Improving Communication: The Path to Performance

“The shortest distance between two points is a straight line, Janiece!” My mother said this to me frequently as I was growing up. Usually this was when I was wandering through the mall or not going in the direction she saw we should be headed. While it’s true that the shortest distance is a straight line, in the real world and especially in the improvement world, that’s rarely attainable.

The reality is that there’s a direction and a path, but it’s not always a straight line. This is especially true when we’re talking about patient experience and communication improvement and involving groups of physicians and care team members in the process.

I experienced this just yesterday with a physician group: we had a direction we were shooting for and I had an outline of how I thought we could get there, but they had a different path. However when we were able to engage them and let them help us shape the journey of how we get to the end point, the outcomes were much better.

This work takes patience, leadership, and keeping the end in mind as you work to engage the physicians and others on your teams. Last time we talked about the Puke-or-Shoot Continuum and this time I’d like to share some tips for getting started to help groups move through this continuum and on to improvement in physician communication.

1. Don’t get stuck in “analysis paralysis”

When it comes to data and improvement strategies, don’t let “great” get in the way of “good” and just get started! At the same time, pause long enough to ask the patients what they’d like to see. Examine what they are already telling you through their comments, complaints, and conversations. Also, be mindful of what else they can readily tell you through the use of Patient & Family Advisory Councils and focus groups.

2. Don’t “chase your tail”

In other words, don’t focus on the left side of the bell-shaped curve, that is, the “Never” responses to the questions. Without fail, when groups look at their survey responses, someone will say “Can’t we just find out whose patients said, ‘Never’? Let’s just deal with those physicians caring for them and we’ll be all set!”

Well, the answer is no. CAHPS surveys only reports the top box percentages. So, instead of trying to eliminate the “Nevers,” focus on moving the “Usually” responses to “Always.” To do this means improving consistency and also exceeding patient expectations.

All we’re trying to do is move the “Usuallys” to “Always” and ensure some healthy competition. From strictly a numbers or CAHPS perspective all you need to do is move the bell-shaped curve to the right. Focusing on the outliers or the “Nevers” will not, in and of itself, get you substantial numerical success.

3. Focus on the “few & the furious”

Realize that this work will take time. There may be pilots that don’t work or ideas that don’t yield what you hope. If you can stay the course, though, it is genuinely possible to achieve transformational success.

Be methodical, logical, and reasonable when it comes to goals for improvement. If you implement five things at once, how do you know what works and what does not? When you can furiously focus on a few specific goals and strategies, your messages will be clearer to the physicians and team, and you’ll be more likely to recognize early success and create strong momentum.

4. Find your “partners in crime”

It takes a village to realize success in this work. Building a core team of physicians and staff who care about this as much as you do is essential to achieving and sustaining results.

5. Get the word out!

Communication is essential and consistency is vital to getting your message out. Get on the agenda at staff meetings and provider meetings, use newsletters and blogs, make it part of ongoing conversations. And once you start, don’t stop.

6. Improvement won’t just happen

The reality is that “if it were easy, it would already be done.” Organizations that have achieved success have chosen to be committed and have made it a priority to make a difference. The good news is that the reward is well worth it—certainly for the team, but, ultimately, for the patients.

Throughout this blog series, I have discussed some key fundamentals to improving physician communication with patients by paying attention to the basics, incorporating key strategies, leveraging a powerful tool in coaching, traversing the trajectory (aka the Puke-or-Shoot Continuum), and implementing the tactics to realize the path to performance.

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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