandkids in the United States,' they've completely transformed our relationship with just that sentence," she told me, "because [they] have made what's important to me, something that they recognize and made me seem like a person."

Jacobs is a huge proponent of these types of encounters and is working to promote the development of what she calls "personal connections" between the staff and patients at Anne Arundel. 

Putting the Care Back in Healthcare
Jacobs' interest in fostering personal connections began about five or six years ago, when she noticed the practice of interacting with the patient as a person was starting to get lost amid hectic days and technology.

"We were getting everything into the computers and getting so technologically savvy and had volumes of information on a patient, but we were missing the human side of their care," she says. "If you look at people who went into nursing, what helps us feel good about ourselves is helping other people. We want to do that, but sometimes [because of] the distractions of busy days and all of the multitasking that people do, we lose track of the caring part that makes that patient feel cared for."

So Jacobs, who has been at Anne Arundel since September 2015, has been working with staff to help develop personal connections without making it into another time-consuming thing on an already overflowing to-do list.

"We've talked a lot about how it's important to go into a room and pick something you can connect on," she explains. "If they're knitting, talk to them about their knitting. If their husband sits at the bedside all day long, say that they're lucky that their husband sits at the bedside all day long."

Jacobs is not alone in recognizing the importance of seeing patients as a whole people and not just the hip-fracture in room 315. In its report, "Crossing the Quality Chasm"—issued all the way back in 2001—the Institute of Medicine cited patient-centered care, which it defines as "care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions," as one of six aims for improving the healthcare system.

And in a 2011 article in The International Journal of Person Centered Medicine, a review of outcome studies found that "compassionate care benefits patients with regard to elected treatment adherence, wound healing, satisfaction and well-being."  

"It makes sense that if you feel like your caregiver cares about you, you're going to be more compliant with what they recommend," Jacobs says. "And little things like my lunch is not exactly what I wanted or I have to wait for my test, I'm probably not worried about any longer because you've recognized that I'm a person that has a life outside of this sick experience."

Make the Connection
Part of what I like so much about Jacob's initiative is its simplicity. As she points out, it's really only "adding a sentence or two to your conversation." She says the majority of nurses have embraced the idea but, interestingly, there was one cohort of nurses who found the concept challenging.

"The group that had the biggest problem, and these were bright, lovely people, were in the Millennial group," she says. "They struggled more on making these personal connections."
Jacobs says this could be because their generation is so used to communicating via electronic tools rather than face-to-face.

"And so now we say to them, 'Here's your five patients, three of them are 87, and think of a personal connection,'" Jacobs says. "And they would very honestly come out and say, 'I don't know how to do this.' "

Rather than lamenting about Gen Y's social skills, Jacobs saw the value in teaching this group of providers how to feel more comfortable making personal connections. "It made me realize that we had to work specifically on training, on helping them learn how to do this task that, in the end, is positive for them, too," she says.

And she has seen success. She received an email from a nurse who said she thinks she's got this down. The nurse noticed a father in the mother-baby unit watching a football game and she asked him if he liked football. He shared that he had played in college and high school, and in particular, loved his high school team. As they continued to talk, they discovered the nurse's grandfather had been his high school football coach.

"It made all the difference and not just for that patient and family, who feel like they're being cared about as people," Jacobs says. It was also good for the patient's nurse who could, Jacobs says, "go home feeling great and call her grandpa. It's good for us, the caregivers, also."