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Medical improv final final 8 11 upload SS #2!


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Medical improv final final 8 11 upload SS #2!

  1. 1. Exploring  Learning  Experiences  that  Promote  Safe  Care,  Patient   Satisfaction,  &  Rewarding  Careers   With  Beth  Boynton,  RN,  MS   Organizational  Development  Consultant  &  Author   ©  2013    B.  Boynton,  S.  Frederick,  &  J.  White   #medimprov08
  2. 2. Sponsored  by  The  Infusion  Group™  with     Judy  White,  SPHR,  GPHR,  HCS   Presented  by     Beth  Boynton,  RN,  MS     •  Lauren  Dowden,  MSW   Candidate   •  Stephanie  Draus,  ND   •  Ed  Dunn,  MD       Co-­‐presented  by     Stephanie  Frederick,  M.Ed,  RN   •  Dan  Sipp,  SP   •  Nancy  Smithner,  PhD   •  Richard  Snyder,  MD   •  Tobias  Squire-­‐Roper,  BFA   With   #medimprov08
  3. 3. “Medical  Improv”       #medimprov08 An  innovaFve  bridge…  
  4. 4. From  many  challenges  we  face…    Errors,  adverse,  and/or  sentinel  events    Patient  complaints    Workplace  violence    Resistance  to  change    Substance  abuse   #medimprov08
  5. 5. and…    Wasted  resources    Staff  turnover,  burnout,  stress    Toxic  cultures    Readmissions    Spiraling  costs   #medimprov08
  6. 6. To  soluFons  we  seek:     1  Safe,  quality  care   2  Healthy  staff  &  organizations   3  Patient  satisfaction   #medimprov08
  7. 7. How  does     Medical  Improv  do  all  this?   #medimprov08
  8. 8. By  building  the  so0  skills  we  need…   1  Communicate     2  Collaborate   3  Lead   #medimprov08
  9. 9. Overview     Introductions:  Meet  our  Expert  Panel     Compelling  evidence  for  building  soft  skills.       Medical  Improv  Classroom:  teaching  strategies,   principles,  and  games.     How  can  you  begin  to  pilot  Medical  Improv  in  your   healthcare  setting?       Q  &  A   #medimprov08
  10. 10. Our  Expert  Panel   Who  are  you?  What  inspired  you  to  join  us  today?   How  are  you  or  will  you  be  using  Medical  Improv  in   healthcare?       (About  2  minutes  each!    )   #medimprov08
  11. 11. Lauren  Dowden,   MSW  Candidate   Stephanie  Draus,  ND   Edward  J.  Dunn,  MD   Dan  Sipp,  SP     Nancy  Smithner,  PhD   Richard  Snyder,  MD   Tobias  Squier-­‐Roper,  BFA   #mediprov08
  12. 12. What  are  so0  skills?     #medimprov08 • Communication   • Emotional  intelligence   • Interpersonal/relationships    
  13. 13. How  are    problems  with  so0  skills   contribu7ng  to  problems  with    safety  and   quality?   #medimprov08
  14. 14. Progress  with  paFent  safety  has  been  slow!   In  1999.  Institute  of  Medicine  (IOM)   Report  -­‐To  Err  is  Human:  Building  a   Safer  Health  System   Estimated    44,000-­‐98,000  deaths   every  year  due  to  medical  errors   #medimprov08
  15. 15. Health  Affairs  April  2011   •  187,000  deaths  in  hospitals  per  year   •  Preventable  medical  errors  are  ten   times  more  frequent  than  hospitals   and  regulators  are  reporting.   •  Estimated  cost  of  17.1  Billion  in  2008   #medimprov08
  16. 16. Soft  Skills   #medimprov08
  17. 17. The  Joint  Commission  tracks  root  causes  of  senFnel   events.       What  do  you  think  the  top  3  causes  of  these   preventable  and  catastrophic  errors  were  in  2010,   2011,  2012?     #medimprov08
  18. 18.  Leadership    Human  Factors    Communication Root_Causes_Event_Type_04_4Q2012.pdf   #medimprov08
  19. 19. Each  cause  or  category  has  subcategories  that  are   filled  with  implicaFons  involving  so0  skills  
  20. 20. Category:  Leadership   Subcategories:   Organizational  planning,  organizational  culture,   community  relations,  service  availability,  priority   setting,  resource  allocation,  complaint  resolution,   leadership  collaboration,  standardization  (e.g.,   clinical  practice  guidelines),  directing  department/ services,  integration  of  services,  inadequate  policies   and  procedures,  noncompliance  with  policies  and   procedures,  performance  improvement,  medical  staff   organization,  nursing  leadership  
  21. 21. Priority  se*ng  requires…   •  Self  awareness   •  Awareness  of  others   •  Being  assertive   •  Being  a  respectful  listener  
  22. 22. How  are  problems  with  so0  skills  contribu7ng  to   concerns  with  our  workforce  and  work  cultures?   #medimprov08
  23. 23. Workforce  &  Culture   Through  the  Eyes  of  the  Workforce:  Creating  Joy,   Meaning,  and  Safer  Healthcare-­‐   Lucian  Leape  Institute-­‐NPSF  Roundtable  Report  (2013)-­‐   #medimprov08
  24. 24. Physical  Harm     Health  care  workforce  injuries  are  30  times  higher   than  other  industries.   “I  need  help  giving  this  patient  a  boost  in  bed”   #medimprov08
  25. 25. Psychological  Harm   Lack  of  respect       A  root  cause,  if  not  THE  root  cause,  of  dysfunctional   Cultures     95%  of  nurses  report  it;  100%  of  medical  students;  huge   issue  for  patients   #medimprov08 A  nurse  waits  a  little  too  long  to  report  a  patient’s   increasing  blood  pressure  to  a  physician.    The  last   time  she  tried  to  talk  with  him  about  a  concern,   he  was  abusive.    
  26. 26. Is  bullying  a  problem  in  healthcare?   #medimprov08
  27. 27. Alan  Rosenstein,  MD,  MBA   Medical  Director  of  Clinical  Efficiency  &  Care  Management  at  ValleyCare  Hospital   No  one  starts  out  the  day  planning  to  be   disruptive.  We  must  recognize  the   emotional  impact  and  downstream  effect  of   inappropriate  behaviors  and  explore   experiential  learning  methods,  like   “medical  improv”  that  build  the  necessary   skill  sets  for  positive  change.     #medimprov08
  28. 28. #medimprov08
  29. 29. #medimprov08
  30. 30. Defining  PaFent  Experience:   #medimprov08
  31. 31. #medimprov08
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  34. 34. What  does  a  Medical  Improv  class  look  like?   #medimprov08
  35. 35. Teaching  Strategies     Frame  with  objectives  &  brainstorming     Principles  of  Medical  Improv     Games  &  activities       Debrief,  reflection,  action  plan   Notes:       Variables:    time,  audience,  skill  focus,  complexity…     Expertise  in  healthcare  AND  improv   #medimprov08
  36. 36. Principles  of  Medical  Improv      “Yes  and…”  Affirm  and  add  (don’t  negate)     Surrender  your  plan  &  co-­‐create     See  ‘failure’  as  opportunity  (to  learn,  be  human,  forgive,   help)     Listen-­‐be  present     Avoid  questions     You  have  everything  you  need!     Support  each  other   #medimprov08
  37. 37.  Games  &  AcFviFes  (100s  more)   Yes  and…,  Yes  but…,  No…     Teaching/learning:  Assertiveness,  listening,   collaboration,  validation/invalidation  &  reinforces   medical  improv  principle:  “Yes  and...”     Status  Slide,  One-­‐Up-­‐Man-­‐Ship     Teaching/learning:    Status-­‐related  verbal  &   nonverbal  communication,  body  language,  comfort   level,  self  and  other  awareness,  leadership  skills,  and   therapeutic  relationships.   #medimprov08
  38. 38. Like  practicing  a  team  sport,     Medical  Improv  elevates   each  player’s  ability  to   communicate,  collaborate,   and  lead.      So  when  the  game  starts,     individuals  and  teams  are   performing  at  their  best.   #medimprov08
  39. 39. Unpredictable  and  fluid,  the  human  interactive  aspects   of  healthcare  interventions  can  emerge  in  the   moment  with  a  positive  dynamic  that  has  already   been  established.   #medimprov08
  40. 40. How  can  you  begin  to  pilot     Medical  Improv  programs?   Beth  Boynton   Stephanie  Frederick   #medimprov08
  41. 41.   Collaboration  across  all  disciplines  of  healthcare   (conventional,  traditional,  complementary)     Medical  Improv  training  coordination  to  facilitate   communication,  quality  and  safety  of  care  in  the  U.S.     Consultant/Advocate  for  engaging  and  empowering  the   Patient  Experience         Program  and  Curriculum  Development  for  healthcare   organizations  and  higher  education  in  the  U.S.     Contact:     Website:     #medimprov08
  42. 42. Beth  Boynton,  RN,  MS  ConsulFng     Medical  Improv  workshops       Integrating  with  ‘Whole  Systems’  consulting  work     Hospital-­‐based  Programs  (pilot  projects)     Undergraduate  curriculum  development  for  of  ALL   healthcare  &  related  studies     Promote/develop  train-­‐the-­‐trainer  programs  (Professor   Katie  Watson,  Dr.  Belinda  Fu  are  planning  next  one-­‐ fall  2014)   #medimprov08
  43. 43. Q  &  A   Working  Definition:   Medical  Improv  is  the  study  and  practice  of  improv  theater   philosophy  and  techniques  as  applied  to  the  unique  challenges   and  environment  of  healthcare  for  the  benefit  of  improved   health  and  well  being  of  providers  and  patients.   -­‐-­‐Professor  Katie  Watson,  JD  Northwestern  University  &  Belinda   Fu,  MD,  University  of  Washington   #medimprov08
  44. 44. Lauren  Dowden   laurendowden@   Stephanie  Draus     Edward  J.  Dunn   Dan  Sipp   Nancy  Smithner   Richard  Snyder   Tobias  Squier-­‐Roper   #medimprov08
  45. 45. THANK  YOU!   Beth  Boynton   Stephanie  Frederick   Judy  White   #medimprov08