caring out loud®What’s the best way to reduce patient complaints? First, it’s important to understand what patients are complaining about related to their care experience.

A 2016 study published in the Journal of Medical Practice Management on patient complaints found that about 4% of complaints were directly related to their medical treatment. But the remaining 96% were related to poor communication between care team members and patients.

When we talk about improving the patient experience, we need to flip the lens and consider the entire care experience from the patient perspective. In other words, we need to see, hear, smell and taste things through the patients’ eyes. We must move past being patient-centered and become patient-driven.

Our Proven Technique: Caring Out Loud®

Have you ever been to Panera Bread or a similar cafe where they have a self-service coffee station? If you have, you may have wondered about the freshness of the coffee. Was it freshly made or has it been sitting there for a few hours? In most cafes, it’s anyone’s guess. But the folks at Panera do something a little different. What they do is so simple and easy that their customers don’t have to guess about when the coffee was made because they know. So what’s their solution? Right next to the coffee pot is a little sign with a message that reads: Coffee freshly brewed at 7:15 this morning. It’s usually written on a chalkboard or a whiteboard so it can be easily updated with each new pot of coffee.

This little sign is a great example of something my team and I call Caring Out Loud® – this is the process by which we proactively anticipate needs by communicating clearly (verbally or nonverbally) with others in a way that reduces any worry, uncertainty, or doubt.

When we think about the Patient Experience journey, the Caring Out Loud® technique is one that we can easily apply in healthcare.

Patients say they no longer want to be treated as a one-way conversation. When we do our job tasks without explaining it first — whether it’s administering clinical care or conducting everyday business processes — patients may feel like they “are being processed.” They don’t want to feel like a transaction, they want to be included in the conversation of their care (at their level).

Narrating what you are doing, while you’re doing it — Caring Out Loud® — is a key factor in reducing apprehension, stress, and fear and making the patient feel cared for.
Consider what patients are feeling when they go to receive care: anxiety … nervousness … stress.

We all know Florence Nightingale’s quote: “Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any physical exertion.”

One of the ways care team members on the clinical and non-clinical sides of the Patient Experience can work to eliminate some of that apprehension, uncertainty, and fear is by proactively anticipating patient and family members needs. We do this by narrating the process of care or, Caring Out Loud®

Caring Out Loud® or narrating the process of care can accomplish three things:
1. Answer a question
2. Anticipate a need
3. Calm and reassure an anxious patient

What Caring Out Loud® Looks Like In The Real World

Here’s what Caring Out Loud® looks like in a real-world situation:

Consider a blood draw. This actually happened to my wife and daughter recently. Our daughter, who is petrified of needles, needed a routine blood draw. When they arrived at the lab, my wife filled out the paperwork and they waited for the nurse to come draw the blood. My daughter was growing increasingly anxious. My wife tried to calm her and explained that the doctor needed the blood samples and that, yes, it would hurt for just a moment but she would be right there to comfort her, hold her hand, etc. She did all the things that good moms do.

When the nurse came in it was quickly apparent that they were just the next blood draw on the long list of patients that day. With a muffled greeting and an abrupt confirmation of name and date of birth, the nurse quickly prepped my daughter’s arm with a cotton swab. She took the needle and to my daughter’s horror, tried to make the stick as quickly as possible. My daughter’s anxiety and nervousness caused her to flinch a little when she saw this giant needle headed her way. And as anyone in healthcare knows, when you’re stressed, your muscles tense up which makes your blood vessels constrict, which makes it harder to get the needle stick in the vein on the first or even second try. As a result, the patient gets poked multiple times. No one is happy – especially a frightened nine-year-old patient.

The nurse left for a moment saying she’d be back in a little while to try again. But my wife wasn’t having any more. She asked the front reception if it was possible for another nurse to take our daughter’s blood.

Within minutes, another nurse entered the room. He was smiling and he introduced himself to my daughter first and then to my wife. He made small talk with my daughter, asking her about school and her favorite music and then he said, “I know needles can be scary, but your doctor asked us to get a little blood from your arm this morning. It will hurt a little bit at first, but not for long. And you can stay seated on your mom’s lap if you’d like.”

Now that he’d made a connection with her, she began to relax. He began to do the blood draw while narrating the process of care as he did his job. He said, “OK, here’s what I’m going to do. I’m going to take a cotton ball with a little bit of alcohol on it – it will feel a little cold on your skin … and I’m going to clean the spot on your arm where the needle will go.…next I’m going to find the vein and insert the needle…but before I do, why don’t you look at your mom … she’ll hold you still so we’ll get it right on the first try, okay? Are you ready?” My daughter shook her head yes. She had relaxed enough that he was able to get the vials of blood he needed on the first try.

Caring Out Loud® or narrating care as it happens, is one of the most effective ways to make a human connection with patients. And it’s not limited to the clinical team; the same is true for non-clinical team members such as housekeeping staff, billing, dietary, environmental services, valet parking, security, and more. Because in the absence of communication, uncertainty, fear, and anxiety take over and the rumor mill fills the void.

We need to apply the same level of rigor and excellence to service quality as we already do for clinical quality. And one of the best ways to do that is by Caring Out Loud®.