Patient and Family Shadowing Neurology Clinic Memphis, TN

Why Shadow? Understand patients and families Identify the positive Renew sense of empathy Reveal inefficiencies that waste time Gain qualitative information

https://www.youtube.com/watch?v=H5u1B7vIbxM&feature=youtu.be

Things to consider before shadowing: Relationship status Building rapport Approaching the practice

Identify practices to shadow YOUR TURN! Identify practices to shadow

What is shadowing?

as they move through each step of a Patient and family shadowing is the direct, real-time observation of patients and families as they move through each step of a care experience.

Key Terms Care Experience Touchpoint Caregiver

Care Experience A “care experience” when you are shadowing can be any aspect of the patient’s and family’s health care journey, in any inpatient or outpatient setting.

Touchpoint A “touchpoint” is any place patients and families go during their care experience.

Caregiver A “caregiver” when you are shadowing is any person whose work touches a patient’s or family’s experience

What to look for when shadowing: Flow of care Caregiver activities Touchpoint duration Emotional reactions

Flow of Care The flow of care includes where patients and families go and with whom they come into contact.

Caregiver activities What caregivers do and how patients and family members view these interactions.

Touchpoint Duration How long the experience at each touchpoint takes.

Emotional Reactions Any emotional cues from the patient or family, especially anything that seems to increase or decrease anxiety.

QUESTIONS?

Follow these 5 steps when conducting your shadowing experiment: 1. Establish your purpose. 2. Set up time to shadow. 3. Follow, observe, and record. 4. Create an observational summary. 5. Report your findings.

Step 1: Establish Your Purpose Your clinic Neurology Clinic The care experience you’d like to examine What you hope to learn Who will do the shadowing MA/Nurse job duties and call center protocols Use staff more efficiently Erin to shadow for 2 wks

https://www.youtube.com/watch?v=JBX6Ee_ic9U&feature=youtu.be

Establishing Your Purpose (cont.) Mapping out the details Which patients? Which days and times? Alone or with colleague?

Step 2: Set Up Your clinic Neurology Clinic When and where the shadowing will take place What they should expect When you’ll share your findings with them Shadow each doctor over course of 2 wks Observe new and established pt. appointments for each doc Week after shadowing is complete

Set Up (cont.) Important notes to remember: Privacy HIPPA Contacting patient At time of appointment? A phone call the night before?

Checklist to follow when approaching patient: Introduce yourself Explain why you are shadowing Explain what you hope to accomplish Explain your role as a shadower, Describe benefits of shadowing Stress that you are here to OBSERVE only Assure privacy Encourage questions Ensure their understanding Ask permission to shadow

https://www.youtube.com/watch?v=UsudOR72_Fw&feature=youtu.be

YOUR TURN! Practice approaching the patient. Use previous checklist as your guide.

Step 3: Follow, Observe, and Record Your clinic Neurology Clinic Touchpoints Keep track of the time Listen Communication Check-in, waiting room, patient room How long did they wait after placed in room? Complaints about always waiting an hour Is the patient really being heard? Do they understand their plan of care moving forward, i.e., prescriptions, exercises, follow up appointments, blood work

Observation Template Time Touch Point (Location) Caregiver (s) (Role) Observations Anxiety Example: Start: 8:15am End: 9:15am Check-in Waiting Room Front desk staff Register smiled and greeted patient, did not introduce herself. Presented him with paperwork to fill out. Patient’s name is mispelled on history form. This worries his wife.

Follow, Observe, Record (cont.) When shadowing is complete: Summarize observations to patient Ask patient for feedback Say thank you!

Follow, Observe, Record (cont.) Summarize findings Compile notes Create “overall” observational report Create summary report Share results

Shadowing Summary Report should: Your clinic Neurology Clinic Define what was observed Convey comments Include narrative details New and established patient visit “Pt seemed unsure of care plan” Create a list of questions for operators to ask before sending voicemail to nurse.

Neurology Clinic Observational Summary Report

Neurology Clinic Actions Hired Nurse Case Manager Protocol for AVS Call center protocol Follow up appointments

https://www.youtube.com/watch?v=T_ubE4_9NN0&feature=youtu.be