Patient Experience Training for Non-Clinical Staff Using Simulated Patients (1090-004201) (Research Abstract Oral: Simulation Methodology)
Start time: Tuesday, January 26, 2021, 8:00 AM End time: Tuesday, January 26, 2021, 9:00 AM Session Type: Research Abstracts (Completed Studies)
Metrics related to Patient Experience (PE) are used as a quality indicator by health care organizations, are publicly reported, and impact public perceptions and reimbursement. In the emergency department (ED), registration clerks (RC) are often the first staff member to engage patients, and can positively or negatively impact PE. Similarly, patient representatives (PR), hired to help patients and families navigate the hospital experience, also have a great impact on the patient experience. Our objective was to evaluate the impact of a simulation based training for RCs and PRs who are unfamiliar with experiential learning.
This was a mixed methods prospective observational study at an urban academic medical center with a hospital-based Simulation Center. PR and RC participated in a 90 minute session consisting of 3 1:1 encounters with a simulated patient (SP). Each scenario was debriefed individually with the SP and a physician with formal debriefing experience. PR scenarios centered on speaking with an anxious mother in the pediatric ED, an angry family member upset about perceived delays of care, and a frustrated patient waiting for CT scan. RC scenarios centered on registering the mother of a critically ill infant, a patient in pain and worried about his lack of health insurance, and an immigrant anxious about his legal status. Learning goals were to improve PE skills such as de-escalation, empathetic listening, resolving conflict, asking sensitive questions, and managing expectations. The training session was evaluated with anonymous surveys and free-text response of action oriented take away goals.
All available PR (n=34) and ED RC (n=39) participated. Post-participation anonymous surveys used a rating scale of 1 to 5 (1=not effective, 5=extremely effective). Each a priori defined learning goal was rated positively with averages ranging from 4.4 to 4.6 (SD range of 0.5 to 1.0) in the RC group and 4.2 to 4.5 (SD 0.6) in the PR group. SPs and Facilitators were rated positively with respect to educational techniques ranging from 4.5 to 4.7 (SD range of 0.5 to 0.8). Thematic analysis of written take away goals in the PR group focused on communication specifically to engage patients and family members in conversations for updates in their care process and to demonstrate empathy for patients who are ill. Representative themes of personal goals in the RC group included not escalating or reacting back, using eye contact, acknowledging pain and stress, using empathic listening skills, and remembering that the patients are in a state of crisis.
Simulation was an effective method to teach skills related to patient experience to patient representatives and ED registration clerks. Both groups of nonclinical providers reported meaningful take away goals for practice. Furthermore, multiple participants verbally related to their supervisors that the simulation sessions made them feel more like valued staff members given that similar training are typically reserved for nurses and doctors. Given the potential impact on patient experience and staff engagement, simulation should be strongly considered as a preferred modality of training for nonclinical providers.