Improve Physician Patient Satisfaction Scores with Free Tool

September 24th, 2015


 Boost HCAHPS scores with a Physician/Provider Self-Administered Indicator Tool

 Dissatisfied with your patient experience scores?  We’ve been using a quick, effective tool to support physician-patient/family interactions. Providers use these indicators to identify their own beneficial (or detrimental) behaviors, using a coaching approach that encourages enduring change.

The recent IOM Report “Improving Diagnosis in Health Care” recommends cultivating communication and teamwork to minimize diagnostic inaccuracy. Being perceived by a patient as a safe empathetic care provider means that we have a much better chance of truly “knowing” our patient–and therefore less likely to miss the mark in treatment.  But many healthcare professionals remain unaware of patient connection best practices.

Using our complimentary tool, paired with a conversation with an outside expert, allows each individual to identify what routine communication alterations could improve their HCAHPS scores related to the questions

  •  How often did doctors treat you with courtesy and respect?
  • How often did doctors listen carefully to you?
  • How often did doctors explain things in a way you could understand?

Implementations Steps:

Download this free tool that’s based on experience working with 175 client organizations, boards, and executive teams and a panel of healthcare administration experts.

  1. Schedule a ½ hour webinar or live conference with Ruth Hansten (your outside expert) with your medical staff, Board, and/or quality committee.
  •  The webinar explains the research behind provider/patient relationships, neurobiology, and correlation with outcomes, such as patient compliance, to help convince skeptics of the impact of bedside/eye level interactions.  (Using an outside expert to explain the science behind the tool will decrease provider eye rolling and boost compliance.)
  • Email us at or telephone us at 360.437.8060 to schedule your webinar at special fall rates.

3.  Use the tool to follow up in tracking provider scores as each physician/provider self-assesses, self-corrects, and then measures improved results.

4.  Ask us to coach providers or executives through short term or longer term coaching engagements (contact

Physician_Provider Indicator Tool 3

“Ruth in the Room” Conference Call Open Dialogue December 10th

December 2nd, 2014


Ruth’s Back in the RoomRuth at Poster Session at AONE

Wednesday December 10, 2014

 By popular request, we have scheduled the next “Ruth in the Room” conference call forWednesday December 10th 2014, at 0900 Pacific, 10AM Mountain, 11 AM Central, 1200 Noon Eastern time zone.

 Please phone 712-775-7100, Access Code 515577# to join our conversation.

During the conference call, Ruth will discuss what she has learned working with nurses nationally over the last few months and open the conversation for dialogue and questions.

If you would like Ruth to address your specific healthcare delivery questions/concerns during the session, please send them in advance to Ruth Hansten via Ruth’s Email

The program will be recorded and made available for all those who would like to listen later.

We hope you can join us!

Bring your Coffee or Lunch to our Complimentary Dialogue

Below are a few questions Ruth has fielded in the last few months.

ruth teaching 004


Making Assignments: What’s wrong with having UAPs such as MAs or NACs reporting to multiple RNs?


Reporting Procedures: Why shouldn’t the NAs give report to each other solely, sift after shift, without involving the RNs?


Nursing Leadership at the Point of Care:

Why should I be held accountable for team members’ practice? Asking someone to help just takes too much time, I should just do it all myself.


Leaders as Coaches: How can I coach a team toward more accountability and connect them with outcomes? 



3 Compelling Coaching Questions about Your Professional Practice Model

January 4th, 2016

It’s 2016! Resolve to renew your nursing care delivery model.

Whether you call “it” a professional practice plan or just “how we work together to help people heal, ” persuasive results (better patient outcomes, employee satisfaction, and patient/family care experiences) will be worth your effort when all personnel share a positive purpose and work culture.

We recommend fielding these 3 coaching questions at your next unit governance council or departmental meeting. As leader, you may think the answers are crystal clear, while your team may disclose divergent answers that can become barriers to best practice.

1) How well does our care delivery model reflect our shared vision and values? 

  • Are patients and families and their preferred outcomes prominent?
  • How well are the nurses’ relationships with the patient/family supported so that nurses “know” their patients and care is not missed?

2) In what ways does our care delivery model sustain our own sense of agency or control over professional nursing practice? 

  • Does it assist RNs and team members to understand and practice at the height of their practice in leading and coordinating patient care?
  • In what ways does our model help us celebrate our accountability for helping the patient/family navigate toward best clinical results?

3) How does our professional care delivery plan create a framework and a team structure to guide our daily work?

  • Does each team member have a shared mental model or map in their brains about how we will communicate within our team including other disciplines, and methods to update each other on progress?
  • How does our structure help set up RN delegation and supervision of assistive personnel?


In our RROHC® Relationship & Results Oriented Healthcare system, a bundle of 10 best practices help clarify a shared mental model and team purpose, from the beginning of a shift or care episode to the end, always serving to help the patient/family achieve their own preferred outcomes through healing relationships.


A new year gives us a refreshing opening to renew our vital calling.  The health of our communities depends (at least partially!) on our healthcare team’s clarity of purpose and commitment to do our best to perform.  The above coaching questions are worth the time and effort!


For additional information, reach us at,,, 360.437.8060.

1 Fundamental Truth for the Patient Experience, Loyalty, and Outcomes

September 8th, 2015

(Spoiler Alert: It’s NOT just smiling.)

The magic of discovering and achieving one major patient goal as a team (Team= the patient/family, the patient care providers and professional team) has been in the spotlight recently in articles and blogs.*  The essential nature of shared goals is not a flash news bulletin for successful organizations that have instituted the 10 best practices of RROHC® (Relationship & RESULTS Oriented Healthcare).  The RROHC care delivery model creates a secure space for understanding and connecting with the patient and helping him achieve his outcomes. When one’s relationship with the patient/family is individualized to the extent that there is mutual understanding of patient priorities, and the patient is able to realize them, satisfaction and loyalty abounds.   Teamwork among care providers at the point of care, and medical specialties, as well as those along the entire continuum of care, is enhanced as we work toward common goals.

Questions similar to those below will help your patients/families focus their thoughts and concerns so you will be able to partner in their care and engage their energies from episodic and short term easy fixes, to palliative care, to the comprehensive requirements of managing long term chronic conditions.

“What’s most important for you right now?”

“What’s your #1 concern for today’s care, and during this hospitalization?”

“What drove you to ask for assistance from us?”

“What are your priorities for this visit?”

“How do you want to be or to feel after you receive our help?”

“What’s really on your mind?” 

“What’s concerning you about the next part of your care? What do you need to be able to stay home? Let’s walk through a day’s events….”

“What’s getting in the way of your ability to live your life comfortably right now?”

“Looking over the next few days, and thinking about the best possible outcomes, how will you judge if this care is successful for you?”

We develop relationships in order to attain intended, patient-driven results. (#RROHC)  Seem deceptively simple?  If so, why are some healthcare organizations just discovering this truth?

Let’s cut the confusion for our patients and ourselves and get authentic about the crucial healing work we do. (No imitation smiles please.)

(*including Press Ganey, The Advisory Board, Becker’s Hospital Review)

Another Look at RN Skill Level & Patient Outcomes

August 6th, 2015
(First Published in Linked In Pulse Aug 5, 2015 by Ruth Hansten)

 Optimal Skill Levels would be 100%.

In reviewing 1382 RNs’ self-assessed skill level before RROHC (Relationship & Results Oriented Healthcare) best practice education, I was  struck by the minimum values of various organizational cohorts.  All groups included RNs with all levels of experience, prior to our education processes.

The implications for patient and organizational results are staggering.

  • If RNs know where patients came from and are likely to be discharged to, if they plan effectively, then patients could enjoy reduced lengths of acute care stay, and potentially fewer readmissions due to excellent care coordination.
  • If RNs lead their teams with appropriate initial direction, delegation, supervision, reciprocal feedback, and evaluation of care then there could be fewer care omissions and acquired problems such as CAUTIs, pressure ulcers, pneumonia, and/or embolic conditions due to lack of movement, hygiene, observation, nutrition, hydration.  Yes, these are nursing care tasks often completed by assistive team members.
  • If RNs understand their impact on patient results, and feel they truly connect with patients, an engaged workforce can be correlated with less employee turnover but also fewer healthcare acquired infections or conditions.
  • How happy or safe would a patient/family be with a nurse that was not willing to stand up for opinions or intuition, or reflect on and evaluate their care processes?  Gaps in critical thinking attitudes and habits can lead to dissatisfied patients and errors.
  • All these issues have economic implications in value-based healthcare.

Perhaps it’s time to review the basics.  Find out whether these professional practice issues are impacting your results.

RNs must lead and practice effectively and professionally for optimal patient safety and results to occur.

For more information, visit us at or, or contact us at, or phone us at 360.437.8060.

Toxic Tornadoes: Poisonous People Preparedness

June 5th, 2015

It’s tornado season. Just as storms brew up in uncertain weather and leave destruction in their wake, the aftermath of a toxic attack from a colleague can devastate even the most centered leader. My coaching clients have reported a surge of passive-aggressive and out-right nasty behavior recently—prompting this spring coaching column. That knife in the gut or stab in the back can be painful–but re-framing and understanding their behavior can help you become more proactive, with steps to heal after the attack and prepare to avoid the next.  After all, these colleagues would not have attacked you if you weren’t the strong leader that you are; it just wouldn’t be any fun for them!

1.  Know why people act mean.  As Richard Rohr says, “You can take it as a general rule: If you don’t transform your pain you will always transmit it.” Attacks come from a wound within that person.  When you are targeted by someone’s venom, active responses as outlined below will help relieve yourself of the poison. Don’t relive or perseverate on nastiness.  Don’t let this person’s toxicity control you or sap your confidence.

2.  From an attitude of curiosity, reflect on what might have precipitated this instance of toxic behavior?

  • If the person is a kind individual that normally does not “have a nasty bone in their body”(I’m channeling my mother here), then it is reasonable for the leader to ask them the coaching question privately “What is going on right now that would have caused this situation to occur or for you to say what you did?”
  • If this individual is normally nasty because of their own issues and they treat everyone this way, then you can choose one of several options. Please note: If you do not address the behavior, lack of follow up makes you an easy target for the next tornado.
  • Make them aware their behavior and ask for them to change their manner of communication.
  • Send them to the Employee Assistance Program or recommend a therapist.
  • Fire them if their nasty communication is an established pattern. Research indicates that toxic behavior affects the team’s ability to communicate and contributes to errors while undermining patient safety.
  • If you are not able to urge this person toward new job horizons due to their place in the organizational chart, then think about ways to avoid them. You have better things to do than deal with toxic energy.

3.  If you as a leader advocated for what you believed was best for patients and for your community—and your behavior thwarted a toxic person or their goals, good for you! Call out their behavior privately“I understand that it was difficult for you and your department that ____ and also I did this for our shared goals. We all look good as a team if our community health improves.”

4.  Perhaps something you said made a colleague lose face and your nicer twin might have avoided a public thrashing. If so, apologize that you made “X statement” that would have been better said in private.

Most of us have buried woundedness that can escape with certain triggers.  With that in mind, do your best to resolve an attack with the steps above, and then let it go.

For additional leadership coaching contact Ruth Hansten RN MBA PhD FACHE at 360.437.8060 or  Follow Ruth at @Rhansten on twitter, and visit our website at or

This Blog entry  was first posted on LinkedIn Pulse on May 29,2015.