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Decreasing Dialysis Patient-Provider Conflict (DPC) Session #4 – Staff Training Modules 7-9 A Collaborative Presentation by Western Pacific Renal Network,

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Presentation on theme: "Decreasing Dialysis Patient-Provider Conflict (DPC) Session #4 – Staff Training Modules 7-9 A Collaborative Presentation by Western Pacific Renal Network,"— Presentation transcript:

1 Decreasing Dialysis Patient-Provider Conflict (DPC) Session #4 – Staff Training Modules 7-9 A Collaborative Presentation by Western Pacific Renal Network, LLC ESRD Network #17 Connie Lorenz, LMSW Patient Services Director 505 San Marin Dr., Bldg. A 300 Novato, CA Southern California Renal Disease Council, Inc. ESRD Network #18 Cecilia Torres-Correa, RN/BSN Patient Services Director 6255 Sunset Blvd., Ste Los Angeles, CA 90028

2 Objectives ● Facilitate key educational strategies ● Encourage critical thinking ● Stimulate meaningful staff discussion ● Complete in a timely fashion ● Keep participants energized and interested ● Increase understanding & build communication skills ● Understand the root cause of the patient conflict

3 Continue to Communicate Module 7 “No relationship, whether personal or professional, is immune to conflict. One constant, though, is that most successful relationships include regular, ongoing communication”

4 Continue to Communicate Module 7 Purpose: ● To share and practice some basic communication skills that can help us listen to and communicate more effectively with our patients Time Required: ● 45 minutes Preparation /Material Needed: ● Case scenario cards ●List of benefits of good communication

5 Continue to Communicate Module 7 Teaching Concept Set a specific time frame to sit down with the patient Be open and ready to deal with the fact that not all conflict is easily resolved If it is evident that the conflict is continuing, consider an independent third party to help mediate

6 Continue to Communicate Module 7 Group Activities ● Group discussion on: Benefits of good communication Why do patients raise concerns? ● Communication Tips: Active listening Assertive statements ● Discussion on the importance of continuing to follow-up and communication ● Open discussion with questions

7 Continue to Communicate Module 7 Benefits of Good Communication ● More confidence in responding to patients ● Less time dealing with disruptions ● Increased patient/customer satisfaction

8 Continue to Communicate Module 7 “How do they think good communication would benefit our patients?” ●Improved dialysis environment ●Increased relaxation during treatment ●Less confusion about expectations

9 Continue to Communicate Module 7 Acknowledge staff challenges: ● We manage a high workload ● Sometimes there are staff shortages ● Patients can be demanding or difficult ● Patients can be disruptive or even abusive

10 Continue to Communicate Module 7 But we all know that: ●Good communication helps us identify reasonable patient requests ●Talking with patients calmly can avoid exacerbating the situation ●We can help identify problems early so that we can inform the appropriate staff

11 Continue to Communicate Module 7 Brainstorming on some reasons patients might raise concerns/complaints: ● They’re scared ● They want to know what to expect ● They’re frustrated, upset, or sad about their health or their personal life

12 Continue to Communicate Module 7 Patients may be dealing with: ●Mental health concerns, such as depression or anxiety ●Mood swings ●Cognitive impairments, such as dementia ●Alcohol/drug use and abuse ●Lack of support from family or other relationships ●Cultural differences or misunderstandings

13 Continue to Communicate Module 7 Communication Tips 1 st Tip – Active listening ● Pay attention to what the patient is saying ● Look at the patient and use body language to show you’re following what is being said ● Tell the patient the feelings that you’re hearing them express

14 Continue to Communicate Module 7 Communication Tips 2 nd Tip – Using Assertive Statements ● Focus on the behavior by being specific about what you need the patient to do ● Acknowledge the patient’s feelings ● Restate the behavior and desired outcome, from the patient’s point of view

15 Continue to Communicate Module 7 Communicating after the Conflict ● Communicate with your patients regularly ● Communication is both talking and listening ● Tell the patient if the conflict cannot be immediately addressed ● Not satisfying someone does not mean that your attempt to resolve the conflict has failed

16 Continue to Communicate Module 7 Negative Responses From Patient ● The professional’s first thoughts ● What was said or done after realizing the patient was still unhappy? ● Utilizing a neutral third party ● Good phrases to use when patients might have to accept solutions that they may never like

17 Continue to Communicate Module 7 Conclusion Effective resolution of a conflict requires follow-up communication. This allows you to monitor the progress being made and demonstrates to the patient your commitment to resolving the conflict. How's it working out?

18 Take Another Look Module 8 Purpose: ● Looking at conflict from a quality improvement standpoint Time Required: 30 minutes Preparation /Material Needed: Handout #1: CFC Requirements regarding complaints Handout #2: Individual facility’s grievance policy Handout #3: Reviewing the facility’s policy on grievances

19 Take Another Look Module 8 “Handling a conflict, like successfully performing dialysis related tasks, requires practice, understanding, education, and monitoring. Regardless of whether a conflict is minor or major, reviewing the steps used in addressing the conflict will be beneficial”

20 Take Another Look Module 8 Teaching Concepts ● Meet with other staff members ● Seek additional training ● Take a close look at the role you played in the conflict ● Evaluate and understand the root cause of the conflict

21 Take Another Look Module 8 Group Activities ● Understanding the grievance process ● Communicating after a conflict ● Wrap up and questions

22 Take Another Look Module 8 Understanding the Grievance Process Three Handouts: ● CFC requirements regarding complaints and/or grievances ● Two individual facility’s policy on grievances ● Questions about the facility’s policy on grievances

23 Take Another Look Module 8 Communicating After a Conflict As a patient: ● Would you feel comfortable raising a concern in this clinic? Why? Why not? ● Would you feel empowered by filing a complaint? If not, how would you feel? ● Who might not be feeling well, does the policy create a process for you to easily file and follow up on a complaint? ● Does the current complaint system provide a means by which you will be notified?

24 Take Another Look Module 8 Conclusion When Dealing With Conflict: ● Be willing to honestly examine the role we may have played ● Be open to feedback ● Recognize the strengths we have for handling conflict ● Always be willing to learn new skills

25 Take Another Look Module 8 Conclusion Continued ● Never stop trying to understand the causes of conflict ● Do not limit our conflict-intervention methods to one approach ● Be open to opportunities for learning that often arise from conflict

26 Common Patient Concerns Module 9 Purpose: ● To identify some of the most common concerns and solutions we’ve experienced in our dialysis unit Time Required: ● minutes Preparation /Material Needed: ● Handout #1: Common patient concerns

27 Common Patient Concerns Module 9 Group Activities ● Common patient concerns ● What’s in your top 10? ● Wrap up

28 Common Patient Concerns Module 9 Most of the concerns we hear fit into one of four categories: ● Staff issues ● Treatment issues ● Food and diet issues ● Safety and policy issues

29 Common Patient Concerns Module 9 What’s in Your Patient’s Top Ten? ● Dialysis takes too long ● I want to get off the machine early ● Why can’t I drink a soda while I’m on the machine? ● I want more privacy ● It’s always cold in here

30 Common Patient Concerns Module 9 Conclusion ● We will sometimes have conflict with disruptive patients ● Asking for help early or reporting conflict to staff sooner rather than later will help the situation ● Help one another to provide support to the patients and help them manage their frustration

31 Additional Resources *DPC Tip Sheet #2 - Staff Training Modules *DPC Tip Sheet #1 - Administration * Developed by ESRD NW#15

32 CEU Requirements EVALUATION! Evaluation forms can be found on NW #17 or NW #18 websites under: “CEU Evaluation for DPC WebEx Session 4” You must attend all 5 sessions to receive CEU credit! Please return completed evaluation forms by fax to: Social Workers - NW #17 (415) RNs - NW #18 (323)

33 Upcoming DPC WebEx WHEN: May 11, 2010 TIME: 9:00am - 10:00am SUBJECT: Quality Improvement Tools Please feel free to contact us with questions Network #17: Connie Lorenz (415) Network #18: Cecilia Torres-Correa (323)


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