HJNO Jul/Aug 2021

HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2021 17 communication, so we use several tools to decrease anxiety, like smiling and intro- ducing ourselves and our role, explaining things in simple terms, inviting them back. The other component of “Caring Commu- nication” is creating a connection with our patients, primarily through the intentional expression of empathy. When providers connect with patients through empathy, their patients feel a sense of trust in their provider, and they become more engaged in their own care, which leads to better outcomes. In sales, they do teach the importance of repeating items several times. In healthcare, in addition to repeating important items, we also teach providers to make sure they repeat the most important points at the very end of the encounter, because statistically speaking, the end of the encounter is most likely what is remembered. We also coach our providers to ask open-ended questions instead of yes/no questions. Typically, when providers end the encounter, they tend to say, “Do you have any questions?” and the vast majority of patients will respond “no” for several reasons. Patients know pro- viders are knowledgeable, important and busy. These factors can all be intimidating. Patients require a conscious attempt at wel- coming questions. I teach providers to sit down and ask in an open-ended fashion, “What questions do you have for me?”This is far more inviting, and studies have shown that being seated also sends a message of not being rushed. Other techniques we coach are the “Teach Back” method where a patient is asked to repeat back what was taught. The chal- lenging piece to this method is to not insult the patient. This must be done using very respectful language, making sure the patient knows that the provider is just ensuring that they are on the same page. We also teach “Narrating the Care” where the providers state out loud everything that he/she is doing while doing it using very basic lan- guage. (e.g., “I’m listening to your lungs, and your breathing is clear. That’s good.”) What segments of Louisianians have lower levels of health literacy; what best practices have you found to better communicate with these groups? I think it is fair to say that we know Loui- siana as a whole has a tremendous oppor- tunity to improve health literacy. Ochsner, as the largest healthcare provider in the Gulf South region, takes its responsibility as a leader in healthcare very seriously. When it comes to reaching out to patients with dif- ferent levels of health literacy, we are very innovative. Traditional methods of deliver- ing care do not always work, and we will always be focused on getting better. First, we do have a tool in our electronic medical record that helps us to determine health literacy and can allow us to flag a patient’s health record to notify others on their care team to assist them appropriately. Several of our departments (cancer, wound care, ED) use patient navigators to help patients who have a difficult time accessing medical resources. Our inpatient and outpa- tient case managers assist patients in finding placement and coordinating care when they cannot care for themselves. We use health coaches as part of our digital medicine pro- gram who call patients on a regular basis to check on their overall health. We have physical O-Bars at many of our locations where patients can be trained one-on-one in person to use digital medicine tools that require very minimal setup, so they may be enrolled in our digital medicine programs, and they can then be followed remotely by our digital medicine team. Our pharmacies use color coding and symbols on pill bot- tles to assist patients inmore easily knowing when to take their medicines. We also have specially designed clinics for those who really struggle with the com- plexities of healthcare and are at the high- est risk for hospital readmission. For these patients, we provide additional assistance in very unique and thoughtful ways. We have our pharmacy create pill packs for them to simplify the process of managing mul- tiple medications. We provide care naviga- tion, increased access to primary care, even transportation when necessary. Studies have shown that 40-80% of the medical information patients are told during office visits is forgotten immediately, and nearly half of the information retained is incorrect. It seems we are underutilizing technology at our fingertips to solve this. Do you think patients videoing or recording segments of appointments, with prior consent, is the simplest answer for those with the ability to do so? I remember about five years ago escort- ing my best friend to the ophthalmologist when she had a retinal detachment. The doctor showed us the exact position that she should hold her head, and the explana- tion was quite complicated. I videoed his explanation and demonstration, and we must have referred back to that video 20 times over the course of the next week. It gave me a true appreciation for the value of a simple tool that most of us carry with us at all times. Ever since then, I have strongly encouraged the use of pictures and videos to assist a patient in remembering the instruc- tions. Examples of this are when a provider shows a patient how to dress a wound or when a therapist demonstrates an exercise. We do print up paper and digital after-visit instructions for all patients. The video is a great adjunct to the written summary.