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Where are you finger prints in my care?

It is unlikely that you will be part of every encounter with the customer, client or patient whatever you do and wherever you work. A barista is not at the table with the customer is presented with their breakfast; a dressmaker isn’t at the checkout when the customer makes their purchase at a department store. Sooner or later you won’t be there in person. However it is likely that whatever you’ve contributed will have an impact. How do you define your role from this perspective in healthcare?

The participants—21 family physicians (fps), 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 general practitioners in oncology—were asked to describe both the role that fps currently play and the role that, in their opinion, fps should play in the future care of cancer patients across the cancer continuum. Participants identified 3 key roles: coordinating cancer care, managing comorbidities, and providing psychosocial care to patients and their families. However, fps and specialists discussed many challenges that prevent fps from fully performing those roles:

  • The fps described communication problems resulting from not being kept “in the loop” because they weren’t copied on patient reports and also the lack of clearly defined roles for all the various health care providers involved in providing care to cancer patients.

  • The specialists expressed concerns about a lack of patient access to fp care, leaving specialists to fill the care gaps. Easley et al

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Do something in your power to make a difference

It’s a small detail. If you are accompanying someone down a corridor as a healthcare professional- don’t stride ahead. Ideally walk alongside the person or let them lead the way if they know where you are headed. If they are wheeling a buggy and carrying a bag offer to help by wheeling the buggy.  Just try it. You might like how they respond. Apart from that you can learn so much about the person even before the consultation begins:

So instead of a doctor assessing a patient’s blood pressure, body mass index, chronic conditions, hospitalization and smoking history and use of mobility aids to estimate survival, a lab assistant could simply time the patient walking a few meters and predict just as accurately the person’s likelihood of living five or 10 more years—as well as a median life expectancy. Scientific American

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Your greatest value is your ability to solve problems

As a healthcare professional you may face problems that require problem solving at the least and the generation of creative solutions ideally. How do you hone your creativity?

The results revealed that leadership clarity is associated with clear team objectives, high levels of participation, commitment to excellence, and support for innovation. Team processes consistently predicted team innovation across all three samples. Team leadership predicted innovation in the latter two samples, and there was some evidence that team processes partly mediated this relationship. The results imply the need for theory that incorporates clarity and not just style of leadership. For health care teams in particular, and teams in general, the results suggest a need to ensure leadership is clear in teams when innovation is a desirable team performance outcome. West et al

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Quitting work may be the best thing you can do

 

Do you quit work? At least until it’s time to be back in the office, clinic, shop or hospital? Are you constantly taking calls and texts from work even on vacation?

Recreational travel may increase creativity by relieving workers from stress, providing diversifying experiences and increasing positive emotions. Consequently, vacations may boost creativity, apparent in a greater variety (flexibility) and originality of ideas after work resumption. de Bloom  et al

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What did you expect yesterday?

As you walked through the front doors at work yesterday what were your expectations? Were you hoping:

  1. To serve to the best of your ability
  2. To learn something new
  3. To enjoy good company doing something meaningful
  4. To make a difference to someone
  5. To earn a big pay cheque
  6. To pass the time before home time
  7. Something else?

Which was it? How did you feel at the end of the day? How do you think those who interacted with you felt at the end of the day?

Picture by Gotcredit

Do you see how that happened?

You may face may challenges or have an unexpected outcome following your interaction with your customer, client or patient. As a healthcare professional these are opportunities to reflect on how an event unfolded, how you were feeling at the time and how you are feeling afterwards. Consider then how those emotions play out through the course of the day. Given that most  outcomes in healthcare are moderated by an interaction with a health professional it is important to ensure that the health professional is attuned to their inner world. We can’t change many things as providers of health services but we can look within.

Know what causes your negative emotions, and which types of feelings you face most often. When those emotions begin to appear, immediately start your strategy to interrupt the cycle. The longer you wait, the harder it will be to pull yourself away from negative thinking. Mindtools

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Is normal too thin?

Try this experiment. If you are tending to overweight ( Body Mass Index (BMI) 25 or over) then try to get to BMI 18.5 -24.9.  If you succeed people will decide you have lost ‘too much weight’  even when your BMI is in the middle of the normal range. If normal was defined as ‘what is most common’ then to have a ‘normal’ BMI is unusual and we may have become blind to normal so that what we perceive as ‘normal’ is not ideal. Rates of overweight and obesity are now at 60-70%.

In an Australian study on the public perception of body size the authors report that:

Overweight participants were also most likely to incorrectly identify themselves as a healthy weight (67 per cent, p<0.001), compared to 12 per cent of obese participants . The majority (89 per cent) of normal weight participants accurately identified themselves as being a healthy weight. Flanagan et al

Therefore it is not surprising that when people are challenged about their weight in healthcare they are reluctant to identify the issue as a problem.

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What do you notice?

Before making any changes that might improve outcomes where you work you have to notice things that don’t look quite right or that hint at a solution. I know someone who notices the tiniest details even when she is out shopping. She generates a huge number of ideas about how things could be improved sometimes with the smallest tweaks. Here’s an example. As a result she is the most successful person I know. You’d be lucky to have her on your side. I know I am. What did you notice about your office, clinic, shop or hospital today?

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Are the barriers to access in healthcare physical?

Imagine you have back pain. Your doctor suggests you need special scan. You have to travel an hour across town to get to the hospital where you have an appointment at 9 am. You take the morning off but hope you might get to work in the afternoon. It’s peak hour traffic as you arrive at the hospital. The queue to get into the car park stretches down the street. You join the line of cars and realise it’s now 8.45am. The X-ray department is a long walk from the car park. Just as you get to the entrance to the parking lot the attendant indicates that it is full and you have to try and get a spot on a side street. The chap in the car behind you is getting frustrated- are you waiting in the queue or trying to back out? It’s a one way street you can’t turn the car here. It’s now 9 am you are going to be late- not sure how late. You toy with the idea of just going home.

In November 2011, an editorial in the Canadian Medical Association Journal called hospital parking fees a barrier to health care, saying the charges amount to “parking-centred health care,” and recommended hospitals stop charging patients for parking. The editorial stirred up a debate in the media. The Ontario Nurses’ Association, for one, agreed with the recommendation and noted that many of its members could tell stories about patients who had avoided seeking care or had cut appointments because of high parking costs. Canadian Nurse

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Do you perform any rituals when you consult?

Before a surgeon gets anywhere near a patient in the operating theatre he must wash his hands, put on a gown and gloves. He then drapes the patient and cleans the skin. As he makes his first incision there is no mobile phone on the table, he banishes all distractions and appreciates that the job isn’t over until he has sutured the wound. Whatever you do for a living how do you approach the job? If you adopted rituals would you perform better? Bacteria can destroy a surgeons work. What contaminates your work and how does that manifest in your results?

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