AIDET? Revisited - Strategy or Tactic?

One can't be in healthcare these days without having heard of the Studer Group's AIDET? communication framework. The iconic acronym represents a best practice for healthcare professionals who are seeking to decrease patient anxiety, increase treatment compliance, and improve clinical outcomes. AIDET? stands for five communication behaviors: Acknowledge, Introduce, Duration, Explanation, and Thank You.

Most of us agree that caregiver engagement, process improvement and effective, empathetic communication are key drivers for sustainable service excellence. Broad, over-arching imperatives such as these provide strategic context for determining what tactics and resources can best serve your organization's goals. Like other performance solutions, AIDET? has found its way into the patient experience toolkit of many high performing organizations. Healthcare systems "hardwire" the AIDET? framework through enterprise-wide training and compliance auditing. A word of caution: Not only are these interventions costly (time, money, resources), but there is real peril in the implementation of tactical solutions in the absence of strategic direction. In the South, we would liken it to building a house on gumbo.

Tactical initiatives, like gumbo clay soil, expand and contract depending on the amount of water they are given and the type of foundation upon which they are built. We've all witnessed the impact of a performance drought brought on when the "how" is not aligned with the "what" and "why." Engagement dries up revealing gaps in service and giant cracks in quality, safety and patient experience.

High performance and high reliability organizations have figured this out. Designing a strategic plan for patient experience involves elements of process improvement, change management and authentic leadership. With well-intentioned artistic license, I'd like to propose a fresh spin on the AIDET? set of initials - five behavioral strategies for leaders that are sure to positively impact internal communication, employee engagement and process improvement follow-through.

A = ASK. When Quint Studer worked in hospitals, he would walk around asking employees, "What can I do for you?" Stepping away from the administrative suite and discovering barriers through face-to-face interactions is a huge component of effective employee engagement and process improvement strategies. The Japanese call it gemba - the place where value is created. The gemba walk is an opportunity for leaders to observe, seek input, and reflect on the way in which care is being delivered. There is no better way to acknowledge and validate a caregiver's worth than to give him/her a voice.

"Half of science is asking the right questions." ~Roger Bacon

I = INSPIRE. I think we fail at galvanizing, motivating and encouraging the workforce because we cast too wide a net; we message to the masses through town halls and intranets. Efforts to communicate culture are often packaged as a one-size-fits-all campaign or initiative that many employees simply disregard. They wear the tee-shirt without truly owning the slogan. Inspiration requires sincerity and authenticity. It is a strategy of hope that encourages ordinary people to do extraordinary things. Inspirational leaders move employees from the margins into the mainstream. Storytelling is a great way to spread the why.

"There's no need to be perfect to inspire others. Let people get inspired by how you deal with your imperfections." ~Unknown

D = DECIDE. Why does it take so long for decisions to be made in healthcare? Hello. Let me remind you, ours is an industry of type-A personalities, first responders and fixers - professionals who must take in a situation, evaluate what's going on, consider multiple options and act decisively - and quickly. Consensus-building has its place, but many organizations have made it an art form. We all concede to the necessity of getting key stakeholders on board, but socializing an issue can't become a stall tactic for decision-making. Strategic advantage resides with courageous leaders who demonstrate tenacity in getting things done.

"Great leaders are almost always great simplifiers who can cut through argument, debate and doubt to offer a solution everybody can understand." ~Colin Powell

E = EMPOWER. You can't fix it alone. Even if you surround yourself with the greatest minds healthcare has ever known, it won't be enough to foster resilience, commitment and sustained excellence. An exceptional patient experience and caregiver engagement require an "all hands on deck" mentality as you navigate the rough waters of change. Step Five of Kotter's Eight Steps for Leading Change, describes three elements for empowering broad-based action:

• uncovering the barriers that may inhibit change efforts
• aligning processes, structures, procedures and reward systems toward the change
• developing the necessary workforce behaviors, attitudes and skills essential to making the change

"Leaders become great not because of their power, but because of their ability to empower others." ~John Maxwell

T = TRUST. We are living in a low-trust world. In his book, Smart Trust, Stephen Covey proposes that we should approach trust both artfully and scientifically. His idea is to strike a balance between rational judgement and our natural, heart-felt propensity to trust. Achieving equilibrium between trusting and trust-worthiness might well prove to be the yin-yang of authentic leadership. Charles Green (Forbes contributor), cited these leader attributes in his post "Why Trust is the New Core of Leadership":

• One who is skilled at trusting, because trusting and trustworthiness enhance each other
• One who collaborates and exerts influence through example
• One who operates from a clear set of values and principles, because opportunistic or selfish motives are clearly seen and rejected
• One who is more intrinsically than extrinsically motivated, and more likely to use intrinsic motivations with others
• One who is not dependent on direct authority or political power

" Trust is like the air we breathe - when it's present, nobody really notices; when it's absent, everybody notices." ~Warren Buffett