Friday, May 15, 2015

The Ripple Effect of a Service Failure

It doesn't happen often, but when it does it's not good. Service failures can come from any discipline: physician, nurse, social worker, Chaplain, volunteer specialist, bereavement counselor,CNA,team manager, et al. When a service failure occurs, you can bet the world that there will future losses of referrals as a result. People talk and when there is a hospice service failure they really talk. Let's face it, hospice is a fairly new industry and one that has its detractors. There are myths about hospice care and when a service failure occurs the mythology takes on a sense of reality. Let's look at how the hospice professional can prevent service failures. I recognize that in some cases no matter how perfect the hospice performed there are some persons that will find something wrong. I get that. In this article I am not addressing those folks. The effective working of hospice is especially dependent upon thorough training. Training not just in one's particular area of work, but also, in people skills. It is not too far a statement to suggest that most all hospice professionals are skilled. It is incorrect to state that each professional has mastered people skills. As I review the training opportunities presented in the hospice industry, the focus is mainly on medical or specialty disciplines. Rarely, is the topic of people skills addressed. However, excellent people skills are fundamental when dealing with a patient who has just received the terminal diagnosis or who has just been told that there is nothing more a physician can do. Beyond that, there are challenging family dynamics the hospice professional must navigate. It's one thing to know how to painlessly insert a foley catheter or how to bathe a patient with dementia or how to use the documentation template for spiritual care clinical notes, but it's a totally different matter to know how to build trust and maintain a healthy relationship with the patient and caregivers. I advocate for more practical training dealing with people skills. Here are several EASY principles to keep the patient/caregiver relationships healthy and happy. 1. Follow through. Do what you said you were going to do and follow up to see that it was done. For instance, recently I served a patient in a hospice house who requested a faith leader to provide rituals for him. I made the appropriate referral to the faith leader who stated he would visit later in the day or the next morning. Experience has suggested that with that large window of time, it is best to follow up. I did follow up the next morning by asking the family if the rituals were performed. They affirmed the faith leader came and the patient was extremely happy and blessed. This good experience plus the excellent care provided this patient will make for a very good relationship, and, might I add, a very good Family Satisfaction Survey. 2. Leave your pain at the door. Hospice professionals are people. People have problems as part of the human experience. Therefore, on certain days hospice professionals are less than 100% because of issues they are facing. It takes maturity, discipline, and determination but it is absolutely necessary that the hospice professional leave his/her pain in the car or at the door before encountering a patient. It is fundamentally inappropriate to discuss personal problems with a patient or caregiver. They are facing enough without being a sounding board or counselor to the very ones supposed to be providing care. Stay in the moment. Focus on the task at hand. Give the patient and caregivers all you have in spite of all you are facing. 3. Watch your language. Remember, the people you are serving are on edge. They are going to be more sensitive and aware of what professionals are saying to them. Never, ever, say, "I am here to see the man/woman who is not long for this world", or "I know how you feel", or "You're like every patient who wants to go the unit". There are so many really insensitive or hurtful statements that it is imperative that hospice professionals guard their language. This is enough to get you thinking. Think of ways you can improve your people skills. Talk to your Manager about training you think would be helpful to the IDT. Bless you, Chaplains, you carry a great deal of expectations. Do your best. I have confidence in you.

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