***All names and some information in this post have been altered in order to maintain privacy***
What do you like to be called? What are your goals? What is most important to you? These may be three simple questions, but we each have a unique set of answers. They are conversation starters, they are personal, and they are important. This tells the story of the About Me project at Sibley Memorial Hospital—a project that has in every moment found ways to connect hospital staff to patients, to connect people with people, to highlight the person in every patient.
It began as a part of a larger Sibley initiative to better understand what kinds of things we were missing in our inpatient care at Sibley. Dr. Larry Ramunno, Sibley’s Chief Medical Officer, assembled a group of physicians, nurses, and other staff with the purpose of hearing and using the stories of patients to fuel changes. At the initial meeting, the team interviewed a group of patients with varying experiences during their time in the hospital. Hearing these stories was hard, but there was one overarching pain point that seemed to resonate with each of the people that shared their story that day—mental exhaustion. From unit to unit, day to day, for anyone new entering their room, it would be the same challenge—they had to re-introduce themselves repeatedly. They had to decide when and if they would share information. What would they share about themselves? It took a toll on their sense of identity.
Finding the spark
The team took this information and ran with it. They went to the Sibley Innovation Hub and set forth on a mini design sprint looking to address this pain point. They started by going out to patients to dive deeper into the challenge at hand, gathering as much information from as many people as possible in this short amount of time. They were able to ask how people want to be known when they come to the hospital and as they move through the hospital. Here are some of the interesting nuances they heard:
it should not be about sharing an entire life story or a live's history
it isn’t about providing more information, it is about providing important information
it should be a snapshot of the person in the present, not just their medical history
it should help be a conversation builder and relationship starter
it needs to be something that helps people share what is really on their minds
Returning to the Hub with this new information, the team started to think about what they could do that allowed people to share these critical pieces of information. Where else do we go that something similar occurs—places like nice hotels, conferences, or even just going to a local restaurant? How might we provide that positive feeling that comes with being known at some level?
The brainstorming stretched far and wide—from seeing if one could get this kind of information incorporated into the patient file in Epic, to having a screen in the room that the patient could customize and personalize much like a Facebook profile, to incorporating these conversations into the handoff between shifts, and much more. The team decided to start simple, however. They reflected back on one story they had heard and its illustration of the need this initiative had to address.
This story happened to be of a retired physician, someone who had spent his life in the world of medicine but now had been spending time in the hospital. He talked about the stress that he felt every moment someone new entered the room—he couldn’t figure out how to tell them he was a physician. He was sensitive to how it might sound like he was pressuring his team, but he also knew that he wanted to be talked to as a medical professional—as another member of the care team. In fact, he expressed how he was more comfortable talking about his care when talked to peer to peer. If only they could know when they walked in.
Because of stories like these, the design team knew it needed something to open the door for these important pieces of information to be shared. It might be that someone previously worked in healthcare, but it might also be that their biggest concern is getting home in time for their kid’s birthday or being able to run again or finding a way to talk about things with their family—these things that are first and foremost on someone’s mind. The team knew that it needed to make sure people could share this information in a way that was available and obvious to anyone entering the room. If it is the first thing on someone's mind, they shouldn't have to re explain it over and over. The team started with a simple prototype to see if they could fill this need.
Matt Brown, Geriatric Nurse Navigator in the NICHE Department, took the initiative to interview patients and ask them some simple personal questions. He would be that initial point of contact who could gather the information that these patients would want to share with others. He took this information and created a simple printout, with a few of the answers and some clip-art relevant to the topics discussed. One would not have called this the fanciest of items to be bringing patients, but the reaction to just this simple piece of paper astounded him.
Finding the gem
Matt saw people reacting with delight and surprise. Some who would even say “that’s beautiful” because of the information that it portrayed. They reacted positively to this act of giving—as simple as it was, it was a gift. A gift showing people that they were heard. A symbol that what was on their mind 24/7 would be on ours too. The paper was displayed in the rooms of the patients for anyone who entered the room to see. Instead of there being a patient in a bed, there was a person, what they cared about, and a piece of who they are, and it was then that this project knew it had found its name—About Me.
The variety of information that began to be shared was amazing. Ranging from worries about what was going to happen, to whether one might feel better, to sharing prior experiences—this new information developed new relationships. Patients would make sure that the poster would come with them as they moved from unit to unit, many of them took it home with them, and some would even bring it back if they happened to be readmitted later. The About Mes were making a difference.
There were some odd moments, where patients would share things that no one expected. For example, one patient relayed that the thing she was most concerned about was the “corporatization of healthcare.” It wasn’t something that the team expected, but they finally understood why this patient continued to ask about the new partnerships Sibley and many other hospitals have formed. She explained how she had felt bad throwing staff off guard by asking these somewhat strange questions. Now, with this, she felt empowered and comfortable in having these conversations with her care team because this interest was clearly stated above her bed. She felt relieved and empowered.
There were some powerful, moving moments, where patients shared things that change one’s perspective forever. One person who had faced many challenges in life—he was a drug addict and homeless at the time. He asked for his poster to say “I am really a nice person, despite all that is going on.” Statements like that change how you look at someone. It changes how you approach an interaction. It brings a whole new meaning to the understanding of who someone is and where they are in their lives.
About the future
These stories have sprung the About Me project into the new tower at Sibley. With white boards in every room, there is not only an opportunity to share these pieces of information with everyone that enters but also a chance to update and change the information everyday. Staff are prompting everyone to fill out these boards and talk about the things that are on their minds.
This is a space that belongs to the patient. It is unique to them. Importantly though, it brings everyone in the space closer together. It reminds us all of what we share with one another. It connects us as humans and as individuals. They are called About Me boards, and they bring the person out of the patient.