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AIDET TRAINING Presented by Organizational Development & Education The Office of Patient Experience
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AIDETTRAINING
Presented by Organizational Development & Education
The Office of Patient Experience
Presenter
Presentation Notes
Welcome to AIDET Training. My name is LaVay Lauter, and I am the Director, Learning and Development, for KentuckyOne Health. I have been a trainer for 25 years, and with KentuckyOne Health three and a half years. (insert your own name and job title and give an AIDET introduction)
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This video, from the movie WIT, is about a renowned professor who is forced to reassess her life, when she is diagnosed with terminal ovarian cancer. This scene is of Emma Thompson, being taken for a CT scan. The video and the movie, show how a patient feels when there is a lack of communication, care and compassion. When there is a lack of focus and attention on “the patient experience”. Watch the video and think about why the patient, Emma Thompson, is “talking to the camera”.
“Being in the hospital is as close as most people get to being in jail and losing all control over their lives”
Susan Edgman-LevitanInstructor, Harvard Medical School
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Let’s have a volunteer read this quote. (read the quote) You may say, “patients don’t feel this way in our hospital, but they do. Think about your options on a Friday night. For fun, would you rather go to Outback Steakhouse and have “all you can eat steak and shrimp”, the movie theater to watch your favorite movie, or the Emergency Room to have a variety of diagnostic tests done after waiting several hours? Being in the hospital, “feels like” being in jail. That is the experience we want to overcome at KentuckyOne.
AIDET What Is It?
A tool to reduce the patient, family member and
caregiver’s anxiety.
AIDET improves the patient’s overall
positive feeling of the care they receive.
Presenter
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The wonderful news about the tool called AIDET, is that this communication platform, does indeed override a terrible feeling of “being in jail”. It reduces anxiety, and therefore, helps a patient or family member, feel that sense of compassion and care from our staff. AIDET used with each other, also reduces our staff’s anxiety and stress level. Therefore, everybody is better served as a result of using this communication platform.
AIDET HELPS YOU MOVE FORWARD!
AIDET Training Implemented
Source: Clark County Hospital, Iowa
Perc
entil
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AIDET is one of those SURE BETS, a guarantee, that if implemented by all STAFF, will drive the patient experience. AIDET, as shown in this example, with Clark County Hospital in Iowa, really does change the level of patient satisfaction. There has been a steady, consistent climb in patient satisfaction, across inpatient, outpatient, and ED, using AIDET.
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AIDET Implemented at Hospital Housekeeping Systems, Texas- 2014
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This recent article from the HHS (Hospital Housekeeping Systems) website shows staggering improvement on HCAHPS scores. The article, published in 2014, attributes AIDET as a best practice that influenced and improved these scores.
WHY AIDET?
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AIDET enables you a framework to organize and clarify your
thoughts.
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AIDET enables you a framework to organize and clarify your thoughts. A picture frame allows you to frame a visual picture. AIDET is a framework that enables you to frame your communication succinctly. Another way to think of AIDET is a communication outline. Remember in school, the value of an outline in writing a research paper or other curriculum? AIDET is the necessary outline, so that in the high stress –often high urgency environment of healthcare, you can keep your communication focused on what is most critical for the patient, guest, or staff member.
A Acknowledge
I Introduction
D Duration
E Explanation
T Thank you!
AIDET
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Presenter
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Let’s begin by reviewing the first letter in AIDET – A (for Acknowledge). In this picture, the KYOne Health manager acknowledges her colleague with a warm welcome.
Acknowledge
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Acknowledge means to greet someone warmly with kindness and compassion. The great philosopher, Plato said, ““Be kind, for everyone you meet is fighting a harder battle.” If we remember that in a hospital or healthcare setting, our patients and guests are indeed fighting health and life battles, we can approach giving an acknowledgement out of this mindset.
Acknowledge
Use Good Eye Contact!
• “We expected you” • “We’re glad you are here”• “We know that this is a
challenge .. But we are glad you chose KentuckyOne Health”
• “We are happy to help you”
Presenter
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Turn and stare your partner down without touching him or her. (Wait until after laughter subsides) Now that is NOT what we mean by good eye contact. Good eye contact is holding your contact with a patient, guest or staff member for 3-4 seconds and then breaking it naturally. These are some opening acknowledge or welcome statements that you can offer as part of your acknowledgement. Choose one of the statements on the slide, and when I say, “Go”, acknowledge the person next to you with this opening welcome. You may think the acknowledgement, using these words, is not so critical. Listen to this great quote by Mark Twain, “The difference between the right word and the almost right word is the difference between lightning and a lightning bug”. The acknowledgement, using these words, is the difference.
Acknowledge
Outpatient Registration vignette
Video of Outpatient Registration - Acknowledge
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Let’s see this example from Sharp Healthcare; these are real employees that have been taped when AIDET was being implemented at Sharp Healthcare. Watch what the registration staff member does to welcome the patient and family member. Think about as you watch this, what works well? What needs improvement from an Acknowledgement standpoint? (If time permits, debrief with the questions listed below, in the large group session). In the video, what worked well? What did the staff member do to acknowledge the guests? What needs improvement from an Acknowledgement standpoint? (Then show the video.)
A Acknowledge
I Introduction
D Duration
E Explanation
T Thank you!
AIDET
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The next letter in our AIDET framework, our outline, is I.
Introduction
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The I stands for Introduce. It means after you acknowledge someone warmly and with compassion, you introduce yourself with your name, skill set, job title, and SMILE!
• Name
• Job Title
• Length of Service at KentuckyOne Health
• Skills, Certifications, License
Introduction
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These are the pieces of an AIDET Introduction. An AIDET Introduction is NOT, “My name is LaVay…”. Rather, it is, “my name is ___________ (insert your name)… I am a Registered Nurse with KentuckyOne and have been here 13 years. I have done thousands of IV sticks over the years, so you will be in good hands with me today”.
Traditional• Name• Title• Department
Managing Up• Self, Skill Set,
Experience and Certification
• Coworkers• Other Departments• Physicians
IIntroduction
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Managing Up means you elevate your credibility as a caregiver or staff member that is best suited to the job at hand. Therefore, you are not bragging, but delivering an introduction that helps the recipient feel better about your delivering the care/process/program, etc. Let’s imagine you were on a blind date. On a blind date, “managing up” may be perceived (and rightly so!), as bragging, praising yourself. An example would be, “I have been on thousands of bind dates!” In a hospital setting, where anxiety is HIGH, and patients and guests are worried and afraid, than managing up is necessary and warranted.
AIDET Value of the Introduction
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Patients really do care about AIDET and how it makes them feel. This is the story of patient Lynn and her husband John. They came to share their 6 day hospital story. Six days in the hospital meant Lynn and John met hundreds of caregivers and staff. However, what Lynn said she remembered most, from her surgery and the 6 day recovery, was the food service deliverer, pictured here in the middle. Lynn and John came to speak to 100 leaders about their experience. They stated, that Elaine, pictured here in the middle, arrived to Lynn’s hospital room, day one after Lynn’s surgery, with a meal tray of broth. Lynn told this story, “I was in such pain, and feeling so poorly”, and did NOT want any broth. But Elaine walked in the first morning, put down my tray on the bed, folded her arms in the choir position, and exclaimed, “My name is Elaine Rogers. I am a Food Service Worker. I have been here 27 years, and, (as Elaine raised her arms in victory), shouted, “I love my job!” This is the power of the AIDET Introduction. Lynn and John were so impressed with this wonderful staff person, who truly was a CAREGIVER. Out of their entire experience, they think of Elaine, when they recall their patient experience. The AIDET introduction, done well and with sincerity, is transforming.
A Acknowledge
I Introduction
D Duration
E Explanation
T Thank you!
AIDET
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AIDET is required of staff members, who are non-clinical, as well as clinical. In this picture, an employee is greeting her internal customer, her colleague. (Acknowledge). In this example, she can acknowledge her guest, introduce herself (Introduction), and advise her of the time frame that their meeting will take (Duration). If her colleague has an informal request, the employee can say, as an example, “this will take me 10 minutes to find out how to help you.”
Duration
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D is Duration, a Time Frame “off the clock”, rather than a vague response that leaves the patient, guest or staff member “hanging”. To say, “This process will be done in 5 minutes” is DURATION. To say, “This will be done SOON” is not Duration. Duration means that you, the staff member, actually provide a time frame. As an example, “the doctor will be here soon”, or “I will be back to check on you in a little while”, is not supportive of DURATION, and only seeks to frustrate the patient or family member. Tell your partner, what could be said instead, using this example, to support DURATION?
Duration
Presenter
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D is Duration, a Time Frame “off the clock”, rather than a vague response that leaves the patient, guest or staff member “hanging”. To say, “This process will be done in 5 minutes” is DURATION. To say, “This will be done SOON” is not Duration. Duration means that you, the staff member, actually provide a time frame.
Duration
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Clinical staff can use the patient’s whiteboard as a visual aid for their own introduction, and to share the duration – test or procedure start time, and proposed length of the test.
• How long will the wait be?
• At what time will there be an answer?
• How long until the results are available?
Duration
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Duration answers these critical life or death questions that are at the heart of the patient’s greatest worries and fears. Duration, perhaps is our most important ethical mandate, for leveraged well, duration answers, “will I live or die”… “does my wife have cancer or not?”, “will my son heal from his wounds”? Close your eyes for a minute, and visualize/think about the person you love most in all the world. Now open your eyes. If that person you love had a severe illness, you would want to know the exact time you would have answers to the questions on this slide. Many caregivers tell us that they can’t provide accurate time frames. We believe you can provide time frames for updates, at minimum. So.. You may not be able to say, “The doctor will be here in 30 minutes”, but you can say, “I will check back with you no later than 45 minutes from now, if the doctor has not arrived”. In the non-clinical world, telling a patient, “I will call you back soon about your billing question”, is better using a DURATION example, of “I will call you back no later than Friday, about your billing question.”
ED Findings:
Informed Patients More Satisfied Regardless of Wait
Emergency Department Patient’s Likelihood to Recommend
30% 28%
95% 95%
0%10%20%30%40%50%60%70%80%90%
100%
< 1 Hour Wait 4 Hour Wait
Patient Kept Poorly Informed Patient Kept Well Informed
N = 1.4 M
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This was research done on communication for Emergency Department patients, that shows the difference between kept poorly informed (lack of understanding about time frames), versus being kept well-informed (significant understanding about time frames.) The survey results/graph shows that patients are not bothered by the differences in time waits, AS MUCH as they are concerned over a lack of information about those delays. So we think the patient will be more upset to the degree we tell them the wait is longer in an ED. In reality, the patient or guest is MORE upset if they don’t know the actual time frame. There is push-pull effect in all communication. The way you communicate can pull people toward you and toward “relationship” with you. However, the way you communicate can also in effect, repel people away from you. Therefore, your sharing a specific duration enables a “pull toward you” and toward positive feelings about you and what you represent. Giving a vague response, not the actual duration, pushes the patient or guest away from you and away from a positive experience.
A Acknowledge
I Introduction
D Duration
E Explanation
T Thank you!
AIDET
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Presenter
Presentation Notes
Please shout out what each letter represents. A (Acknowledge), I (Introduction), D (Duration), and E is Explanation. Explanation is what we tend to call “telling the full, detailed truth”. Wikipedia defines “explanation” as “a set of statements, constructed to describe a set of facts which clarifies, the causes, context and consequences of those facts.” Thus, an AIDET explanation refers to you as staff member, offering context for the process, procedure, or program, potential causes or reasons, and potential consequences or outcomes. In this picture, the staff members is explaining the patient’s bill using an AIDET explanation.
Explanation
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Look at this baby… his fist is clenched, and he DEMANDS an explanation! You may feel like you have seen this expression on a patient, guest or staff member. While a patient or guest may be perceived as demanding, the truth is, he or she is DESERVING of a full explanation, an explanation that describes context, causes and consequences. Context means to share words that will “shed light” on your performing the procedure, process or function. Causes or those reasons you are doing the procedure, process or function, and consequences are intended outcomes. So as you give an explanation to a patient, guest or staff member, address with him or her the CONTEXT, CAUSES, and CONSEQUENCES.
Explanation
Video of Ambulatory Patient Care- Explanation
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Now let’s watch a video that provides several examples of the AIDET explanation, done well! This is the caregiver team from Sharp Healthcare again.
Explanation
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Our KentuckyOne Health clinicians can leverage the white board as a visual aid when they provide an explanation to offer staff names, times of appointments, and other helpful information for the patient.
• Why are we doing this?
• What will happen and what you should expect?
• What questions do you have?
Explanation
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Here is another way to offer an Explanation, using these questions, as an alternative to explaining CONTEXT, CAUSES, CONSEQUENCES. Now we will conduct a skills practice or role play, so that you gain practice on giving AIDET explanations. Turn to a partner now, and determine who will play the patient, and who will role play the caregiver/phlebotomist, and provide “the AIDET explanation”. The patient will simply listen, and ask any questions as needed, after the caregiver/phlebotomist provides the explanation. Caregivers, you are to explain why you are suddenly drawing blood of this patient, even though blood was drawn very recently. Specifically offer a response to each question on the slide, and think “context”. The goal of “context” is to “shed light on what you are doing and why”. Caregivers, you are role playing this, and so you are answering these questions from the perspective of the phlebotomist. (Take 3-4 minutes to conduct patient/caregiver skills practice.)
Albert Mehrabian Study on Communication:
7% Word Content
38% Tone of Voice
55% Context, Body Language
93% about how I say something to the patient or guest
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Albert Mehrabian, professor Emeritus of Psychology at UCLA, is a noted expert on the differences of verbal and nonverbal messages. His findings on nonverbal communication research have been quoted in seminars worldwide, and have also become known as the 7%-38%-55% rule. His research shows that words actually have less impact in communicating my message, than does TONE or BODY LANGUAGE. What his findings show is that my AIDET explanation must be fueled by a tone and body language that matches or aligns to my intended words. Therefore, my body language and tone, if sarcastic or tired, or showing a lack of empathy, will override any attempts at using AIDET explanation words. I need to ensure my body language and tone deliver the AIDET explanation I am seeking. Turn to a partner and demonstrate an OPEN body language and a tone as you say, “I am glad you are here today!” (Insure your tone and body language demonstrate your enthusiasm and sincerity! (Take 1 minute to conduct this exercise).
A Acknowledge
I Introduction
D Duration
E Explanation
T Thank you!
AIDET
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The last letter in AIDET is one of the most critical – the thank you. Another great philosopher, Aesop, said, “No act of kindness, no matter how small, is ever wasted.” The Thank You, is the supreme act of kindness, but takes no time, and no extra effort for the caregiver/staff member. In this picture, the KYONE Health Leader thanks his team verbally, using the AIDET Thank you, in a recognition program. ��
Thank you
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Zig Ziglar said, “You never know when a moment and a few sincere words can have an impact on a life” . This is the advantage of the Thank You. A quick, short phrase, that has ability to have lasting impact on a patient or guest’s life, at often the most critical time of life. These two pictures show two different roles – clinical and non-clinical at KentuckyOne Health. All employees (clinical OR non-clinical) are “caregivers” and therefore, should provide a sincere, kind thank you to any patient or guest they communicate with.
“Thank you for choosing KentuckyOne Health!
•“Thank you for coming to our office/department/facility”.
•“Thank you for allowing me to help you.”
•“I know this is a really hard time, but appreciate you coming to KentuckyOne.”
Thank you
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Here are some examples of the thank you messages that support our AIDET platform. Turn to a partner and share the message you feel most suits your communication style, and/or your job function.
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This gentleman is Ernest. He is 6 ft 6 inches tall, and a former military leader, in the hospital. He was a leader used to commanding many soldiers, and used to seeing significant conflict. He returned to the hospital six months later to share his story with an all-employee audience. When he told of his cardiac procedure in the hospital and the six days he spent there, he didn’t mention the quality of the nursing staff, or even the physicians. What he mentioned as “indicative” of his stay, was the elephant towel that an environmental services worker made for him and laid on his bed. He said, “She did more than clean my room. She lightened my mood and gave me something “fun”. I returned from a medical procedure to my room, and the elephant was propped up on my bed. That made my day”. So… let’s look at the Maya Angelou quote… People will never forget how you made them feel…. AIDET is transforming…. Our KentuckyOne Health communication framework that if employed, will insure your patients, guests and fellow staff will never forget how you made them feel.
Presenter
Presentation Notes
This gentleman is Ernest. He is 6 ft 6 inches tall, and a former military leader, in the hospital. He was a leader used to commanding many soldiers, and used to seeing significant conflict. He returned to the hospital six months later to share his story with an all-employee audience. When he told of his cardiac procedure in the hospital and the six days he spent there, he didn’t mention the quality of the nursing staff, or even the physicians. What he mentioned as “indicative” of his stay, was the elephant towel that an environmental services worker made for him and laid on his bed. He said, “She did more than clean my room. She lightened my mood and gave me something “fun”. I returned from a medical procedure to my room, and the elephant was propped up on my bed. That made my day”. So… let’s look at the Maya Angelou quote… People will never forget how you made them feel…. AIDET is transforming…. Our KentuckyOne Health communication framework that if employed, will insure your patients, guests and fellow staff will never forget how you made them feel.
