Sometimes, its what you say

Words are important and when communicating with patients what we say sets the tone for the patients expectation of care.  Here’s some information I received in an email from one of our Studer Coaches, Regina Shupe.

I have also found that there are words that cause anxiety or doubt or mean absolutely nothing to patients. These are words that we may not expect will cause anxiety. Take for instance the word “hope/hopefully“. This is an innocent word that we use in the healthcare setting that causes doubt and concern in our patients. Take for instance saying to a patient, “Mr. Smith, I am giving you this medicine to reduce your pain. Hopefully this will take care of it.” To a patient, that does not instill trust that we are going to work to relieve their pain. Hope is not a strategy. It’s better to say, “Mr. Smith, I am giving you this medication to reduce your pain. I will recheck you in 20 minutes, and if this has not improved your pain to an acceptable range, I will check with the Doctor to review your plan and make adjustments.” That describes a plan for this patient that instills trust and reduces his anxiety.

Another word that I hear repeatedly in healthcare is the word “probably“. For instance, “Mr. Smith, we are probably going to get an x-ray of that ankle.” We are either going to get an x-ray or not. ‘Probably’ creates anxiety for this patient because it is vague and non-specific. We can say, “Mr. Smith, we are going to get an x-ray of that ankle, review and proceed from there with the appropriate treatment for this injury.” That is a plan that instills trust and reduces anxiety.

The words that I hear most often that have no positive impact for a patient center on the “D – Duration” in AIDET. One of the priorities for our patients is to have an understanding of how long something is going to take. That is the number one driver of patients’ perception of care in the emergency department. The words that I hear regarding duration include – “As soon as we can“, “As soon as possible“, “Pretty quick“, “Few minutes“. These statements do not give a patient an expectation of how long something is going to take. Staff and Providers admit they use these statements because they don’t know how long something is going to take.

The truth is, we know more than we say. The problem with these words and phrases is that we leave it to the patient to set their own expectation of time—and we may or may not meet this patient’s expectation. For instance, I may say “Mr. Smith, I am going to have you take a seat in the waiting room and we will get you to a room as soon as possible.” I have left it up to Mr. Smith to determine what “as soon as possible” means. Now when I use a few different words, I set a very different expectation for this patient. For instance: “Mr. Smith, we are experiencing a high volume of patients in the ED right now. I am going to ask you to take a seat in the waiting room. We are committed to keeping you informed of your progress so we will be rounding in the waiting room every hour to check on you. If you feel your condition changes please let Mary, our triage nurse, know.” This sets a more accurate expectation for this patient. Now he knows he can expect up to an hour wait and someone will be out to let him know the progress.

About Craig Thompson

I am a young professional with two great sons, and I work in the healthcare setting. I am employed in hospital administration and serve as Chief Executive Officer at Golden Valley Memorial Healthcare in Clinton, Missouri. At GVMH we care for our families, friends and neighbors. We're committed to providing the safest, friendliest and most compassionate care to all we serve.
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