How do you greet your patient? Are you a GIVER?

In a recent blog “Discharge, Adios, Goodbye, Thank you for seeing me…”, I shared some insight on the discharge or “thank you, goodbye” practice that can improve patient care.

 What about when you first meet a patient? How do you greet your patients for the first time? Or on return visits? How do you greet the family members or significant others that accompany the patient?

Quint Studer (2003) recommends using A-I-D-E-T. AIDET stands for the following:

• Acknowledge:" “You are important.” Make eye contact, shakes hand, acknowledge everyone in the room, ask or make a relationship-building question/statement (e.g., “your shirt says ‘University of South Carolina’, I went to school there.”).
• Introduce: “You are in good hands.” Tell the patient about yourself and mention the referring physician. Example: “Hi! I’m Dr. Tamala Bradham, your audiologist. I want you to know that I’ve worked with more than 500 families who have children who are deaf or hard of hearing during the past 20 years. I see that Dr. Houston referred you to me. We’ve worked together for many years. You’re fortunate to have such an excellent speech-language pathology who specializes in listening and spoken language communication.”
• Duration: “I anticipate your concerns.” Tell the patient what to expect (e.g., how long will the test take, what will happen, when will they know the test results, does insurance cover this, etc.).
• Explanation: “I want you to be informed and comfortable.” Carefully listens to your patient’s story and use language the patient can understand when describing what will occur during the visit today.
• Thank You: “I appreciate the opportunity to care for you.” Thank the patient for choosing your clinic for services. In closing, ask, “What other questions do you have?”
  
  

This is an excellent tool to use, one that I have trained many people to use. I, however, want to propose a new tool for consideration. We need to be a “GIVER” when we meet our patients.

• Greet: “Greet the patient!” Make them feel comfortable. Smile, shake hands, and make eye contact! Essentially, use your manners!
• Introduce: “Tell them who you are!” Let them know your specialty and “manage up” the referring professional. At the minimum, given them your business card. Even better, given them a biosketch card with your picture!
• Verify: “Do you have the right patient?” The Joint Commission requires that you check for two identifiers to make sure you have the right patient. Not only should you confirm their name, ask them for their address, date of birth, or ask for a photo id. Patients really want you to do this!
• Engage: “Let’s talk and listen to one another!” Patient engagement is central to improving healthcare outcomes. Listen to what the patient is saying, pause briefly, and then respond to the patient. Sometimes it is helpful to summarize what the patient said to show that you were an active listener and that you care. This is also an excellent time to obtain your case history.
• Review: “Review what will happen during the visit.” Based on your case history and what the patient shared with you, tell them your plan for that visit and what to expect from you and your practice.
  
  

So what’s the evidence in using GIVER? 

First, we should always be respectful and use our manners.

Second, patients who received written information about the provider showed significant improvement on patient satisfaction surveys (Morris et al., 2014).

Third, a Joint Commission safety goal is aimed at improving patient identification to prevent medical errors. There have been multiple occurrences where patients have received the wrong care because of not appropriately identifying the correct patient and/or site on the patient. Furthermore, there are studies that indicate that even with this safety goal (required for hospital accreditation) that we need to do a better job in patient identification (Hennenman et al., 2010; Schulmeister, 2008).

Fourth, studies also suggest that by engaging the patient in their care, there are better outcomes. With over 1,000 articles in PubMed using “patient engagement” and “outcomes”, while they are not all relevant, it is obvious that this is a hot topic! Finally, being an active listener and providing an action plan on what will happen during the visit will ultimately help everyone involved. While not all the patient’s stress will dissipate, it does provide some direction that will help the family navigate often uncharted waters.

When you start to use “GIVER” or “AIDET”, select just one of the letters and do a small test of change. Over time, gradually add the other letters to your practice. Find what works for you and the patients you serve.

References:

• Henneman, P. L., Fisher, D. L., Henneman, E. A., Pham, T. A., Campbell, M. M., & Nathanson, B. H. (2010). Patient identification errors are common in a simulated setting. Ann Emerg Med, 55(6), 503-509. doi: 10.1016/j.annemergmed.2009.11.017
• Morris, B. J., Richards, J. E., Archer, K. R., Lasater, M., Rabalais, D., Sethi, M. K., & Jahangir, A. A. (2014). Improving patient satisfaction in the orthopaedic trauma population. J Orthop Trauma, 28(4), e80-84. doi: 10.1097/01.bot.0000435604.75873.ba
• Schulmeister, L. (2008). Patient misidentification in oncology care. Clin J Oncol Nurs, 12(3), 495-498. doi: 10.1188/08.cjon.495-498
• Studer, Q. (2003). Hardwiring excellence. Gulf Breeze, FL: Fire Starter Publishing.