Ease restructuring woes with communication plan
Ease restructuring woes with communication plan
"ER" step aside. Overlook Hospital in Summit, NJ, is challenging the popular television series with its own productions. First there was Patient-Focused Care the movie, and now there’s Patient-Focused Care, the video.
The two productions have been box office hits at the hospital, part of an elaborate communication plan designed to ease the transition to a new care delivery model.
The first production, the movie, premiered shortly after administrators announced the patient-focused care (PFC) initiative. Although the details of the hospital’s program had yet to be hammered out, several employees were eager to bring it to life. Using a hand-held camera, they shot a film portraying their vision of PFC in action. The movie, by showing the concept could become reality, generated support for the cutting-edge restructuring.
Later, when the hospital’s new model had been nailed down, the in-house audiovisual team produced a professional-quality video. The video aired repeatedly in the physician’s lounge during the transition to explain the new program and its goals. The in-house production team is now creating a video for patients explaining how patient-focused care affects them.
The communication team that backed the productions was one of nine implementation teams created when Overlook decided to adopt a PFC model that resulted in a 21% cost savings. The PFC model chosen compressed 13 jobs into four. The self-directed care teams include nurses, a technical partner cross-trained to perform such tasks as phlebotomy and EKGs, an administrative partner cross-trained to handle medical records and to perform bedside registration and scheduling, and a service partner cross-trained in dietary, housekeeping, and patient transport skills.
Communication team played crucial role
The communication team, which was made up of representatives hospitalwide, was crucial to reducing the negative effects of change. A good plan could garner support for the redesign and help staff during and after the transition.
"It can bring harmony to change," says Pat Treiber, CHE, MPH, who helped lead the development of the communication plan. "The more information you present to people and the more people you reach, the more anxiety you can reduce about the unknown."
Here, Overlook Hospital shares the details of its plan with the readers of Patient-Focused Care.
The communication team designed its plan from scratch under the guidance of the team leader, the director of public relations. First the team identified three key hurdles to change:
• uncertainty of the value of PFC among employees, physicians, and the community;
• general lack of knowledge about PFC;
• the way PFC is factored into consolidation, closing of units, and loss of jobs.
The group then came up with the following objectives of the communication plan to address the above issues:
• Affirm Overlook Hospital’s commitment to PFC.
• Position PFC as a unified, positive direction for Overlook Hospital.
• Revisit the fundamental issues of PFC.
• Clarify how the transition process affects employees, physicians, and the community.
• Present PFC success stories.
• Improve inter-team communication.
The team then designed the tools it would use to spread these messages. These tools included:
• Newsletters.
The team created the Patient Focused Care: Patients Come First newsletter and distributed it to staff, volunteers, hospital foundation members, and the board of trustees. It was also posted throughout the hospital. The newsletter started as a monthly, then as the PFC pace accelerated, increased to twice a month.
The newsletter keeps staff abreast of the transition process and addresses common questions, such as: "What is PFC?" "Why restructure?" and "Will I lose my job?" Also, some units created their own newsletters to encourage buy-in.
• General meetings and presentations were held for:
staff, addressing such questions as job security and explaining the difference between PFC and the traditional closed-unit structure;
physicians, explaining how the transition process affects each unit;
auxiliary, relaying PFC success stores;
board of trustees, updating them on the program’s progress and dispelling rumors;
community, explaining PFC to business and government leaders and other members of the "opinion elite," says Treiber.
• Media releases.
The hospital sent out press releases to generate positive media coverage of the restructuring process. The releases offered the hospital’s position statement on PFC and relayed success stories.
• Internal publications.
Inserting PFC updates in the hospital’s internal publications, including Medical Staff News and the weekly employee bulletin.
• PFC question hotline.
A 24-hour number anyone can call anonymously to ask questions about PFC.
• Guest services hotline.
A 24-hour hotline established to ensure patients’ needs were being met during the tumultuous transition. Patients can call the line with any request they feel has not been adequately attended to, such as the room temperature or bed functions. The attendant contacts the appropriate care partner via pager.
The staff tracked the nature of the calls to determine the reason. The analysis revealed the bulk were unrelated to PFC but were instead typical hospital problems, such as a malfunctioning bed or misfitting urinal covers.
"At first, everybody wanted to blame PFC for problems. But the review of the issues and complaints shows that the PFC model wasn’t the primary factor," Treiber says.
• Posters and bulletin board displays.
Posted throughout the hospital, one poster portrays the new care team dressed in their respective, signifying colors. The poster also carries the 24-hour guest services hotline number.
• Information kits.
Given to mangers and department heads, the kits included:
updates on the transition, addressing employee, physician, and process issues;
prototype units;
phase-in procedures.
• Letters.
Mailed to physicians, trustees, and foundation members updating them on the transition process and success stories.
• Fact sheets.
Fact sheets are sent to physicians to address their concerns. One fact sheet sent last March, for example, updated the progress of phlebotomy training for new technical partners and listed the personnel who could answer physicians’ questions about the roles of the new caregivers.
• Fliers.
Fliers were distributed to patients, explaining PFC and its goals and requesting comments.
• Patient questionnaires.
Questionnaires requested patients’ response to PFC. The survey revealed patients were happy with the new model.
• Videos.
Videos were shown in the lobby and cafeteria and addressed such topics as "Role of change," "Why PFC?" and "Job information: Who, When Why." The staff are producing a video explaining PFC to patients. It will be broadcast on the hospital’s information channel.
Communication efforts continued after roll-out. The content changed to reflect the new goals of maintaining staff commitment to the restructuring and resisting the temptation when confronted with obstacles to revert to the traditional care model.
The communication plan was elaborate, but not a cure-all.
"There’s a change in their routine," Treiber says. "There are bound to be complaints."
Treiber says the program was, in fact, a success because people moved from a position of accepting the status quo, even if a particular process was failing, to questioning ways to improve it.
"I hate to use the expression empowerment, but that’s what it truly is," Treiber says. "People are saying, Now maybe we should look at this when it’s not working.’"
[For more information about the communication plan used at Overlook, contact Pat Treiber at Overlook Hospital, 99 Beauvoir Ave., POBox 220, Summit, NJ 07902. Telephone: (908) 522-2284.]
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