Furthering relationship centered care with compassion and tool

Some years ago I was meeting with Mary Smith, a case manager, who was renowned for her empathy, compassion and ability to establish trust with her patients and their families.

At that time, she relayed the following story to me …

“Knock. Knock.”

She knocks on her patient’s hospital room door.

“Yes.”

“My name is Mary Smith and I am a hospital case manager. Is it okay if I come in?”

“Oh, yes. Please come in.”

“It is so very nice to meet you today, Mr. Petry.”

  • A smile.
  • Eye contact.

“And you are?”

“I am Jimmy’s wife, Ellen.”

“Very nice to meet you too, Ellen.”

  • Mary knocking prior to entering Mr. and Mrs. Petry’s room was a terrific initiation of their connection as it highlighted the fact that she respected them and their space; and she values each of them as human beings.
  • Introducing herself served to further the connection.

Mary went on to establish a rapport with her patient. By scanning the room, she realized that Mr. Petry was a dog lover, and Mary also loving animals was then able to make that connection prior to turning to Mrs. Petry and learning more about her story as well.

“As a case manager I am here to help you. I am here to …”

  • Sharing the WHY of the visit.
  • Decreasing the stress of her patient and his wife.

“Your physician, Dr. Jones, is absolutely terrific and so well regarded in this community. And I see your nurse today is Lisa, she is also amazing. She cared for my mother last year and to this day my mom talks about ‘her wonderful nurse, Lisa’”.

  • Managing up Mr. Petry’s doctor and nurse.
  • Instilling confidence in his care team.
  • Lessoning Mr. and Mrs. Petry’s anxiety.

“It is important to your entire care team that you are well-positioned upon discharge from this facility for continued healing and safety. And I am here to partner with you both and ensure we have a plan in place that best meets your needs and preferences.”

Mary relayed to me at this point in the story how when the Petry’s heard that she was there to help, both Mr. and Mrs. Petry lowered their shoulders a bit, exhaled, and leaned in further.

“May I pull over a chair and sit with you as we talk?”

  • Again showing respect for their space as well as now, with their permission, positioning herself in closer proximity and at the same level.

“Our discussion today should take about fifteen minutes. Is that okay with you?”

  • Setting an expectation while respecting her patient and family’s time.

“I have been a case manager here for over twenty years. And have partnered with many hundreds of patients and families to ensure they are well cared for even after they leave this hospital.

  • Establishing credibility.
  • Continuing to lesson anxiety.

“How are you feeling today, Mr. Petry?”

Mary was well known for having a wonderful way of pausing, connecting, and creating a calming and safe space to truly listen for understanding.

“And you Ellen. How are you doing? How can I and your care team be of service to you too?”

  • Continuing to engage both patient and family member.
  • Care collaboration.
  • Partnership.

And over the next ten minutes Mary balanced appreciative inquiry, listening, explaining, and ensuring mutual understanding and agreement. And together with the Petry’s they co-created a care pathway to best position Mr. Petry to achieve his healing goals.

  • Shared decision-making.
  • Trust.

“What additional questions do you have for me?”

  • A pause.
  • Holding space.

“My husband’s brother passed away two days ago.”

  • Another pause.

“I am so sorry.”

  • A caring touch on the knee.

“With this additional information, how can I be most helpful to you?”

  • Space held for further and deeper sharing.

“I need to be at my brother’s funeral. I must.”

  • Mary’s open heart, open mind, and servant leader perspective.
  • A revised game plan is established … together.

“Thank you, Mary.”

“You are most welcome. How else can I be helpful?”

  • Another pause.
  • Sacred space held for additional sharing.
  • Calm.

“Mary, can I hug you?”

“Of course, Ellen. Of course.”

  • A hug.
  • Peace.

“Me and your entire care team are here for you.”

“Thank you, Mary. Thank you.”

“Thank you for allowing me to share this journey with you.”

  • Gratitude.

Looking back, I now realize Mary was in fact using the principles of the Studer Group communication framework AIDET® to connect with her patients and families, establish relationship and trust, and best meet their needs.

AIDET is an acronym that stands for Acknowledge, Introduce, Duration, Explanation, and Thank You.

AIDET …

  1. Improves patient and family perception of their care and the service they receive (patient experience)
  2. Helps reduce their anxiety while increasing connection and adherence to care plans (and thus improves outcomes)
  3. Positions clinicians (physicians, nurses, others) to consistently deliver compassionate, empathetic care with gratitude
  4. And builds trust between clinicians and their patients and families

AIDET is a wonderful tool.

  • A tool that creates a framework in which to connect at both a head and heart level.
  • A tool that helps to position caring doctors and nurses and others to create and hold a safe space for authentic human connection and relationship.
  • A tool that reminds a clinician of key areas of sharing that evidence shows best positions patients for optimal outcomes.
  • A tool that enhances the trust between clinicians and the patients and families they serve.

AIDET® is a tool that doesn’t replace compassionate, trusting, relationship centered care … rather it provides a framework to further it.

Thank you, Mary, for the reminder. But even more so, thank you for all you do each day in service to your patients and their families.

 

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