Redesigning Clinical Workflows to Return Joy to Patient Care
Tell Me More – Humanism in Action
Tell Me More – Humanism in Action

“Tell me more.”   As a busy family physician, I felt significant ambivalence about uttering those three words.  I knew that in order to connect with my patients in a meaningful way, and to ensure I wasn’t missing something significant, I should offer them in every patient encounter. I also knew that uttering “Tell me more” could open a Pandora’s Box of other concerns that would overwhelm my 15 minutes with that patient, forcing me to either fall further behind in my schedule, or to cut off the discussion fairly soon after I had just asked for more information.

“Tell me more” – A Catch 22

I went into primary care for many reasons. Getting to know my patients as people was at the top of the list. In the clinic setting, there were rare times when I could dig deep in a single encounter. More often than not there wasn’t time in the schedule. The process took place over time in multiple short encounters. In each of these encounters the patient would share something a bit more personal, and by my response the patient would get to know me better as well. We built a personal and healing relationship, one interaction at a time, over many months or years.

In the hospital, it was even harder. I’d see the patient every day, which you would think would help. However, the pressure to complete rounds quickly while addressing the multiple issues of patients sick enough to be hospitalized, created equal ambivalence for me about slowing down enough for “Tell me more.” I knew it was important to offer, but worried about how I would have the time take care of everything else – getting the day’s discharges done on time, reviewing all the test results, tracking down those that weren’t done, communicating with consultants and the patient’s primary care physician.

A Great New Way to “Tell me more”

This past August I had the good fortune to attend the Inaugural Meeting of The Gold Foundation Corporate Council. Since its founding nearly 30 years ago, The Arnold P. Gold Foundation has become recognized as a thought leader in Humanism in Medicine. It is the founder and sponsor of the White Coat Ceremony that initiates all medical students on their journey in our profession, and has spread now to nursing as well. It sponsors the Gold Humanism Honor Society (GHHS), recognizing medical students and residents who embody high relational practice.

Along with IBM Watson Health, the Corporate Council includes Quest Diagnostics, BD, Medtronic, and Henry Schein. These founding members are committed to furthering humanism in healthcare within their own organizations as well as by supporting the work of the Gold Foundation.

The Gold Foundation has also launched the Tell Me More program, which works with healthcare providers to support a culture of communication and collaboration with patients. Recently, the Gold Foundation has begun collaborating with EDI Institute to add a visual component to Tell Me More®, allowing patients and healthcare professionals to express themselves through digital imagery created on mobile devices.

The History of “Tell Me More”

As stated on the Gold Foundation’s Tell Me More history page, this project was originally designed in 2014 by GHHS chapter members at the Icahn School of Medicine at Mt. Sinai. Concerned that patients in medical systems are often depersonalized, medical students set forth to learn about their patients and share some of that knowledge with other care providers.

After obtaining consent, GHHS members spent time learning about patients’ personal lives in order to craft signs for display over their patients’ beds. The three questions they asked were:

  • What are your strengths?
  • How would your friends describe you?
  • What has been most meaningful to you?

Patients lit up when asked about their personal lives. Students were awed by the depth and resiliency of the patients they interviewed. Everyone who entered the room – from residents, attendings, and nurses to food service, other support staff and visitors – were able to see those signs and remember that each patient is a unique individual.

An Enhancement to Visual Management

It struck me that the sign over the patient’s bed provides a great reflection to the white board that is now common at the other end of the patient’s room. The white board communicates key technical information – including identifying the patient, the nurse and doctor for the day, procedures that are planned, allergies, and expected day of discharge. This information is important for the patient and their family members.

The Tell Me More display, posted across the room above the patient’s headboard, shares information that is important for the clinicians:

  • It helps clinicians engage in a much more humanistic healing interaction with the patient.
  • It helps clinicians quickly know what makes this patient unique as a person.
  • It opens doors by sharing mutual interests, experiences, and values.

The Quadruple Aim – Purpose Protecting Us from Burnout

I now work as a coach and consultant, supporting healthcare leaders and clinicians who are working to improve the care they deliver, across all dimensions of the Quadruple Aim.  My good friend, colleague, and mentor Dr. Gene Lindsey describes the Quadruple Aim this way

…Care better than we’ve seen, health better than we’ve ever known, cost we can afford,…for every person, every time,…in settings that support caregiver wellness…

As an advocate of Lean management, I like the way that “Tell Me More” adds a robust and creative new dimension to the Lean approach to visual management. It gets beyond the left brain focus that most of our visual management boards are appropriately focused on – data, graphs, and charts that track our performance and guide improvement work. It fires up the neurons of the right brain, and draws us into humanistic relationships quickly and deeply. It reconnects us to our purpose, protecting us from burnout.

And we are all better off for it.

What do you think?

Have you had a personal experience with the “Tell Me More” campaign?

Are you ready to give it a try?

I invite you to contribute you thoughts in the comments below – your questions or insights can help others as we all work to strengthen humanism in medicine.

Leave a reply