Best Discharge Instructions Ever… When Things Do Go Right


This past year we’ve been on a bit of an adventure with our eldest who’s been dealing with some ankle issues. It was at one of our last doctor appointments, with some pretty disappointing  news to a teenage girl who loves to run, that we had one of our best patient experiences in recent memory.

In the past few blogs, we’ve been talking about service recovery and when things don’t go right. This experience, which was not an ending that I would have predicted, made me shift gears to share a story of when things do go right!

I love my daughter, but she’s petrified of needles, shots, injections, blood draws, and anything else that involves something sharp coming in contact with her skin. I’m ashamed to admit, I didn’t even make her get a flu shot last year just because I didn’t want to deal with the drama (and last year’s dose wasn’t that effective)!  Fast forward to this past spring and summer when my daughter, an avid cross-country runner, was experiencing pain in her ankle whenever she ran. We’d tried everything that the orthopedic surgeon had suggested to help her ankle, all to no avail. The next step was to have her go in for, you guessed it, an injection in her ankle. I lost the parental arm wrestle and ended up being the one to take her. She was a bundle of nerves like I’d never seen before. Every time someone came to call a patient back to the room, she literally jumped in her seat!

We did finally make it into the room and the provider came in. He did an ultrasound to show us what was happening inside and where he was going to do the injection. He developed a rapport with her, made some jokes, and even got her to laugh and smile. At one point he said, “Ok, so what’s it going to take for me to get you to let me try this for you?” There was some banter back and forth about how I’d promised her Caribou Coffee afterwards if she got through this appointment. As he started the procedure, he got her talking. He asked her about her running, what her pace was and what her goal time was for the season. She responded throughout and finally he said, “Would you believe me if I told you I was all done and have been for a few minutes?!” She couldn’t believe it and neither could I!

Sadly, that injection didn’t do the trick and she continued to have a lot of pain. So, after an MRI and another consult with the surgeon, we needed to go back for a different type of injection. This time, one directly into the heel to try to help with the bone. Just typing that makes me grimace and squirm.

When the day of the injection came, she was remarkably calm. I, on the other hand, was not! It wasn’t just about the pain, this was a big appointment for her. If the injection worked and she felt no pain afterwards, then the treatment plan entailed her immediately getting into an immobilizer boot for 4 weeks.  In that case, her cross country season would be over. While I wanted her to be free from pain and to figure out what was wrong, my heart broke for her to give up something she loves, even for just the season.

As we drove to the appointment, I couldn’t believe how different she was – no nerves, no jumpiness. I asked her what was different. She said that she’d liked the provider she saw previously because he didn’t just talk to her about “doctor stuff” but talked to her about things she cared about, like her running.

She and I joked that as long as she only had “silent tears” we’d stop at Caribou again after the appointment. During the procedure, the provider asked about Caribou and what she liked there. He recommended the hot chocolate and kept her talking about her interest in smoothies, which kinds, etc.

The procedure was a success but it also meant we’d be going to pick the boot and that her season was over. She understood all of this but seemed, surprisingly, unfazed.

As we left the office and headed to Caribou, she was reading her after visit summary and burst out laughing. I asked her what was so funny and she read what he’d written: “Good to see you again and good job with the injections. Get the hot chocolate from Caribou, it’s really good.”

My girl who always gets a smoothie, broke her trend and got a hot chocolate at this provider’s recommendation. As we drove home she told me “He’s my favorite doctor ever, even better than the ENT who gave me a pack of gum at my tonsil appointment when I was 4!”

I’m pretty sure I owe this provider a Caribou Coffee gift card for the transformation her did for my daughter. It wasn’t anything huge – just letting his personality and sense of humor come through and even bringing it into his discharge instructions. He may do that all the time but I’d love to let him know what a difference it has made. My daughter has embraced her non-running end of the season with an ease and a grace that I never would have predicted. I’m convinced it is due, in part, to his interactions with her that sent us off on the right foot!

Janiece Gray

I began my career as a social worker and later, with my Master of Health Administration (MHA), directed operations at Allina Health in Minnesota. I later directed patient experience at Allina. My background and experience give me strengths in approaching healthcare opportunities and challenges through a systems lens – with unique strengths, challenges and activation points. My experience is also informed by leadership roles leading performance improvement in patient-centered care and patient experience departments. Working in the client role with healthcare consulting firms inspired me to address some unmet needs in the industry, and to co-found DTA Healthcare Solutions. I have a Lean Six Sigma Black Belt, and find that the discipline of practice translates to healthcare work very well.

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