September 25, 2013 Volume 2, Issue 16
With an estimated 23 percent of the U.S. population admitting to needle phobia, creating a comfortable experience for patients who need blood drawn is critical. So when patient experience surveys reflected low customer service scores in Phlebotomy, the department that specializes in drawing patients’ blood for testing and other clinical purposes, the team knew they had work to do.
The first step was to provide training to all phlebotomists.
“We needed to develop a customized training that would address the cultural diversity of our department and a variety of levels of experience,” says Jodie Williams, Technical Supervisor, Phlebotomy Lab. “The goal was to have the phlebotomy team realize that time is a commodity for our patients, that phlebotomists are an important part of the care team and that each patient encounter counts; each one should be as pleasant and efficient an experience as possible.”
At BMC, there are outpatient phlebotomy stations located on the first floor of the Preston Family Building, the third floor of the Moakley Building, the lower level of the Shapiro Center and the third floor of the Yawkey Ambulatory Care Center. Inpatient services are offered in the Menino and Newton pavilions. With 46 members of the phlebotomy team covering such a widespread area and range of environments, tackling the development of a training program was a daunting task.
The team worked with Clara Serpa, MEd, Education Specialist in the Quality, Safety and Patient Experience Department. Serpa began shadowing the phlebotomy team to identify challenges. In addition to the types of issues that can be found at any hospital, such as frustrations with wait times, phlebotomists deal with more specialized problems, such as patients’ fear of needles, patients fainting at the sight of blood and a demand for smaller needles when it isn’t medically necessary. Armed with this information, Serpa and Williams brainstormed both inpatient and outpatient scenarios and developed a two-hour, hands-on training curriculum where members of the phlebotomy team would work in small groups in BMC’s Solomont Clinical Simulation and Nursing Education Center.
“Using the Simulation Center as a training ground allowed the phlebotomists to practice real-life scenario with team members observing in real time,” says Serpa. “The scenarios were then played back on video, giving the participants the opportunity to reflect on the scenarios and how key takeaways could be applied on the job.”
The scenarios ranged from a scared patient insisting a smaller needle be used, to frustrated patients who demanded to know why they had to undergo yet another test to a mother who wanted to hold her baby while the baby’s blood was drawn (an unsafe practice). “The scenarios were realistic and prompted phlebotomists to problem solve special patient requests and interactions with challenging patients,” says Serpa. “It gave them a chance to practice their everyday interactions and learn from mistakes and from each other in a realistic but low-stakes environment.”
After the training scenarios were completed, the team had a debriefing session where they watched their recorded sessions and focused on learning new behaviors as defined by a checklist that Serpa and Williams developed. The checklist addressed the clinical and communication behaviors phlebotomists must balance in a single patient interaction, such as using a standardized script for greeting a patient, correctly identifying a patient, collecting and labeling specimens and saying thank you to the patient before leaving the room.
The results have been nothing less than remarkable. Since the training last spring, Phlebotomy’s patient experience scores have soared, with 91 percent of patients said they were treated in a professional and courteous manner (up from 68 percent a year ago), 89 percent of patients saying their discomfort from the blood draw was better than they expected (up from 66 percent) and 95 percent saying their specimen collection experience was “excellent” (up from 78 percent). Positive comments include, “Your service is much improved,” “Fast, efficient and friendly,” and “Love this place, wouldn’t go anywhere else.” The department was also pleased to see unexpected results, like 100 percent staff compliance in hand washing and a decrease in mislabeled specimens and STAR incidents.
“What I’ve learned is that it doesn’t matter how long you’ve been doing something, there is always room for improvement,” says Phlebotomist Patricia Izevbizua. “When patients arrive, I am usually the last person they see before their departure. Therefore it's important for me to leave them with a good impression of BMC. The training helped me realize that we are all working to achieve one goal, which is patient satisfaction.”
“We can see the difference the training made, not only with the patient experience but with working with our colleagues, both inside and outside of the department,” says Janet Means, Administrative Director, Department of Pathology and Laboratory Medicine. "We know the hard work that lies ahead, with continued reinforcement to maintain new found skills, but the members of our phlebotomy team have stepped up and embraced the new perspective they gained from this training experience”
“The Phlebotomy staff have demonstrated that improving patient experience is mostly about effective communication,” says Rebecca Blair, Executive Director, Patient Experience. “After reviewing more than 2,000 survey comments, it has been a pleasure to see the number of times staff are named and thanked by patients for the exceptional care they deliver. They are role models for all of us.”
In the aftermath of the Boston Marathon tragedy, donations poured into BMC as people around the world reached out to support the victims of the bombings, in amounts large and small.
Since April 15, BMC has received hundreds of donations. The contributions range from large corporate gifts, to smaller localized fundraising efforts and individual gifts from the wallets of people all over the United States and beyond.
“We received the first email the night of the Marathon tragedy, and from that point on, the floodgates opened,” says Kristen Gleason, Director of Operations, Development. “From corporations and foundations donating thousands of dollars, to children holding a bake sale, the range of donors was amazing. Soon after the tragedy, we put a link on our website to collect donations because we were receiving so many inquiries.”
Yoga Lagniappe, a yoga studio in New Orleans, La., sponsored From the Bayou to Boston, a fundraising event where yoga teachers from across the city held a special class for their students and donated all proceeds from the event to BMC. The studio had 15 students participate and together raised $287 for BMC.
“We raised this money to help people who got hurt in the Boston Marathon. We are so worried about what happened. We hope this causes your patients to feel better,” read a note from a group of children who sponsored a bake sale in Short Hills, N.J. that was enclosed with a $48 contribution to BMC.
Though BMC has received donations from as far away as the United Kingdom, local companies from the Greater Boston area also have stepped up to help with the Marathon relief effort. Genzyme Corporation, based in Cambridge, contributed a generous $9,000. Intex Solutions in Needham collected more than $8,500 from their staff and the company matched it 100 percent for a total of $17,000. BMC also was the recipient of a $25,000 donation from the Baupost Charitable Fund at the Boston Foundation.
“People sent in donations with no prompting on our part," says Gleason. “Many of these individuals had never heard of BMC before the marathon, but saw on the news the exceptional care we provided to the victims and wanted to support our work and mission.”
In total, BMC has received more than $70,000 in unsolicited donations alone to help both the victims that it has cared for and its own staff. The funds are being equally split among Care Management and Social Work, the creation of a new trauma social work fund and for efforts focused on staff wellness.
“We’re very appreciative of the funding we have received,” says Amanda Wright, MSW, LCSW, Social Work Supervisor, Care Management. “We will use it to pay it forward and help our patients and families with their ongoing resources needs.”
The trauma funding will be used in a similar way, to help meet the needs of trauma patients and their families.
Country music superstar Kenny Chesney came up with a unique way to support Marathon victims. He worked with BMC to establish the Spread the Love Fund, a fundraising initiative that will provide support not only for prostheses but also for the ongoing care and physical therapy of all the amputee patients of the Boston Marathon bombings. The proceeds from his single “Spread the Love,” which is available for download on iTunes, and Spread the Love merchandise both go toward the fund. So far, Spread the Love has collected more than $200,000. Chesney recently visited BMC to visit with the bombing victims the hospital cared for and to thank staff.
“All of us at BMC are so very proud of the extraordinary work undertaken by our colleagues in caring for the Marathon victims and in many cases, saving lives which may have otherwise been tragically lost,” says Norman Stein, Vice President, Development. “The outpouring of support is both a form of recognition of the stellar work done by our BMC colleagues and a genuine expression of compassion by people from the Boston area and across the country for those affected. All of us at BMC feel honored for the recognition and to be able to offer longer-term help to the Boston Marathon victims.”
Did you know that on Fridays through October there is a farmer’s market in the Menino Pavilion lobby? Stop by to pick up your weekly supply of fresh fruits and veggies, especially for this recipe from the Demonstration Kitchen’s Tracey Burg!
Eating healthy doesn’t mean you have to sacrifice flavor. Beef Bourguignon (pronounced bow-guin-yawn) is a traditional French stew that gets its name from the burgundy color of the red wine used in the sauce. This is a great healthy option to feed your family on a chilly fall night. Serve it with crusty whole grain bread and a tossed salad.
Beef Bourguignon (Beef Burgundy Stew)
Nutritional Information Per Serving:
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The Carl J. and Ruth Shapiro Ambulatory Care Center has won a Modern Healthcare 2013 Design Award. The Design Awards program recognizes excellence in the design and planning of new and remodeled health-care facilities and includes hospitals, extended care facilities, hospices, ambulatory care centers and medical office buildings. The nine-story ambulatory building was designed with patients in mind, making wayfinding easier for patients and improving the overall patient experience. The Shapiro Center, which opened in 2011, was designed by the architectural firm Tsoi/Kobus & Associates.
BMC has received the prestigious Peter F. Drucker Award for Nonprofit Innovation. BMC won the award for its efforts to ease patients’ transitions from hospital to home through Project RED (Re-Engineered Discharge), the brainchild of Brian Jack, MD, Chief and Chair of Family Medicine, and his team. The Drucker Institute is dedicated to working with organizations to strengthen society and is named for Peter F. Drucker, a leader in management. This year the Institute received a record 864 applications from nonprofit organizations in 49 states and the District of Columbia, and BMC emerged the winner.