Patient Navigation Certificate - Lesson 4: Interaction 3

Please watch the following video demonstration and respond to the discussion question below.

Ending the meeting with the client, list the key observations that stood out to you.

Instructions: You must post your responses in the comments section below before the next live lesson to earn your certificate of completion. The instructor will review your comments and have a debrief discussion during the next live session.

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11 comments on “Patient Navigation Certificate - Lesson 4: Interaction 3

  1. Hi Julie,
    Yes, thanks for sending this. Sorry that it did not appear in the course page!

    Rosemary

    Rosemary Kohr, RN, BA(Arts Plastiques), BScN, MScN, PhD
    Tertiary Care Nurse Practitioner Certificate

    Program Director
    Health Leadership & Learning Network
    Faculty of Health
    York University (Canada)

    Adjunct Associate Professor
    Faculty of Health Sciences
    University of Western Ontario

    kohrconsulting@gmail.com

    cell: 519-871-1581

    "in the reality of the clinical world"

    On Wed, Apr 28, 2021 at 1:43 PM Julie Hamer wrote:
    Hi Rosemary, below are my reflections for the videos for today session. I’m not sure what happened with the postings. Please confirm that you have received these. See you tomorrow.

    Thanks,

    Julie

    Scenario 1 – Key Observations:

    The primary thing that stood out to me in this scenario was a lack of empathy and desire to support the patient’s daughter; despite her words saying that she wanted to help she seemingly could not appreciate the daughter’s needs and concerns. Initially, when the patient navigator was asked to slow down she did but then returned to speaking quickly with complicated language. While watching the interaction, it was clear that the daughter was confused/stressed/anxious and showed this both through what she said and through her body language but the patient navigator did not seem to recognize this and address it or adjust her communication style.

    Scenario 2 – Key observations:

    This interaction was much more successful. The patient navigator spoke with respect yet acknowledge that there was a language barrier and adjusted her communication style appropriately. She spoke slowly, clearly and used simple straight forward language. She effectively ensured that the daughter understood and checked in to see if she had concerns as the conversation progressed. She showed empathy and respect and reflected back her concerns. She was helpful and provided reasonable suggestions.

    Scenario 3 – Key Observations:

    In this conversation the patient navigator did a good job at summarizing the conversation, reflecting back concerns to the client and ensuring that she had a good understanding of the next steps/timelines. She continued to use simple language and speak slowly and clearly to ensure that Maria understood which was very effective. Wondering if using a translator, if available, may have been even more effective in helping to calm Maria by ensuring she understood the plan and was able to ask all questions. At my facility we have access to telephone translation services, which for a language like Spanish would be quite quick and easy to access to ensure effective communication in the patient/daughter’s first language. This would be a good way of ensuring the plan met the pt/family needs, addressed the concerns effectively and ensured understanding.

  2. I like this wrap up scenario because the navigator took the time to ensure the client understood the key points discussed in the meeting and the plan forward which made Maria seem way more at ease and comfortable. She was not rushed, but rather efficient with the time in tackling Maria's concerns. She was very proactive in meeting the client where she was at and made herself available to the client post-meeting - allowing an additional layer of comfort to the client which was met with much gratitude.

  3. In this conversation, the PN continues to show empathy and respect while talking to Maria. She continued to use active listening which can be seen in the PN’s body language. To make sure she understands what the daughter was saying, the PN paraphrased and summarized what the conversation was about. She also clarified what Maria wanted. The PN provided different solutions to Maria’s concerns. For instance, the PN said she will follow up with the doctor to tell them about the situation and asked about what can be done. She also said she will send a letter to Maria to give to her boss. At the end of the conversation, it can be seen that the conversation was productive and a plan was created.

  4. Professional meeting
    The PN let the daughter know that the meeting was coming to a close and they had a few minutes left. She looked at the daughter when she spoke. Gave the daughter her attention. She thanked the daughter and the daughter seemed to appreciate this. This helps to build respect.

    The PN summarized the daughter’s issues and concerns. She told the daughter what she would do to alleviate her concerns, such as speaking to the doctor to ask to make an exception and allow the daughter to be present during surgery. The PN did not offer false promises but said she would try.

    She mentioned that she would send a note to her boss to ask for time off. When asked about a timeline for the note the PN gave an approximate timeline of the end of the day or next day. Its important to give a realistic timeline that the PN can actually meet.

    The PN gave a brief plan B in case the daughter could not get time off work. The meeting time was running out but still this discussion seemed too brief. I feel the daughter would have preferred a bit more time to understand and confirm this option.

    The PN confirmed that the daughter had her phone number and encouraged her to call and leave a message. She empathized that it can be difficult to leave a message when English is not your first language. She reassured the daughter that they would speak again.

  5. There were good things about this interaction but still some helpful information was missing. This time the PN did offer to send a letter to Maria that she can give to her employer to help Maria ask for the day off. However, Maria was quite anxious to get this letter as soon as possible. The PN did not seem to instill confidence that this would happen. She also did not ask Maria if it would be acceptable for a church member to accompany Mr. Gomez for his surgery. She did summarize the plan and Maria seemed less anxious at the end of the call.
    The PN also thanked Maria for taking the time to attend the call and did seem to be sincere and genuine. She also seemed sincere when she gave Maria her contact information and told her that she could call her with any questions or concerns.

  6. It was great that the navigator thanked Maria for her time and for meeting with her today. I also thought it was great that they went over the plan in place and some action items. Some things that could have been improved are the navigators urgency in getting the letter to Maria, as it was clear that was an area of concern and stress for her.

  7. I found there were some things the Navigator did well (at least at the beginning of the wrap up); however the Navigator had much room for improvement.

    I appreciated the navigator thanking the client for her time while also identifying that the zoom appointment was wrapping up. The navigator did list the identified goals, however, it did not feel all that concrete or final. The navigator was listening to some level at the timeline and the need to advocate for the client to be with her father during his surgery and giving the surgeons office a "heads up" that they are Spanish speaking; however, I would have liked to see the navigator have a concrete plan 'B' in the event that the daughter couldn't get the day off of work.

    It sounded as though the time frame was very important for the daughter in order to communicate effectively to her father the steps and what is going to happen, however the navigator did little to ease this concern.

    There should have been a discussion about preferred communication style- written, text, email, or phone for the client. The navigator missed the mark on giving the client a follow up time/date to expect a phone call from the navigator in a timely fashion if Plan 'A' no longer was an option on how to navigate next steps. There is nothing worse than planning last minute and only causes additional stress to the client and their families.

  8. I found this exchange disappointing in that the Navigator had an opportunity to suggest concrete solutions, however she seemed pushy and directive especially for example when suggesting they would make arrangements with someone from the church to take her dad to the appointment.
    It appeared this was of concern to the daughter and not an option she wanted to explore
    However, I was encouraged when she said "We have a plan" and that the daughter could call the Navigator at any time and gave her direction on how to access the Navigator.

  9. I feel like this closing conversation was very wordy.
    The conversation did not flow well.
    I feel like she was pushy with making plans that did not involve the family's wishes.
    I liked how she encouraged her to call and leave a message but she did not give her a time frame as to when she would get back to her. She also mentioned that she would be receiving and email for confirmation of plan. She did not ask which way is best to communicate.
    with the language barrier, would it be helpful to have someone who maybe knows the language come sit and be part of the conversations.

  10. This interaction was slightly improved. The provider thanked the client for spending the time to try and find a resolution/ways to overcome the barriers to help her father attend the appointment. She recapped the current issues with the client, to ensure those were the priority concerns that needed to be resolved. She provided a solution to getting time off of work by explaining she would provide a note for Maria's employer. However, Maria noted she required the note asap and the provider was unable to provide a concrete date that the letter would be available. This may have been helpful as Maria could have explained the situation to her boss, and provided an actual date that the letter would be received. The provider also identified that the daughter wanted to stay with her dad for as long as possible during the appointment. She did explain it was unlikely Maria could be present during surgery, but she was going to reach out to the doctor and have them explain the situation to the specialist. I do feel she could have better verified Maria's understanding of the current plans in place to help resolve the situation. The provider also provided a solution in the event Maria could not attend, which included connecting with a contact who goes to their church to provide support at the appointment. However, this would not be ideal. At the end of the conversation she could have asked Maria is she had any further questions or concerns, or if she needed anything clarified. She did provide her contact info and encouraged Maria to reach out if she had any questions or concerns. Finally, I feel she could have provided a date she would follow-up with Maria. Whether it be after sending the employer note, or closer to the appointment date. That may provide Maria with some relief, knowing she was planning to reach out again and reassess the progress on situation.

  11. She did not hear the client, instead she told the client what she needed to say . Poor listening skills. Did not ask questions during interactions to verify client's understanding of discussion. She should have said could you please
    tell me what your understanding of our call today was about. There is a good chance the patient will not show up for the appointment. Why not use a translation app ?

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