Hospital Education

Strategies for Developing Successful, Professional Relationships... FROM THE INSIDE OUT by Christina B. Pippin, RN, PTC

Wheel of Service… Hub - AOC (organization, purpose, mission statement, values, expectations, SOP’s, etc.) Spokes - Staff (perception, work ethic, attitude, morale, motivation, dedication, performance, etc.) Rim - Clientele ( Hospital staff members, community, donor families, fellow OPO staff, etc.)

How well does the wheel function???

Factors that affect function… Organizational “set-up”, structure, and values Hub : a center of activity or “ focal point” Employee morale, dedication, work ethic, and leadership Spokes : any of the small radiating bars inserted in the hub of a wheel to support the rim CLIENT PERCEPTION!!! Rim : the outer part of a wheel joined to the hub usually by spokes

Internal Marketing “Stabilizing the wheel” Spokes : any of the small radiating bars inserted in the hub of a wheel to support the rim

Is Internal Marketing Important??? *When employees commit to the value of the company and its mission, external marketing strategies become extremely effective , because the employee is not merely “ doing a job”… HE/SHE IS A CHAMPION OF THE CAUSE. ~BNET Editorial

Defining Morale Morale : 1.) the mental and emotional attitude of an individual to the function or tasks expected of him by his group and loyalty to it; 2.) a sense of common purpose with respect to a group; 3.) a state of individual psychological well-being based on factors such as a sense of purpose and confidence in the future . ~Webster’s Dictionary, 1969

“ THE DIRTY DOZEN” (Common everyday actions that destroy morale) Personal insults (either direct or INDIRECT) Invading one’s “personal territory” Uninvited physical contact Threats & Intimidation, BOTH verbal and non-verbal “ Sarcastic jokes” and “teasing” used as insult delivery systems Withering e-mail flames Status slaps intended to humiliate their victims Public shaming or “status degradation” rituals Rude interruptions (Lack of respect) Two-faced attacks (gossip) Dirty looks Treating people as if they are invisible ~Robert I. Sutton, PhD The No Asshole Rule, 2007

“EIGHT IS ENOUGH” (eight steps to improving morale) Focus on what you can control, Not on what you can’t. Do “The Big Three”. Notice what colleagues do right, listen, and show appreciation. Engage one another in ongoing conversations about improving morale. Ask for feedback, especially after difficult interactions (show you care). Ask yourself: “Am I inspired?” Ask yourself: “AM I INSPIRING?” Learn Which Factors And Practices Make The Biggest Difference In Morale And Productivity, And Commit To Executing Them. Learn more about human nature and commit to working for it, not against it. (Maslow’s hierarchy of needs) “ 8 ways managers can improve morale” The Employment Times – April 19, 2004 By David Lee humannatureatwork.com

“ All humans have a need to be respected, to have self-esteem, self-respect, and to respect others. People need to engage themselves to gain recognition and have an activity or activities that give the person a sense of contribution, to feel accepted and self-valued, be it in a profession or hobby.” Wikipedia – Maslow’s hierarchy of needs

Creating workplace champions… “ The best measure of human character is the difference between how a person treats the powerless versus the powerful”… ~ Robert I. Sutton, PHD THE NO ASSHOLE RULE, 2007 * When an organization appreciates that EACH and EVERY “spoke” is anchored to the “hub” with an equal responsibility in supporting the “rim”, an organization will effectively move forward .

What is your impact on morale???

External Marketing … “Where the rubber meets the road” Rim : the outer part of a wheel joined to the hub usually by spokes

Psssst! Somebody’s Watching You…

Dissatisfied Customers… “The Aftermath” “ Strong client relationships impact an organization's productivity more than any ad campaign or public relations effort. Most organizations know that a satisfied client translates directly to increased opportunity. Dissatisfied clients produce devastating ripple effects. Client loyalty is the key to building a thriving organization. Companies create loyalty by building long-term relationships based on trust. These relationships lead to new opportunities and satisfied clients.” ~Building Better Customer Relationships IFI Training, 1999 A dissatisfied customer will tell 9-10 people about a negative experience. That number increases if the problem is not serious. ~Six Sigma

Hearing vs. Listening Repetition, Repetition, Repetition… “ Teaching something repetitively strengthens horizontal connections in the brain's cortex, where the circuitry of long-term memory operates.” Nature Neuroscience, July 1998

HIGH FIVE!!! “ Multiple studies reveal that an advocate will repeat a key message a minimum of five times before a client will begin to retain it.” ~Amedisys Sales Training & Leadership Development Conference, 2005 Orlando, FL

FIVE RULES FOR GREAT REFERALS… Earn trust Be specific about what you want Ask for action Find creative ways to repeat the message Follow-up three times *Express gratitude for the referral within 24 hours. This is not only polite, but gracefully reminds the potential referrer of the commitment & helps establish client relations . * Send a thank-you e-mail / thank-you note to the referral source, give a brief status report, and reinforce appreciation . * If a referral converts to a donor, follow-up with a donor letter/thank you. Geoffrey James ~ Sales Machine , September 2007

Avoid Repetitis!!! (Becoming sick of repeating your message)

What Do We Want to Accomplish? Increase Organ and Tissue Donation Assess to determine barriers to and opportunities for, increasing donation Determine information needs of target populations and programs to increase donation awareness Conducts and evaluates specific activities to develop and improve donation rates Achieve 75% Conversion Rate Achieve 100% Timely Referral Rate Spread HRSA “First Things First” Best Practices (as defined by ODBC) Maintain Increases

Public Education Activities Increase the publics awareness of organ, eye, and tissue donation. Provide information about donation to community and corporate groups Encourage a pro-donation culture

Public Education Activities Evaluate donor awareness activities by reviewing trends in consent rate. Review internal sources of data - specific hospital or DSA data Review external sources of data – OPTN.org HRSA

Determine the Hospital’s Donor Potential Conduct Medical Record Reviews (MRR) Death Record Reviews (DDR) Identify critical elements to assess in the MR including: hospital unit, date and time of referral, patient demographics, cause of death, and outcome Document critical data on an evaluation tool Generate and provide a report that reflects the data outcome to share with each hospital and OPTN. Use the data to develop your strategic HD plan for the hospital

Determine the Hospital’s Donor Potential Review referral activity at each hospital Determine whether all: deaths were reported cardiac deaths were reported in a timely manner imminent deaths were reported when established clinical triggers were met withdrawal-of-ventilatory-support cases were reported prior to the withdrawal process

Establish and Analyze Hospital Performance Goals Identify hospital performance goals established by HRSA, JC, and OPO. Compare the hospital’s data to established goals Utilize your DDR data to evaluate reporting compliance

Clinical Triggers Identify common clinical triggers for timely referral associated with: Severe neurologic injury loss of 3 or more cranial nerve reflexes physician determination of grave prognosis on ventilatory support Donation after Cardiac Death withdrawal of dependent ventilatory support neurological injury

The HD Learning Curve Where are you now? Hospital Education and Rounds OPO Education, Hospital Education and Rounds Partnership for Organ Donation National Associations on Board Collaboration and Relationships Waiting for Donors Where would you like to be?

Survey Key Hospital Staff What is the donation climate of the hospital? Who are “Key Hospital Staff”? Determine attitudes and knowledge regarding donation Collect qualitative and quantitative information from the key staff: face to face individual interview after action reviews post donation staff surveys

Hospital Action Plans Create, implement, and modify the hospital's action plan based on data collection Determine what level of authority is necessary to implement the plan Utilize performance goals to establish or modify an action plan Document the strategic plan for endorsement by upper level management Periodically reevaluate implementation of the strategic plan and modify if necessary

Hospital Profiles Compile and update specific information for each hospital to develop or review at least annually May include : CMC Provider number address Trauma Center Level Services # in-pt beds # CC beds Helipad access Transplant Hospital Med/Surg Residency Program

Donation Champions Conduct effective rounding to establish relationships with potential champions Identify champions based on their behavior during a donation case, or their consistent, frequent and timely referrals Integrate champions into the OPO culture that serve as a resource in real time. Provide information to champions regarding the hospital’s donation data and the comparison to national benchmarks

Donation Champions Identify and support organ donation champions at various levels including leaders who are willing to be called on to overcome identified barriers to organ donation in real time.

Hospital Performance Compare the hospitals performance to other hospitals in the region and national benchmarks… How? Utilize dashboards to compare hospital performance to national benchmarks

Dashboards Evaluate process measures: Referral Rate Timely Referral Rate Effective Request Evaluate outcome measures: Conversion Rate Organs Transplanted per Donor (OTD)

Collaborative Relationships Build and maintain the necessary collaborative relationships with key hospital staff/physicians at all levels that impact the donation process

Hospital Presence Create and maintain a consistent visual hospital presence Visual presence: Develop promotional materials Distribute donation reminders Distribute professional education materials Physical Presence: establish and conduct routine effective rounds conduct routine meetings as indicated

Improvement Activities Conduct a needs assessment and establish targeted venues for improvement activities Examples: Grand Rounds In-services Hospital orientations Medical staff meeting Donation councils

Hospital Education Remember: Tailor education to the needs of the identified staff Deliver education at a time and place as indicated by the hospital staff We are a service organization

Impact of Other Recovery Agencies? Determine the impact of other recovery agencies on the donation process Ask the hospital staff for feedback regarding their experiences Assess donation trends: organ, eye, and tissue

Communication Maintain a formal process for comprehensive immediate follow-up communication between the hospital and activity Determine information necessary to detail events and outcomes of each donation referral or case Determine communication medium for distribution of follow-up information Establish routine standards for dialogue relative to all follow-up communication

Hospital Reports Provide regular reports of hospital donation outcomes to all key hospital staff Determine appropriate reporting frequency Standardize outcome information based on hospital goals Deliver, or distribute in an effective manner, report to appropriate hospital personnel Respond to questions and feedback

Culture of Accountability Establish a strong culture of accountability for donor outcomes Collaboratively establish expectations with staff authorized to make a difference Identify opportunities for improvement Reinforce behaviors that optimize outcomes

Review Question #1 A procurement coordinator should schedule hospital in-service education activities: Quarterly with medical and nursing staffs After every 20 referrals Only when requested by the hospital Based on individual hospital needs

#1 Answer 4. Based on individual hospital needs

Review Question #2 A Regional Trauma Center appears to have a significant donor potential that has not been developed by any OPO. In seeking to develop an organ donor program, the procurement coordinator should first schedule an appointment with: Neurospecialty staff Critical Care Supervisor Hospital Administrator Director of Nursing

#2 Answer Hospital Administrator “ Leadership drives values, Values drive behavior, Behavior drives performance.” ~Ann Rhodes President and CEO of Jet Blue

Review Question #3 Public Education programs regarding organ donation should include all of the following issues EXCEPT: Religious Beliefs Brain Death Declaration Organ allocation Methods Medicare Cost reports formats

#3 Answer 4. Medicare Cost Reports formats

Review Question #4 National Benchmarks include: 100% Consent Rate 100% Timely Referral Rate 75% Conversion Rate 5 Eligible Donors per hospital

#4 Answer 75% Conversion Rate 100% Timely Referral Rate

Review Question #5 One Method to evaluate donor awareness in the public is to: Evaluate hospital death records Evaluate consent rates Evaluate the size of your DSA considering urban versa rural population Evaluate your DSA’s Faith Base

#5 Answer Evaluate consent rates

Review Question #6 Hospital Action Plans: Are generalized to accommodate all hospitals in your DSA. Are developed based on the direction of the hospital Administrative staff. Are to be evaluated annually in your “A” hospitals. Utilize Performance goals to establish or modify an action plan.

#6 Answer Utilize performance goals to establish and or modify an action plan .

Review Question #7 Donation Champions: Are identified during effective rounding. Need to be upper level management. Need to be staff members who work directly with patients and their families Are available at any time 8-5 pm .

#7 Answer 1. Are identified during effective rounding.

On your mark… Get set… Get rolling!!!

Hospital Education

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