The last time I went shopping with a friend, we were in Chicago, on the Miracle Mile.  Anne had me try on things that I NEVER would have taken off the rack myself, and even talked me into buying some of them.  You know what?  I’ve worn all but one item to shreds.  One became my new “uniform” at home.

Well, trying out changes to make improvements is a little like shopping for clothes.  When staff or experts come up with a bright idea, your job as a Clinical Manager or Director is to figure out how to ‘try on’ the idea.  Maybe you’ll ‘buy’ the idea, and maybe you won’t.  This is where some improvement science can help.
We get ideas from inside and from outside of home health care (sometimes ideas from outside can be very innovative).  When presented with a new idea, ask yourself, “How can I try this on and see how it fits (test it) without purchasing it?”  With a little ingenuity, it’s usually possible to test drive the idea, or at least a part of it.

For example, take the health literacy concept of Teach Back. Teach Back is a non-shaming way to figure out how successful you’ve been in teaching patients how to take care of themselves or how to take their medications (click here for the Teach Back tool, and click here for a video showing how it can be used).  When using Teach Back, I might ask the patient, “If a neighbor came to visit this afternoon, how would you explain to your neighbor what we just went over?”  Then listen.  You’ll hear what the patient really understands, and learn what you need to reinforce, and what you need to explain further or practice (if it’s a procedure or exercise).

Here’s how I would “try Teach Back on”:

• I’d start by asking two staff members to teach each other something, and practice asking each other the Teach Back question. We know that when you ask a patient if they understood, they’ll often say “yes” even when they don’t, because they hate to disappoint. So asking in a non-shaming way is important.
• I’d then ask the two staff members to try Teach Back on their next admission, or with the next patient they see.
• Finally, I’d have the two staff members phone in the results.

Their results can help you decide what to do next. Perhaps you’ll ask all of the members of your team to try Teach Back on their next patient visit.  My hunch is that Teach Back may even become your new favorite shirt!

Jane Taylor, CHAMP Improvement Advisor

Click here to read Jane’s previous QI-Tip of the month.