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Modeling a Culture of Caring

Modeling a Culture of Caring

How one patient experience coach champions empathy.

As the patient choked back tears, her words tumbled out:

“I know the doctors think I’m a junkie, but I was clean for 20 years until the night after my son was killed in a car crash. I’m here because a friend gave me a freebie to cheer me up, and I got high and overdosed. I’m so disappointed in myself.”

The woman’s prolonged previous history of drug abuse made it difficult for caregivers to find her veins for blood draws. Though her nurses had asked doctors to insert a peripherally inserted central catheter (PICC) line for quick, painless access, they had refused, concerned that the line would make it easier for the patient to resume using drugs. Now the patient was pleading her case to two new visitors.

Jade Hewitt, a Johns Hopkins Hospital patient experience coach, recently recalled this scene (with some of the details changed to protect the patient’s identity). As the patient broke down, Hewitt embraced her. “I’m so sorry,” she said, adding that she couldn’t imagine what she’d been through. A support staff member who had accompanied Jade into the room stood frozen, unable to relate to the patient.

Later, Hewitt tried to put things in perspective. “I’ve been trying to lose weight my whole life, but if someone put a doughnut on my desk, I’d probably eat it,” said Hewitt. “For me, it’s about food; for this patient, it’s about drugs.” With this analogy, recalls Hewitt, the colleague’s face softened.

Discussions like these are part of Hewitt’s daily work. She is a patient experience coach on the inpatient medicine units, one of six staff members allotted for this newly created position. The goal: to teach staff members ways to better understand and communicate with patients and how to approach problems together. 

Lisa Allen, Johns Hopkins Medicine’s chief patient experience officer, says there’s a need for people who can coach physicians, nurse managers and front-line staff members on empathic behavior. “I look for people who are warm, open, driven by purpose, and really great at communicating and building relationships,” she says.

Each coach—covering inpatient and outpatient medicine, neurology, Gyn/Ob, oncology and surgery units—plays a slightly different role, based on his or her expertise and the team’s needs, says Allen. The Johns Hopkins Hospital’s patient experience/service excellence staff will soon number 14. Some will spend part of their day in the Emergency Department, ensuring a smooth transition for patients from the ED to the units.

Since hiring the patient experience coaches in April 2015, Allen says the hospital’s HCAHPS scores have improved. (The Hospital Consumer Assessment of Healthcare Providers and Systems Survey measures patients’ perspectives of their hospital care.) “We got a score of 91.9 percent in discharge communication, up from 88.8 percent last year. This puts us in the top 10 percent nationally. We also scored 82.2 percent in nurse communication, the highest score in five years.”

Hewitt began working at the hospital in 2012 as a clinical customer service coordinator, the central point of contact for patients, families and health care teams in a patient care unit. A graduate of Morgan State University, she previously worked in a similar role at Memorial Sloan Kettering Cancer Center. She aims to convey the importance of providing a hospital stay “where patients feel we care about them,” she says. “It’s about digging deeper to know the things that make that patient a person.”

Terry Nelson, assistant director of nursing for the Department of Medicine, attests to Hewitt’s positive impact. Hewitt ensures that communication boards in every room have current information about attending physicians and when to expect the next medication.

She also provides service excellence training and shares the latest HCAHPS scores with staff. “Jade is one of us,” adds Nelson. “She’s visible and sensitive to both patients and staff members, and celebrates our successes.”

Hewitt also educates people that things don’t always turn out the way patients like. The patient who desperately wanted the PICC line, for example, never received one because of the doctors’ concerns. But Hewitt continues to cite the experience to discuss the power of empathy. “When patients reach out,” she says, “we have a small window to connect with them.” It’s a moment, adds Hewitt, that offers a chance to validate a concern—and work to resolve it. 

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