We Ask Because We Care: The Story from Admitting Perspective This is going to be story based, best way to go over this experience Angela Gayle Admitting Department 13 May 2014

In the beginning… When we were told that we have to start asking these questions, our gut reaction was: OH NO PRECONCEPTIONS: Impact on work. Our workflow is so busy and fast paced that we were worried and unsure of the pressure this will add Difficult to envision how the data will be used Scared about patient response based on past experience of asking marital status and religion ESP income, sexual orientation, gender Personal comfort “We’re not nosy. It’s none of our business. We are not supposed to know this about people”, unlike what you see in other places like the US

One Year Later… Glossary Flashcard Laminated Questions Brochure DAY IN THE LIFE: Desk in picture throughout the day How Angela does it - Set up adapted to patient flow volumes. In the morning, different set up that still ensures staff will review the form with patient and answer questions Biggest thing that changed: TURN AROUND What we perceived as fear is not there anymore, even a little empowering Training gave boost Set up provides privacy and speed Saw where it was going to and its importance, which we picked up from patient interactions - Workload not an issue - Patient reaction wasn’t an issue 95% of patients are OK Question why: Sometimes they want to know why we are collecting, targeting questions at times like income. The first reaction is that the hospital wants more money, but we say “we want to understand where our patients come from so we can provide better care. Your income is a big part of it” we then provide examples Positive stories: I see the impact directly, I see it in the stories we get from patients people have said ‘it’s about time’, seem actually happy, we never would have predicted that A lot of interest, people trying to take pictures Types of patients when it doesn’t work: Stories: Patients asking is this legal, this is not the time, I’m not doing it 1 patient, not majority We can immediately tell by their demeanor so we are not always surprised We remind them of option not to answer and give pamphlet Comment about questions: Other is helpful Being able to explain absence of category, esp language, helpful Prefer not to answer is helpful - Opportunity to educate the patient: I’m the ‘normal’ one, questions about categories (glossary of term) - Data quality: As data quality supervisor, have to monitor. Give a story Brochure Glossary

Lessons to Pass On… ENGAGE INVEST IN TRAINING EMBED IN OPERATIONS From front line perspective, these are lessons to pass on for other places doing this: ENGAGE: Include front line staff: Gives us a chance to ask questions and know what’s going on Hear us out: Give us a venue to communicate ideas and solutions because we are the ones who have the lived experience Example: We helped develop the set up and it made a huge difference for us EMBED IN OPERATIONS When possible, think of how this works with other training and make the linkages For us, went with “service with heart training”, we could really see it coming up Make it part of ongoing operations Don’t treat it as an independent project E.g. complaints go through Patient relations, now part of admitting, etc INVEST IN TRAINING Train staff- that was really helpful It helps you understand reason of questions Helps you see vision and get perspective We are not just doing it to know their business but because we want to be there for them