Trust in the Time of Coronavirus

Added on Mar 25, 2020

By Chrissy Daniels, Chief Experience Officer

AT A GLANCE

– Organizations can help patients and caregivers feel safe in these uncertain times by nurturing an environment of trust between patients and caregivers and between caregivers and the leaders who support them.

– Adopting and promoting universal communication skills for relationships, reliability, and leadership builds confidence of team members who must come together quickly and effectively to deliver challenging care to highly stressed patients.

– By embracing communication processes that focus on relationships, consistent behaviors over time, and leader awareness, organizations build trust among caregivers and empower them to create and maintain the trust patients need to feel safe.

Patients are scared for their safety. Caregivers are scared, too. 

Chrissy_Daniels_SBIn these unprecedented and uncertain times, the trust between caregivers and patients has never been more important. Neither has the trust between caregivers and the leaders who support them. Trust is what allows us to move forward with agility from a world of health care that is familiar to one that is unfamiliar in many ways. When trust is present we do our best to work together. We align around a common purpose, take risks, innovate, communicate, and have each other’s backs. Trust helps us feel safe when we are vulnerable.

For caregivers to continue to make these critical connections with patients, we must take care of them. We must do everything possible to help them feel and actually be safe. When caregivers feel supported and believe their leaders and their organizations are deeply responsive to their needs, it is easier for them to care for patients.

Organizations can nurture an environment in which these connections thrive by adopting and promoting universal communication skills for relationships, reliability, and leadership. Once understood, these skills help create and maintain trust. This is especially important in times of crisis, when teams are under pressure to expand, contract, and change frequently to meet evolving needs. In these situations, we don’t have the luxury of familiarity to rely on. New team members must come together quickly and effectively to deliver challenging care to highly stressed patients in different settings. 

Universal Skills

Patients want three things: to feel safe, to have us work together to care for them, and to be treated with compassion. Caregivers want the same. In times like these, we can’t rely on our individual commitment and good intentions. We need process. This is where the following universal communication skills help. Consistently practicing these behaviors can make a difference with patients and caregivers. 

Universal Relationship Skills

Focusing on the relationship between patients and caregivers, these simple behaviors, performed consistently, can help create and maintain the trust patients need to feel safe.

  • Greet warmly and ask the person's preferred name.
  • Introduce yourself and explain your role.
  • Communicate clearly with intentional language, avoiding medical jargon.
  • Provide an opportunity for others to ask questions.


Universal Reliability Skills  

The reliability of our communication is also essential. Consistently clear, focused, and empathic communication reduces stress and alleviates fear. Following are some of the high reliability communication tools and behaviors that can be used to achieve this end.

  • Pay attention to detail: Self-check using STAR (Stop, Think, Act, Review).
  • Communicate clearly: Ask clarifying questions, repeat and read back, and use the SBAR (Situation, Background, Assessment, Recommendation) technique to facilitate prompt and appropriate communication.
  • Have a questioning attitude: Qualify the source, validate the content, and verify your action.
  • Speak up for safety: Escalate as needed using ARCC (Ask a question to prompt a safety concern, Request a change, voice a Concern if there’s resistance, and use the Chain of Command if necessary).


Universal Leadership Skills 

How we present ourselves as leaders is foundational to building trust. Leadership needs to continuously demonstrate their commitment to the safety of patients and caregivers. Standardizing this effort helps everyone know leadership’s priorities and ensures that we close the loop on important concerns. 

  • Create closed-loop reliability huddles: Conduct a daily safety brief and daily departmental huddles.
  • Send the message of Safety First: Start communications with a safety message. Ask the safety question when making decisions.
  • Role-model and influence: Use 5:1 (positive/negative) feedback and rounding to influence.

Embedding high reliability leadership skills is an ongoing process, and it is important to consistently take advantage of opportunities and resources to advance this mission. Leaders facing new challenges in safety and high reliability with the spread of coronavirus can look to Press Ganey's recent webinar, "Applying High Reliability Operating Principles in Crisis Situations."

Focusing on these few crucial things allows us to keep our focus on the important, while we respond to the urgent. Safety is the core of the patient experience and it is central to supporting our caregivers. Some sociologists describe trust in health care as the confidence that you will be treated fairly in circumstances you have not even thought of yet. For most of us, those circumstances are occurring today. When we move forward with intentionality in creating trust, patients will be extraordinarily grateful for care and caregivers will be even more united in their call to heal.