Exceptional Customer Service: AIDET

1. Exceptional Customer Service: AIDET Department of Family Medicine March 3, 2010

2. Customer Service: A Physician’s Perspective Dr. Christina Finlayson, Associate Medical Director, University Physicians, Inc. Professor, Department of Surgery University of Colorado Denver School of Medicine

3. Goals • Introduce you to Studer Philosophy • Introduce you to AIDET • Show you that AIDET makes good clinical and business sense • Patient outcomes • Patient compliance • Patient satisfaction • Invite you to join our service journey

4. Background • Quint Studer – Hardwiring Excellence • Principles: • All of us want to make a difference • Engage in meaningful work • Healthcare is built on relationships • With patients • With one another • We can proactively create value and influence patient perceptions and feelings about their care

5. Studer Program Key Components: • Employee/Provider Satisfaction - Currently reviewing Department results • Patient Satisfaction (E.g. Scripting) • Performance Management (E.g. focus on moving medium-low to high performance or out)

6. Studer Clients • Sharp Chula Vista (Baldridge Winner) • TCH – Denver • Cleveland Clinic • University of Arizona – Tuscon • Ohio State University • Vanderbilt University • Columbus Regional Hospital (2x Baldridge Winner)

7. What do our Patients want from us? Medical Outcomes BUT ALSO….. • Feel Important • Be Comfortable • Feel Welcome • Have their problems solved • Feel Compassion/Concern • Receive Timely Service • Be listened to and seen as a person

8. Sometimes in the flurry of the day to day • Caregivers and staff are not consistent about using words with patients that help them feel welcomed, valued, and unique • We get rushed and forget • to greet patients • to help them feel welcome and special • that they do not know what to expect from our healthcare system

9. AIDET.........communication tool that lends consistency to our interactions with patients and each other…… 9

10. Simple Words that Work : AIDET AAcknowledge I Introduce D Duration E Explanation T Thank You An acronym that represents a very powerful way to communicate with patients who are often nervous, anxious, and feeling vulnerable.

11. How Does AIDET Work? A– Acknowledge the patient by greeting them with a smile “Good morning, Mr. Brown. It’s good to see you today” I– Introduce yourself and tell patients about your experience background “Hi, I’m Dr. Sullivan. I’ll be caring for you today. I thought it would help you if I gave you a little background information on me. I graduated from University of Colorado, Denver. I have been in practice to 20 years and at UCD for 15 years” D – Duration: Tell the patient how long your part of their care will take and the approximate time before the next caregiver will see them. “This procedure will take about 15 minutes; and you will recover for about another 15 minutes.” E – Explain the process “Here’s what you can expect in your ED visit today.....we are going to…..” T – Thank the patient and make it personal “Thanks, Mr. Jones, for visiting with us today. If you have questions after this visit, please call and ask for my nurse, Jenny, she will be able to answer them for you. She will confer with me as needed.” Page 14

12. What’s the Value of AIDET? Decreases Patient Anxiety Improves Medical Outcomes & IncreasesPatient Satisfaction Increases Patient Compliance + =

13. Why Does AIDET Work? Each interaction is an opportunity to make a difference in the patient’sexperience You and your team can create thefeelings patients leave with and theirperception of the department 13

14. Research around Customer Service

15. Patients global rating of care in the outpatient setting are: • Significantly correlated with their physicians communication skills (coefficient = 1.73, 95% CI 1.10 – 2.35; p = .00) • Not correlated with quality of care, as determined by chart reviews that investigated whether the standard of care was met (coefficient = 0.03, 95% CI -0.12 - -0.18;p = .68) Chang, JT et al, Annals of Internal Medicine 2006; 144: 665 – 672

16. Physician behaviors that contribute to patient adherence to care • Excellent communication between the patient and the provider improves adherence to medication regimens • Patients who do not comprehend all aspects of their disease or the importance of the treatment in controlling the disease and preventing adverse outcomes are less likely to be adherent with the treatment plan • Harmon G,et al, Curr Opin Cardiology 2006; 21: 310 – 315

17. The importance of the Greeting • 78.1% of patients wanted their physicians to shake hands • 91.3% of patients wanted to be addressed by their name • Makoul G, Zick A, Green M, • Annuals of Internal Medicine 2007;167: 1172 – 1178 • If you are worried about hand hygiene…explain that you aren’t shaking patient’s hands and why………

18. Communication and Malpractice Claims • Risk of most malpractice suits is predicted by practitioners’ inability to communicate well with their patients • Specific physician behaviors that significantly increased the likelihood of malpractice suits include: • Lack of respect • Not listening to the patient • Not providing adequate feedback • Hickson, GB, et al. NC Med.J 2007: 68:362-364 • Levinson W, et al. JAMA 1997; 277: 553 – 559

19. Relationship between patient satisfaction, complaints and lawsuits • Physicians with lower patient satisfaction results are more likely to have  patient complaints (RR 1.79;95% CI 1.38-2.33; p<.001) • Each one point decrement in patient satisfaction scores is associated with a – • 6% increase in complaints (RR 1.06, 95% CI 1.03 – 1.08;p<.0001) • 5% increase in risk management episodes (RR 1.05, 95% CcI 1.01 – 1.09;p< .008) • Lower performing physicians were at greater risks for lawsuits (RR = 2.10;p 95% CI 1.13 – 3.90; p<.019) • 75% of complaints were related to communication issues • Stelfox HT, et al, The American Journal of Medicine 2005; 118: 1126 – 1133

20. Patient Satisfaction Results Using AIDET

21. AIDET Patient Satisfaction Experience AIDETSM Training Began Source: Illinois Hospital, Beds = 303, Admissions = 17,486, measured by Press Ganey Associates, Inc. 21

22. Patient Satisfaction Results using AIDETSM Increase of 28 percentile points

23. Patient Complaints using AIDETSM

24. Why introduce AIDET at UCH? • We want to build on the exceptional clinical care that you currently provide • We want to couple consistently high customer service with outstanding clinical care

25. AIDET Roll Out Plan (Staff) • During summer all ambulatory staff went through AIDET training • Starting November ~ • Staff meetings include practicing AIDET • Rewards and recognition program for staff • Include AIDET in all new employee orientations • Begin to evaluate staff in their consistent use of AIDET • Looking to expand to other departments in the near future

26. AIDET Roll Out Plan (Faculty/Residents) Take AIDET on the road to faculty meetings across the SOM T. Finlayson/R. Zaccardi A. Meacham/S. Sullivan

27. Join The Game! 27