Tag Archives: communication

The Patient Experience: The Importance of Care, Communication, and Compassion in the Hospital Room

Book cover of "The Patient Experience"

Book cover of “The Patient Experience”

I believe in healthcare because I owe my life to modern medicine.

As a Hopkins M.A. in Communication student, healthcare advocate, and former ICU patient, I have focused my efforts on improving the level of communication in the hospital between the patient, their family, and the care providers that are taking care of them.

I frequently speak about the patient experience throughout the year, and I have collaborated with several health care institutions on communication projects related to patient and family engagement in the hospital setting. One project in particular that I really enjoyed working on last year was ‘Project Emerge’ with Dr. Peter Pronovost and the Armstrong Institute for Patient Safety and Quality at Johns Hopkins. This project consisted of a technologically innovative electronic tablet that improves communication in the hospital setting. Later this summer I will be working with the Armstrong Institute again on a national project regarding mechanically ventilated patients.

My path to the health communication field began one month after I graduated high school in 2004. I was coming home from swim practice and was involved in a near fatal car accident with a speeding dump truck. My dreams were shattered like the bones in my body. I lost 60% of my blood, heart was ripped across my chest, lungs collapsed, major organs were damaged, pelvis and ribs were pulverized, and I was resuscitated eight times. While in a two-month long medically-induced coma, I was unable to move or talk to anyone around me, yet I was able to hear, see, and feel pain for a majority of my time in the Intensive Care Unit.

As a family, my parents and I never thought that we would face such a traumatic situation, or rather, such a horrific nightmare. We were thrown into a place consisting of surgeries, machines, tubes, blood, and medical terms that caused utter confusion.

Due to a concussion, I woke up not knowing how I arrived at the hospital, or why I was paralyzed, or why my parents were hysterically crying every time they came in my room. I had so many questions and needed so many answers. My parents had many questions also – about my prognosis, what the future would hold, and if life would ever return to normal. But again, there were no answers. There was no guidebook or support group to prepare us for what we were in for as a family.

What I learned throughout my time in the hospital is that while I may have been the patient lying in the hospital bed, I was not the only one in that room who was suffering. The observations that I made truly inspired me and helped me understand how important the role of communication is among the patient, family, and health care provider. When I was able to learn how to talk again, I soon discovered that the power of the voice is amplified when the message is of gratitude, that a simple smile cannot be underestimated, and that body language and tone of voice are critical components within the hospital room.

Speaking at the 2012 Johns Hopkins Patient Safety Summit

Speaking at the 2012 Johns Hopkins Patient Safety Summit

This background that I have as a patient, and now healthcare advocate, is what inspired me to want to pursue my M.A. in Communication at Hopkins. I have the background of being a patient, but now I’m gaining the knowledge and resources in my classes to be able to influence the level of care and communication in the healthcare realm. Last semester in my Independent Study course, Professor Susan Allen gave me guidance and support as I wrote my second book called, The Patient Experience: The Importance of Care, Communication, and Compassion in the Hospital Room. In this book, my parents and I share our sincere gratitude and insight with the medical community from a patient and family perspective. We also hope that our experiences can offer hope and guidance for families facing the heartbreaking sadness when an unexpected, life-altering medical situation occurs.

Our goal is to offer suggestions that we hope will improve the overall experience for both the caregiver, the patient, and their family. In order for us to provide better care for these individuals, we must understand the experiences they go through within the health care system. We must observe what they think and feel as they go through their journey. Our story is only one journey and it is intended as a means to express our appreciation to health care providers and also initiate the much-needed conversation of how we can take a step further to improve the experience for the patient and their family.

This book offers a rare and unique glimpse of what the patient and family are going through, and it covers the information that my parents and I wish we had during our time in the hospital.

brianboyle_biophotoBrian Boyle has been on a mission to make an impact in healthcare education since he left the hospital in 2004. He has been recognized for his contributions with several national awards, including the American Red Cross Presidential Award for Excellence, the Daily Points of Light Award, the Johns Hopkins Martin Luther King Jr. Community Service award, and the Champion of Change award from President Obama. Brian has appeared on the Ellen DeGeneres Show, NBC’s Today Show, ESPN, CNN, and several other programs throughout the country. He is the National Volunteer Spokesman of the American Red Cross, a columnist with The Huffington Post, a blogger for The British Medical Journal, a patient advocate for The Armstrong Institute, and is currently in grad school at Johns Hopkins University earning his M.A. in Communication and an MBA with a concentration in Healthcare Management. He resides in Southern Maryland. More information on Brian’s story can be seen on his website, Twitter, and LinkedIn account. 

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Behavioral Economics helped a communications campaign—Lessons from the Behavioral Interventions to Advance Self-Sufficiency (BIAS) project

HHS & ACF logosAs communicators, we know people don’t always make the choices we hope they will in spite of our most persuasive campaigns. Recently, the Department of Health and Human Services, Administration for Children and Families (ACF) wanted to see whether applying behavioral economics theories could help improve social service programs and policies. We, the Office of Child Support Enforcement, specifically want to understand how people’s behaviors and decision-making abilities affected their decisions in child support situations. In this specific study in Texas, could behavioral economics research help improve the number of applications an office would receive from their mailing campaign to get incarcerated parents to apply for child support order modifications? Based on the data, it worked!

Background

There are 1 million parents in federal, state, and local jails. Many have court orders requiring them to pay child support. Some state and local child support offices often try to get these parents to have their court-ordered child support payments changed for the time they are incarcerated so they don’t build up child support debts during their jail time.

Order modification is not an automatic process in most states; parents need to request a review when their economic status changes, such as when they are incarcerated. The majority of noncustodial parents do not request a modification so they leave prison owing thousands of dollars in back support.

The Behavioral Interventions to Advance Self-Sufficiency (BIAS) Project Texas Study

The ACF Office of Planning, Research and Evaluation  wanted to understand two things: why these parents fail to respond to mail outs that explain how they can request modifications; and what kinds of small, inexpensive process changes could state and local agencies make that would influence more parents to complete a modification packet.

The ACF research team studied the process the Texas Attorney General’s (AG) Office used to see if changes based on behavioral economics research could increase request rates.

The Standard Process

The AG’s office would send parents letters that told them they had the option to apply for a modification, gave them instructions on how to start the process, and included a form for the parent to fill out. Less than 30 percent responded to this outreach in spite of its benefits. The BIAS team looked for bottlenecks in the process and tried to figure out what behaviors motivated the parents to ignore the opportunity.

The Barriers

INCARCERATED_Initial_Inverse_Postcard

Back side of teaser postcard

The BIAS team saw some potential behavioral bottlenecks in the modification application process. When inmates received envelopes with the Texas Attorney General’s return address, they may have thrown them away without even determining what was inside. For others, the form letter was not written in plain language so it may have been difficult for inmates with limited educations to understand. Still for others, the form may have been daunting. It had too many blocks to fill out and the inmates often did not have important information such as their child support case number or the custodial parent’s address. Another significant barrier was likely meeting with the prison’s law librarian to get the paperwork verified and notarized. It sometimes turned into multiple visits to ensure the paperwork was accurate and complete.

The Solutions Tested

Front side of teaser postcard.

Front side of teaser postcard.

Staff members sent a teaser postcard before the letter was mailed. The AG’s office removed its office designation from the envelopes to make them less intimidating. The staff made the form letter more readable and then printed it on colored paper to make it stand out. They included a short, four-step checklist for the parents to follow. Staff members pre-populated a section of the application so the inmate wouldn’t have to try to find the data. Finally, the office sent a reminder postcard a few weeks after the letter was delivered for those who hadn’t returned the application.

Results

The entire effort added less than $2 per inmate for printing the postcards, purchasing the postage, and pre-populating the applications. The results were much more significant. The response rate rose from 28 percent to 39 percent!

Next Steps

Here at the Office of Child Support Enforcement, we’re excited to continue our studies in communications and behavioral economics. ACF awarded a new grant awarded October 1 called Behavioral Interventions for Child Support Services. Five state-run child support agencies and the District of Columbia will receive portions of the nearly $4 million grant to continue to test strategies that might improve outcomes in broader child support situations.

More Information

If you would like to find out more about behavioral economics and how ACF applied the theories in this BIAS study, the information is on this webpage, Taking the First Step: Using Behavioral Economics to Help Incarcerated Parents Apply for Child Support Order Modifications.

Members of the BIAS study team also spoke at a panel discussion at a Welfare and Evaluation Research Conference recently. The video is on YouTube, https://www.youtube.com/watch?v=cRy8gxI5Mdo&list=TLQzSJxueVr71qyTz3cs5IdS5z-WQnaCxt

 

Danek_Kim_6X5-5Kim Danek, a 2013 JHU MA Communication alumna, is a Writer/Editor at the Office of Child Support Enforcement in the Administration for Children and Families, Department of Health and Human Services. She is also a retired Army public affairs sergeant major. You can find Kim on Twitter at @KimDanek or LinkedIn, Kim Danek. Her email address is kim.danek@acf.hhs.gov.

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How to change people’s minds

I noticed that one of the points I made in my first blog post that generated some interest was the idea of “changing people’s minds” through communication.

After all, as a nonprofit communication person, that is ultimately my job. So, I am going to lay out what I see as the five basic steps to using communication to change people’s minds about an issue.

1) Just the facts, ma’am. One of, if not the first, things you need to do is make sure you have out the facts out there about why behavior X is better than behavior Y. Data is cold and heartless and is never sufficient for changing someone’s mind, but it is necessary to supplement everything else you are doing. In our case, we make sure folks know that, on average, when children grow up without fathers, they face a variety of risks across various measures of well being.

2) Give them something to do. When trying to end one set of behaviors, you can rarely make someone stop without giving them something to replace those behaviors with. Moreover, as I said in one of my replies to the first blog post, it is easier to act your way into a new way of thinking than to think your way into a new way of acting. That is why fatherhood skill-building is a huge part of what we do. We make sure that we are actually helping dads build their skills (communication, parenting, relationships, etc) and giving them practical ideas for every day involvement in their kids lives.

Image3) Inspire them with “fluff.” From time to time it is important to supplement the facts and the action with inspirational messages and stories to keep folks motivated. There has been much written about the power of telling good stories, so I won’t go into that here, but just know that showing (via stories) is often more powerful than telling (such as using data). There is also the concept of “social learning,” where people learn by watching others. So, in our case, the more we can show examples of fathers being involved in their kids lives, the more we can hope to inspire other fathers to do the same.

4) Cut out the negativity. On the other side of the “inspiration” coin is “the word that is the opposite of inspiration.” I don’t have a thesaurus handy, sorry. But just like people can be inspired by a good story or an inspirational PSA, they can also be de-motivated or discouraged if they see too many examples of people engaged in the behavior they are trying to move away from. In our case, there are far too many examples of “bad dads” out there in the media, and far too many messages out there about how fathers are “replaceable.” We do what we can to discourage folks from producing those types of messages, and, if they are produced, from consuming them (eg, write a blog post condemning a bad sitcom).

5) Rinse and Repeat. I wonder how many people actually wash their hair twice, like the shampoo bottle suggests. But I digress. The point here is that you have to keep doing all of the above over and over again in order to help people really move from one attitude and set of behaviors to another. It is a long, tough process, but it is worth it! When we hear stories about how a dad turned things around and is involved in his child’s life, it makes all the effort worth it.

What do you think? Did I leave anything out? Would love to hear your feedback.

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Communicating for Social Change

Greetings! I’m Vincent DiCaro, and this is my first blog post here on the JHU Communication Career Blog!

I hope over the next few weeks, I can share some insight about communication in general, and specifically about my experience working in the nonprofit world.

ImageAs you can guess from the title of this blog post, my job is really about “communicating for social change.” I work for the National Fatherhood Initiative (NFI), a national nonprofit based in Germantown, MD. At the end of the day, I am trying to get people to change their minds and, hopefully, their behavior. As you can guess, we are working to help men be better dads, and educate and inspire the public as a whole about why it is important for children to have good fathers in their lives. It is not an easy job, but it is important work, and that is why I have been at NFI for over 11 years now. 

I started my career at NFI answering phones, and now I am a vice president. I hope to share on this blog how that all went down, and what I have done in those 11 years to “communicate for social change.”

I will write about some of speeches I’ve given, and why you shouldn’t be afraid of public speaking. I will write about some of the cool technology I use every day to help me do my job. I’ll write about some of the things I’ve picked up about leadership and how I think you can become a better leader.

So, rather than diving into those topics right away, I want to ask some questions; I want your suggestions on some of the things you want to hear from out here in the hinterlands of Montgomery County 🙂 

So, what would you like to know about working in the nonprofit sector? Do you have any questions about the tools of the trade I use to do my job? Is there anything you want to know about leadership and growing as a leader? Any other questions are welcome, too!

I look forward to communicating with you!

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