The WHY is critical and should never be assumed

For those in healthcare, we excel at fixing issues promptly and identifying/implementing best practices to ensure more efficient and effective quality care. However, we do a disservice to our staff when we overlook or assume that everyone understands the reasons behind our actions and the importance of embracing them.

I recently facilitated a Bedside Shift Report (BSR) SIM Lab with the nursing staff of a client that I am working with...250 nurses took part in this SIM Lab in which I played a patient - this Lab was primarily focused on the patient's involvement and engagement during this best practice. The initial findings from the SIM Lab were unsurprising. Most nurses showed connection and engagement with the patient upon entering the room to introduce themselves and explain they were there to provide a shift report. They also asked the patient, "Do you have any questions?" before leaving. However, the actual report to the oncoming nurse was strictly clinical and clearly intended for the fellow nurse's understanding, but did not involve nor engage the patient at any point during that phase of the process.

What fascinated me was when I asked the nursing staff, "How did you engage me as the patient?" The common response was, "At the end, we asked if you had any questions." As a patient advocate and patient experience professional, I find this level of patient engagement insufficient for the goal of patient involvement. A reset is needed to meet our patient engagement goals, but something more is needed.

Inquiring with the staff, they did not recall anyone explaining WHY Bedside Shift Report was so important to patient care, nor have they received any suggestions as to ways to pull the patient into the BSR conversation to ensure that the patient felt involved and a part of the encounter. We cannot expect our clinicians (or hospital staff) to be fully in support of an initiative or best practice if they are unaware of the reasons for doing so or the importance of ensuring quality patient care. We MUST arm them with the tools that they need to be confident in those practices and allow them to use those skills in a safe space - SIM Labs where the intention is to practice what has been taught.

Let's slow down the perpetual whirlwind and pause for just a moment to ask: Are we certain that our staff understands the WHY so that they can support and practice what we are preaching? We cannot expect them to support and implement what they don't fully understand, and without that understanding, we cannot expect accountability either.

resource: https://www.ahrq.gov/patient-safety/patients-families/engagingfamilies/strategy3/index.html