Decreasing Dialysis Patient- Provider Conflict (DPC) Facility Training

Transcription

1 Decreasing Dialysis Patient- Provider Conflict (DPC) Facility Training Kathi Niccum, Ed.D Director of Patient Services The Renal Network

2 Today s Agenda 1) The likelihood of conflict 2) Overview of DPC and the Toolkit 3) Trainer Tips

3 Today s Objectives 1) Identify the DPC Conflict Model 2) List three tools in the DPC Toolkit 3) Describe three ways adults learn and retain information 4) Describe three ways trainers can encourage participation in sessions

4 The Likelihood of Conflict Patients and/or staff?

5 Potential for Conflict: Patients Fear Lack of Information/knowledge Disrespected/ demeaning attitude Less than optimal care Feel sick Mental health issues Substance abuse issues Poverty issues Lack of support (or too much!) Communication issues

6 Potential for Conflict: Staff Non-adherence Disrespected/ demanding Loud voice Threatening words or behavior Staffing issues Insufficient training Personal issues Communication issues Personality issues

7 Conflict Resolution Conflict happens No easy answers Not always resolved Attitude Understand resolution steps Work together

8 What is the DPC Project?

9 Practical Toolkit Approach To: Decreasing Dialysis Patient/Provider Conflict

10 DPC Toolkit Is Also A coordinated, national effort by the ESRD community funded by CMS A compilation of resources to educate dialysis providers on ways to better respond to and cope with the issue of conflict

11 Why Is DPC Toolkit Important? Improves patient/staff relationship Prevents escalation of conflict to maintain a safe workplace Improves patient care /outcomes Improves employee morale Decreases staff turnover

12 What s in the Toolkit?

13 Toolkit Contents 1. CONFLICT Poster 2. Provider Manual 3. Brochure:decreasing conflict & Building Bridges 4. Pocket Guide 5. CONFLICT Interactive Training Program 6. Additional Resources on CD-Rom

14 Poster Where is a good place?

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16 DPC Provider Manual User friendly

17 DPC Provider Manual Introduction & Background Step I- Management Orientation & Preparation Step II- Trainer s Guide Step III- Ongoing Quality Improvement DPC Position Statement on Involuntary Discharge

18 Brochure: decreasing conflict & Building Bridges What can you do with them?

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21 Pocket Guide Can you carry it around?

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23 CONFLICT Interactive Training Program Where to keep it and when to use it?

24 What It Is CD-Rom Conflict scenarios Interactive learning module and scoring methods Uses information in the brochure Prints certificate

25 When To Use Set up computer time to do as individual or small group Before, during or after module training New employee orientation Have a celebration of certificates

26 DPC Resources CD-Rom

27 Conflict Resolution Resources 1) Conflict Pathway 2) Tips on Cultural Awareness 3) Bibliography 4) Introduction to DPC power point 5) Provider Manual 6) QI Tools

28 DPC Conflict Log Date Conflict Occurred Time of Day Conflict Occurred Name(s) of Patient Involved in Conflict Name(s) of Staff Involved in Conflict Cause of Conflict Type of Conflict

29 Documentation Form Used to describe conflict Used to describe intervention and resolution Is the patient/staff satisfied with the outcome of the conflict? Could the conflict have been handled more effectively? If yes, how?

30 Implementation Plan Now what do you do?

31 Preparation 1) Top down approach 2) Know the material 3) Review & update facility policies/procedures 4) Who are the trainers 5) 5 Ws of training

32 Staff Trainers / Facilitators Advantages of peer training Disadvantages of peer training Confidence as trainer/facilitator Credibility Believe in program Be well prepared Motivational

33 Plan Staff Orientation 1) Post DPC Poster in staff room 2) Plan introduction of the DPC Program 3) Determine if program will be facilitywide or by shift 4) Determine timing of training program and staff schedule

34 Plan Staff Orientation (cont d) 5) Determine if mandatory in-service training or staff meeting 6) How often will training session be repeated 7) How will individual computer training be accommodated

35 Training Environment Non-threatening Non-judgmental Encouraging Respectful Relaxed Focused Stimulating

36 Training Anxiety and Stress-Breakers Anxiety Cues Discomfort doing or being at training program Nervous laughter Putting program down Some Stress Breakers Sing/ hum My Bonnie - Actions Blow bubbles

37 Motivate and Peak Interest Music CCCCs Velcro Dart Set Magnifying glass Sunglasses Scale Bubbles or bubble gum

38 Trainer Tips Start with a question or a prop If no one answers questions What s one thing Personal example Flip chart 101 Eye contact Names Closed/open questions Encouragers

39 Adult Learners Use personal experiences Interactive sessions Relate to the information presented Understand how they can use the information Techniques learned will be useful Variety of learning approaches

40 Decreasing and Resolving Conflict A National Model for Dialysis

41 Use Of The Model Provides practical tips for decreasing conflict Encourages sequential thinking for solving conflict Suggests non-threatening tips for staff to use when thinking about their role in conflict Offers a common language for staff to use when discussing conflict

42 Create A Calm Environment In order to effectively address a conflict, you need to be aware of the physical surroundings, as well as the thoughts and feelings you are experiencing because of the conflict

43 Creating Awareness Close your eyes

44 How to relax/stay calm

45 Open Yourself to Understanding Others When addressing a conflict, it is important to acknowledge the perspective and feelings of the other individual (s) involved

46 Hearing vs. listening Article title/ setting the scene

47 We re all Thumbs Who s right.

48 Need A Nonjudgmental Approach As a dialysis professional, it is important for you to maintain an objective and professional approach as you address the conflict. Keep in mind that words exchanged in the heat of an argument are often not intended as personal attacks.

49 Whose music is it, anyway CD / Body language

50 Focus On The Issue When conflict occurs, there is a tendency to lose sight of the issue that started the disagreement.

51 Here comes the kitchen sink Interrupting/ Yes, but /I know what you mean

52 Look For Solutions Not all conflicts can be resolved nor are all conflicts based on valid complaints. But working in collaboration with the patient will improve the likelihood of a positive outcome.

53 Building a bridge Open and closed questions.but why brainstorm

54 Implement Agreement If you take the time to work through the conflict, it is likely that you will reach a stage of agreement when changes will need to be put into action.

55 Let s Shake on it. Action statements, difficulty of consistency

56 Continue To Communicate 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.

57 Respect vs. Resent Assertive, aggressive, passive

58 Take Another Look 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.

59 Are we on the right road? Stop, look and listen

60 Checks and Balances Between Sessions Practice/model techniques introduced Staff meetings Check DPC progress and results Review DPC Data regularly Identify and address any trends or patterns

61 Facility Training Plan

62 Putting the program to work

63 The In-service Training Plan Who will be the trainer (s)? Initial Staff Meeting CD Rom training Modules QI Tools Follow Up staff meeting

64 QI And Conflict Allow for data collection related to conflict - Number - Causes - Types Provide trending analysis of conflict Create objectivity toward conflict Identify areas for improvement or training

65 In summary Staff members want to learn how to handle conflict and avoid it if possible The DPC Toolkit provides an easy to follow training approach Repetition, relevance, and follow up helps learning process Document and discuss cases at staff meetings

66 THANK YOU! Questions or Comments Kathi Niccum, EdD Or