Transcription of Podcast

Julie Soukup

All right, so Hi, I'm Julie Yorumez with an take one patient podcast. And I am very excited that we're going to be talking today with Jermaine McCauley. She is the director of patient experience she's been in patient experience for a really, really long time. And she works with a lot of hospitals to increase the the the ratings in order to make their hospitals show that they're really abiding by patient communication, and abiding by patient experience and all of those things. So this episode uptake with patient is Jermaine McCauley, let's start. So Shane, tell me a little bit about your role in a hospital as a patient experience officer. What What does that entail, and why is it important?

Germaine McAuley

So my role in a hospital is to help drive strategic initiatives around the patient experience. And several of those initiatives have to do with evidence based practices. Much of it has to do with culture, a lot of it has to do with physician and employee engagement. And in the end, hopefully, by providing exceptional patient care, we then achieve really great h cap scores are lagging indicator to evidence of the care we've provided. So those with those h cap scores there is in the end, and those are attached to value based purchasing, and with IBM purchasing their dollars attach there. So our goal is to really change culture, we work with the strategic it with the strategic team to drive change.

Julie Soukup

So communication really plays into a patient experience. As far as the way that a patient is even just being talked to in that respect.

Germaine McAuley

Communication, whether it's as a leader or as an employee, doesn't matter. Communication is the core of life, right? It's the core of every single relationship we have. And that is no different in a hospital, where emotions run high. This is your only mother, this is your only sister. And communication is everything. So, you know, we can't always control outcome for patients, we can't always control their disease process. What we can control is how we communicate about those things. Communication is absolutely everything, from the doctor, to the patient, from the nurse to the patient, from each of the support or service technicians to the patient. Communication helps to alleviate anxiety, the more you tell me, as an informed person, a person who wants to know what's happening to me, you know, I've lost control as a patient of everything in my life, I've lost control of the clothes I wear, I've lost control of the food I eat, when I'm a hospitalized patient, I've lost control of who gets to come in and out of my room, I've lost control of my ability to move around freely, the only thing I have control of is information and communication. So communication is everything.

Julie Soukup

That's so interesting that you say that because I guess I never really thought of it in that way that the lack of control of Okay, all of a sudden I don't know who's coming in and out I don't have any say for my schedule, how the day is gonna look, all of those things. So outside of being overly, you know, not overly probably respectively, emotional about the situation for yourself is where it was, maybe some of your caring for that lack of control is is a really hard space for a lot of patients to be in, you know, too

Germaine McAuley

huge. And for family members. Think about it. As a family member, you've really lost control, right? You may not even be able to in the times of this pandemic, be able to visit your family member. So again, communication is key. How do I know what's happening to mom? How do I know what you're doing today? How do I know mom's Okay, how do I know who's taking care of mom today? Those are all things again, the lack of communication leads to greater anxiety and suffering and that's what we do in healthcare as we try to alleviate suffering and lack of communication and suffering. So when

Julie Soukup

you are seeing you know providers you know, obviously if there's a not great experience it does impact the patient it does actually impact the finances of the hospital and that's why these things are measured. So for paid for providers that you see are like excellent communicators consistently. You know, scoring the highest on patient experience scores? What do they do differently than those that are scoring lower? with patient spirits? What do they do differently in the way they communicate to patients and families.

Germaine McAuley

providers who score higher in my 35 years of being in service excellence in patient experience, I can tell you, those providers who consistently score higher tend to consistently do certain practices. And one of those practices is they sit at the bedside as much as they can. Sometimes you have large groups, right? So you may have a neurosurgeon and, and several residents, if you're a teaching hospital, just that sort of thing. But sitting at the bedside key, looking at patient in the eye, however, that happens, placing a hand on the patient's arm as you're speaking, and then asking, tell me what questions you have. That's huge, as opposed to a hand on the door saying, Do you have any questions? Yeah, really, really wanting to understand, tell me what questions you have. Or tell me what you understand about the plan of care. I've explained to you, because that's truly caring? Do we really know the patient understood what was said? So we see the, the the physicians who get greater scores are ones who really want to know, did the patient understand what I just said, as opposed to wanting, you know, needing to get on to the next patient? Would you have any questions? And getting out of the room? It's those physicians who are invested in their patients understanding what's happened to them?

Julie Soukup

Well, I think you just hit really to two important things. The first one is all about nonverbals, which is actually when you're thinking, Okay, the act of sitting versus standing, and the act of just pure icontact. The act of like reaching out and touching someone, it literally doesn't then matter why man matters, but like, sounds like what comes out of the mouth, or the way that they present something or the way they say something matters less than just simply the act of like, sitting down for a second, and like reaching a hand out, which is three, four seconds to kind of like, make sure that you're in the good physical space, before you're even communicating. And that's really interesting. You know, they did Moravian and I'm sure you know, Dr. Moravia, and he did all these studies about communication and that verbals were seven or not 9%, and nonverbals, like tone, and body language has such a bigger impact in the way that someone was being received. So that's interesting that usually you say, Oh, they say this, or they say that they just sit down,

Germaine McAuley

they sit down, they get it i level that says to the patient, so many nonverbal things. So such a great point, Julie, it says, I'm here to listen to you. It says, We're even so I'm you're no longer a subordinate to me, I'm not standing over you. And my Chris clean, you know, lab jacket, with my hair's perfect, and I smell good. And, you know, I have all of this knowledge about you, the patient already feels a bit inferior in that situation. So to sit at eye level, says, I'm here to look at you, as an equal to me. And I'm going to listen to you and I'm going to explain things to you. And patients perceive there's many, many studies out there. You can you can research, but there are studies out there that show patients perceive that a physician stayed longer when they sit versus stand.

Julie Soukup

Right. Wow. And you think that it's like, half a second to sit down. And, as you said, it's We are a team, we are we are on this together, we're looking at this together. And it is I can see especially when you're saying what you said before, is it gives the perception of I have nowhere to be like I like even though he does or she does, you know and that but just that I have this extra time to sit and thinking about that. How long does it take us about half a second, you know, just to have that.

Germaine McAuley

So I think I'm sorry, if you think of someone who comes over to your house, right? Someone who you value and respect and you really, you know, really want to see them and speak with them if they walked into your house and just stood there. It's a different perception than if they said Is it okay if I take a seat? Of course, please take a seat. Wow, you're gonna sit with me? Yeah.

Julie Soukup

Well, I'm thinking about so I have twin two year olds, and they're, you know, two year olds, and so they're right at that age, where they're trying to communicate. They're feeling out Control, like very similar, and that's a lot of the reading I've been doing is that down, get on their level. And then because I'm out of control, I don't know what I want, I know I want something I mean, it's so it's so similar. It's just basic, you know, thought process there. That's, that's, that's interesting. And that's something I think that's an easy trip that takes an extra half second, you know, same with eye contact extra half second, just to make sure if you think of nothing else, in that time, just think of those two things, and then allow yourself to just give the information as you do normally.

Germaine McAuley

Absolutely, in that listening to someone's concerns. You know, it's, it's a skill, and not always taught in a nursing school or medical school, but just to really be present in the moment. It's another thing sitting does is it says, I'm present here with you right? Now, you have my attention. And by being very focused by listening while and saying, I'm going to be back tomorrow, or my resident will be back tomorrow. Do me a favor, write down any questions you have, because we want to be sure to be able to answer your questions when we come. And then you can also really direct the conversation. So you're not in a room for long periods of time, you can get in there be very strategic, make sure your patient understands what's happening. That's really what great doctors do. The other thing I would add just the last piece is these, them. And when I say great doctors, you know, you can be great clinically, you can be great in terms of communication, age, capture quality outcomes, but if you're a well rounded, all hitting it on all cylinders, right? quality, finance, patient experience, you name it. And then I would say, another thing is, really, your patients have to trust you to trust that your plan of care is the best plan of care for them. Trust that you're that you are invested or you care about them. One way to do that is sometime in that encounter, connect on that patient care back to an upper level, right? Can I get your warm blanket and I asked her to get your warm blanket? Can I get your warm blanket? You know, is there something you need? Can I turn off your light? You know, would you like me to close your curtain for your privacy, something or who sent you the flowers, or the pretty pictures from when a patient sees that you saw past just clinicals anything attached and their human being is suffering. And that really goes far in create a trusting relationship.

Julie Soukup

Right. And it kind of goes back into just as you said, is taking a second to listen and taking a second even to have something that's just not not patient related. Because back I said, getting yours I thought was really profound as like this person has lost all control, they're only being seen as a patient. A lot of them have, you know, parent or you know, our parents or executives are working. And they're used to having a lot of that power. And so now they're like, Oh, I'm just this patient that's been poked and prodded or whatever. So having even like a second of personal element, 10 seconds, hey, what can I do, I'm still here, you know, to do anything, don't like embrace the barriers of that doctor patient relationship down just a bit to kind of say, okay, like, as a human first, I'm here before the person that's educated to take care of you, you know,

Germaine McAuley

the dignity factor and like Maya Angelou says, No, I don't care how much you know, till I know how much you care. Make it, you know, these things are our in we measure how often doctors treat you with courtesy and respect, may not like the big O. But that is on HQ for a reason. Patients have to have us team relationship in order to follow the plan of care, to trust and to care, to trust in their physician goes a long, long way.

Julie Soukup

You know, it's interesting also to with what you said is the things that you're saying are so simple and basic. Like it's not simple and basic. It's actually like very intently, you know, like, thoughtful, but it's something really easy for someone to implement right away. Like all of a sudden, she's like, Don't think of anything else. Just sit down. Don't think of anything else sit down icontact like those are your two things to do first. And then even like before you leave the room, like did you have anything that like you need? You know, those are three things that don't take a lot of time. And I think people always be like, Oh, that's not improved communication, I need to just talk more. And that's not what you're saying. You're saying just do the little tiny pieces. And it will provide a better experience of communication, a better experience, you know, to that patient.

Germaine McAuley

Well, sad and truthfully, if I had a short list, I'll tell you what if I needed to, if I were working with an organization to improve the patient experience Around physician communication, first thing I would do that absolute shortlist because you can't give people you know, a whole lot of things to improve. Boop, some simple things like you said, this is a short list. Sit down when you can, can always sit down. Many hospitals have invested in listening stores, to great idea they hang on the wall, don't take up a lot of space provider can plop one down, even if there are many, like I said, residents and they know everybody in the room, one person sits down. But that's huge. So one system when you can, can't always but when you can make a personal connection. Three, explain and ask, What do you understand that I've just explained to you, that's that's it, you hit those three, you never have to look back at each hop, just wait for those great scores to come in and know that your patients understand their plan of care.

Julie Soukup

Yeah, no, absolutely. So So one thing that's starting to become more prevalent and as we know and you know, we work you know, I work with medical memory, that actually is video recording a lot of these encounters and and to hit upon. what you were saying is not only does the patient has the patient lost control with their family members have also lost control. I don't understand what's happening. I don't understand what's going on. Um, what are your thoughts as far as some of these providers that are now using either a telehealth that's consistent or a lot of these hospitals are now starting to record these interactions that we just talked about sitting on the bed reaching out? How much do you understand let's have a conversation? Why do these doctors and practices are recording these that the family members get those updates and the patients can react us those? Um, but one thing is how do you think that differs the way that they should think about now that all of a sudden, like, take one like it's being recorded these these interactions are being recorded.

Germaine McAuley

So you know, it was really interesting. With this pandemic, how we suddenly became a virtual world, right? meetings became virtual patient visits. Many hospitalists at my hospital were visiting patients virtually, there were COVID positive, there were just, you know, telemedicine just boomed and you didn't have to go into your doctor's office, which was a plus, you could just do a telemedicine visit those go on today. So really saw this boom, and these virtual visits. So that kind of changed the way health care is provided. The other thing is, family couldn't people use FaceTime, they use different tools to contact family to allow family member to, you know, speak with their loved one. So that was huge for the patients and for families as well. The one of the tools we used was medical memory. And that, that for me, changed the face of of the way we deliver information. And I'm going to say I'm going to tell you why. I think FaceTime is wonderful for a patient who has COVID to speak to a family member real time in a back and forth exchange. I think it's it's just really good for those family to family member to patient communications. It's great. When I think about telemedicine and I think about other tools use to to talk with patients about health care about very important health information, medical information that's kind of difficult to follow patients, especially if you have brain fog, right? Um, so what we when medical memory, the difference was, this video recording is made of the provider or the nurse or the technician, whoever and to have a conversation with the patient, it's recorded, and therefore the family and the patient can watch it and say, What What did you say whereas I did FaceTime and gave that medical information or if I did telemedicine and gave that information, I still have that same deficit I had if I deliver that information at the bedside, I still am not sure they understood everything I said, I'm not sure they understood the plan of care. But if if they have a video, and if a video is pushed to family and if a video of the patient has it now you have this team approach. Everyone can pause, rewind, pause, rewind, we're gonna watch that again. What did the doctor say about wound care when mom gets home so that was a game changer for us during COVID in and it really drove home the difference between I'm going to deliver this message, I'm going to let you have this conversation, I'm going to deliver this information to you. And now poof, it's gone. Right? Once that call hangs up once that virtual visit is is over information, it's gone. With medical memory, that information is still there. That was the difference.

Julie Soukup

Yeah, you know, it's interesting. So we, we, we medical memory, we were out in Arizona, and we were recording or, or a few patient testimonials. And one of our patients was telling me, you know, he's like to be able to not only like, rewatch that video, but he's like, we all were in this, I have six sisters, I am the I Am the power of attorney. And he's like, so it's not only just the doctors responsibility to make sure that I understand everything, but now it's my responsibility mature, all my siblings, were already playing the game of three or four times. So he was, you know, to now have that recorded, and be able to share it with all of them, just as you said, we all knew how to support. But also, we got to see the doctor doing the little things that you said on your checklist. He's like, we got to see that he was laughing with her about how she always needed an extra blanket. And we were seeing that he sat down with her and had that conversation. And so he said, not only did she start seeing, okay, he's treating my parent as a person. But we're also seeing, we're seeing this doctor, as a person, we're seeing this doctor, as someone that's like doing the best I can for my mom, and not just leaving it, but now my family member, we all have the ability to make better decisions and better understand it and watch it three or four times. But we saw that human element of which put us at ease, and definitely made us trust him more because we could see the care he was providing to our mom. And I thought that was really interesting. And you always think of it doctors Just think of it the other way, like oh my god, what if what they see is you being gentle, and kind and empathetic and doing all the things you already do really, really well. Like you're they're looking for the best of you not looking for a reason to be upset, you know, and that was the first reaction that this patient had. You know,

Germaine McAuley

I you know what? Absolutely. And the truth is, think about when we used to allow seems like so long ago, they're all family members at the bedside, I have five, you know, brother, four brothers and one sister, so five siblings. And everyone has different questions and people like, you know, sit around, like, kind of stocking the doctor waiting for the doctor to show up. I have to hear what the doctor says. Because God forbid you miss that window. It's gone. Right? Yeah, you don't hit that bewitching hour, you it is over forever, and never get it back. And mom sure can explain it back to me. You know. So the fact is, it takes away that anxiety and suffering. That's the beauty of this. The other piece, I would say is just what you said, How caring is it, that your provider care so much that your provider is willing to be transparent, and put on video, those instructions, so not only you have to you don't have to remember it, it's on video, but your family can also see it and they can help you how caring is that insulate that patient? Help caring is that to be transparent. If the information you're deliver, you should never as a provider, you know, think the information I'm telling a patient about pre op worker or pack in the packet about the surgery or at the bedside the plan of care, you know, worried about that information being used against you hopefully that information is solid and sound and based on science and, and research. And so what you know, there's no problem with it being recorded. It's it's what you say to your patients. So the transparencies key to again, when you talk about Julie V's you know body language or these other things people can infer from your actions, I would infer Wow, that's a transparent provider. Wow, that provider getting paid extra to do this. That provider is so confident in this clinic that providers willing to put it on video.

Julie Soukup

Well, and that's what you saw too, then like okay, taking it out of you that experience for a patient is you saw that, wait a minute, when this was even happening, it's showing and data is showing in money back into the hospital if there's a true ROI to to even having that recorded. We even saw two.

Germaine McAuley

That's right. Absolutely. Absolutely.

Julie Soukup

You know, so it does kind of go of like, you know, outside of the the there's always you know, medicine still business No matter how much you want to pretend it's not it is and it feels like wait a minute, when we actually are being more transparent, we are providing this extra second to sit down and lean in and eye contact or pressing record, you know, on the device, it does actually, it does actually support the hospital too. And and interesting you said that is, you know, recording over 86 I think we're up to 87,000 patients at this point. We've never had anyone be sued because of one of the videos not once so to me. But we haven't and and actually, I think we've had a few providers that have used the video to say, I clearly told you to stop smoking and not smoke.

Germaine McAuley

Yes, again,

Julie Soukup

it's it's providers, I think, I don't know if it's a cultural thing, or what we've evolved of everyone's looking to sue and I don't think it is I think people are just looking to be supported and get some of that control back that that you say is so hard that they can't have, you know, in in the hospital, and I think that's where you start seeing it more that way versus what's gonna happen, you know, what, what are like two things that I can do that won't take up any time to make this easier? Sit down prep record, you know, I don't know

Germaine McAuley

how you I'm going to tell you there are, again, 35 years in healthcare, you know, started out as a surgical tech in the army, and I have seen every patient encounter, you can see I have lived on the frontlines, right. And I'm going to tell you, patients who Sue Sue because they're angry. And a lot of times it has to do with the lack of communication, people who file complaints, file complaints, because they're angry, and generally they feel something's been withheld from them in terms of information. So when patients trust their provider, when patients feel their provider care about them as a person, they are less likely to sue, even if something goes wrong. We patients just like anyone else, you and I understand human error, we understand our bodies are not an exact science, right? And can happen. But we trust in that provider skills we trust in that providers competence. We trust that the the decisions they're making are clinically sound. And we know there are risks, they're explained to us in detail. And so patients definitely get it there are risks. When I see people angry. Predominantly, it has to do with a lack of communication.

Julie Soukup

Yeah, lack of control. You know, that's so interesting. You said that, well, awesome. Jermaine, you are always a depth and breadth of knowledge. I love like the three little things you even mentioned that are so simple and easy to think about. You know, sitting down in asking one question, I mean, that's something I think someone could really almost start utilizing tomorrow as a trick to just think a little differently, you know, change. And so I always appreciate you and your wisdom. And thank you so much for joining us. And for anyone that ever has any questions about what it means for recording and the implications there. Go to the website, medical memory.com or download the app to try it out or CDM. Any questions? Thanks again, it's your man. I appreciate you being here, Julie. Take care.