1. Exploring Learning Experiences that Promote Safe Care, Patient Satisfaction, & Rewarding Careers With Beth Boynton, RN, MS Organizational Development Consultant & Author 2013 B. Boynton, S. Frederick, & J. White #medimprov08

2. Sponsored by The Infusion Group with Judy White, SPHR, GPHR, HCS Presented by Beth Boynton, RN, MS Lauren Dowden, MSW Candidate Stephanie Draus, ND Ed Dunn, MD Co-presented by Stephanie Frederick, M.Ed, RN Dan Sipp, SP Nancy Smithner, PhD Richard Snyder, MD Tobias Squire-Roper, BFA With #medimprov08 3. Medical Improv #medimprov08 An innovative bridge 4. From many challenges we face Errors, adverse, and/or sentinel events Patient complaints Workplace violence Resistance to change Substance abuse #medimprov08 5. and Wasted resources Staff turnover, burnout, stress Toxic cultures Readmissions Spiraling costs #medimprov08 6. To solutions we seek: 1 Safe, quality care 1 Healthy staff & organizations 1 Patient satisfaction #medimprov08 7. How does Medical Improv do all this? #medimprov08 8. By building the soft skills we need 1 Communicate 2 Collaborate 3 Lead #medimprov08 9. Overview Introductions: Meet our Expert Panel Compelling evidence for building soft skills. Medical Improv Classroom: teaching strategies, principles, and games. How can you begin to pilot Medical Improv in your healthcare setting? Q & A #medimprov08 10. Our Expert Panel Who are you? What inspired you to join us today? How are you or will you be using Medical Improv in healthcare? (About 2 minutes each! ) #medimprov08 11. Lauren Dowden, MSW Candidate Stephanie Draus, ND Edward J. Dunn, MD Dan Sipp, SP Nancy Smithner, PhD Richard Snyder, MD Tobias Squier-Roper, BFA #mediprov08 12. What are soft skills? #medimprov08 Communication Emotional intelligence Interpersonal/relationships 13. How are problems with soft skills contributing to problems with safety and quality? #medimprov08 14. Progress with patient safety has been slow! In 1999. Institute of Medicine (IOM) Report -To Err is Human: Building a Safer Health System Estimated 44,000-98,000 deaths every year due to medical errors #medimprov08 15. Health Affairs April 2011 187,000 deaths in hospitals per year Preventable medical errors are ten times more frequent than hospitals and regulators are reporting. Estimated cost of 17.1 Billion in 2008 #medimprov08 16. Soft Skills #medimprov08 17. The Joint Commission tracks root causes of sentinel events. What do you think the top 3 causes of these preventable and catastrophic errors were in 2010, 2011, 2012? #medimprov08 18. Leadership Human Factors Communication http://www.jointcommission.org/assets/1/18/Root_Causes _Event_Type_04_4Q2012.pdf #medimprov08 19. Each cause or category has subcategories that are filled with implications involving soft skills 20. Category: Leadership Subcategories: Organizational planning, organizational culture, community relations, service availability, priority setting, resource allocation, complaint resolution, leadership collaboration, standardization (e.g., clinical practice guidelines), directing department/services, integration of services, inadequate policies and procedures, noncompliance with policies and procedures, performance improvement, medical staff organization, nursing leadership 21. Priority setting requires Self awareness Awareness of others Being assertive Being a respectful listener 22. How are problems with soft skills contributing to concerns with our workforce and work cultures? #medimprov08 23. Workforce & Culture Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Healthcare- Lucian Leape Institute-NPSF Roundtable Report (2013)- http://bit.ly/104KSE4 #medimprov08 24. Physical Harm Health care workforce injuries are 30 times higher than other industries. I need help giving this patient a boost in bed #medimprov08 25. Psychological Harm Lack of respect A root cause, if not THE root cause, of dysfunctional Cultures 95% of nurses report it; 100% of medical students; huge issue for patients #medimprov08 A nurse waits a little too long to report a patients increasing blood pressure to a physician. The last time she tried to talk with him about a concern, he was abusive. 26. Is bullying a problem in healthcare? #medimprov08 27. Alan Rosenstein, MD, MBA Medical Director of Clinical Efficiency & Care Management at ValleyCare Hospital www.physiciandisruptivebehavior.com No one starts out the day planning to be disruptive. We must recognize the emotional impact and downstream effect of inappropriate behaviors and explore experiential learning methods, like medical improv that build the necessary skill sets for positive change. #medimprov08 28. How are problems with soft skills contributing to problems with Patient Experience? (Presented by: Stephanie Frederick, M.Ed., RN) #medimprov08 29. We all have an equal opportunity to be recipients of hospital care What would YOU want your Patient Experience to be like? #medimprov08 30. Defining Patient Experience: The sum of all interactions, shaped by an organizations culture, that influence patient perceptions across the continuum of care. -The Beryl Institute #medimprov08 31. COMMUNICATION is the key Patients observing hospital administration/staff: Interactions (content, tone, manner of whats said) Culture (is it supportive?, safe?, respectful?) Patients and family members want to: Feel listened to,understandinformation and options, be encouraged, engaged, and empowered in their care #medimprov08 32. Medical ImprovBuilds Soft Skills for Communication Collaboration Leadership To support the sum of all interactions (the Patient Experience) #medimprov08 33. Patient Experience Will you tell about how well you were treated, or what was done to you while a patient in the hospital? #medimprov08 34. What does a Medical Improv class look like? #medimprov08 35. Teaching Strategies Frame with objectives & brainstorming Principles of Medical Improv Games & activities Debrief, reflection, action plan Notes: Variables: time, audience, skill focus, complexity Expertise in healthcare AND improv #medimprov08 36. Principles of Medical Improv Yes and Affirm and add (dont negate) Surrender your plan & co-create See failure as opportunity (to learn, be human, forgive, help) Listen-be present Avoid questions You have everything you need! Support each other #medimprov08 37. Games & Activities (100s more) Yes and, Yes but, No Teaching/learning: Assertiveness, listening, collaboration, validation/inval idation & reinforces medical improv principle: Yes and... Status Slide, One-Up-Man-Ship Teaching/learning: Status-related verbal & nonverbal communication, body language, comfort level, self and other awareness, leadership skills, and therapeutic relationships. #medimprov08 38. Like practicing a team sport, Medical Improv elevates each players ability to communicate, collaborate, and lead. So when the game starts, individuals and teams are performing at their best. #medimprov08 39. Unpredictable and fluid, the human interactive aspects of healthcare interventions can emerge in the moment with a positive dynamic that has already been established. #medimprov08 40. How can you begin to pilot Medical Improv programs? Beth Boynton Stephanie Frederick #medimprov08 41. "Creative Solutions for Integrating Healthcare" (Stephanie Frederick, M.Ed., RN) Collaborationacross all disciplines of healthcare (conventional, traditional, complementary) Medical Improv training coordination to facilitate communication, quality and safety of care in the U.S. Consultant/Advocatefor engaging and empowering the Patient Experience Program and Curriculum Development for healthcare organizations and higher education in the U.S. Contact: stephaniefrederick@outlook.com Website: stephaniefrederick.com #medimprov08 42. Beth Boynton, RN, MS Consulting Medical Improv workshops Integrating with Whole Systems consulting work Hospital-based Programs (pilot projects) Undergraduate curriculum development for of ALL healthcare & related studies Promote/develop train-the-trainer programs (Professor Katie Watson, Dr. Belinda Fu are planning next one-fall 2014) #medimprov08 43. Q & A Working Definition: Medical Improv is the study and practice of improv theater philosophy and techniques as applied to the unique challenges and environment of healthcare for the benefit of improved health and well being of providers and patients. --Professor Katie Watson, JD Northwestern University & Belinda Fu, MD, University of Washington #medimprov08 44. Lauren Dowden laurendowden@ gmail.com Stephanie Draus sdraus@nuhs.edu Edward J. Dunn edwdun@gmail.com Dan Sipp dsipp@nc.rr.com Nancy Smithner ns23@nyu.edu Richard Snyder richardsnyder@me.com Tobias Squier-Roper tobysr@gmail.com #medimprov08 45. THANK YOU! Beth Boynton confidentvoices.com Beth@bethboynton.com Stephanie Frederick stephaniefrederick.com Stephaniefrederick@outlook.com Judy White theinfusiongroupllc.com Judy@theinfusiongroup.com #medimprov08