Relationship-based Care

March 10, 2016 by

Karin LeagueNataroJ

As we settle into 2016 it’s a good time to pause and consider what we truly want to accomplish as a team this year. We have much to be proud of in Children’s Hospital and many exciting new services will be available this year. With so much going on it’s easy to get lost in the list of to dos, email, and the daily grind.

With activity swirling all around how do we remember that patients and families care little about our” to do” list and more about the relationship we are building with them? A good place to start is to ground ourselves in the concept of relationship based care. At UVA, relationship based care is our agreed upon framework for nursing care delivery. It’s actually a good model for the entire care team, but only if it is mindfully applied.

  • What is relationship based care? Relationship based care is centered around one’s relationship with self, team members, and the patient. Let’s spend some time on each of these concepts.
  • A healthy relationship with one’s self is essential to ensure that each of us has the energy and enthusiasm to give to others. Take the time to care for yourself. Here are a few things to consider:
  • Do you eat with a friend or eat at your desk or on the run?
  • Are you spending time each week doing something that makes you feel relaxed and happy?
  • Are you getting enough physical activity?
  • Are your personal relationships healthy?
  • Your relationship with the team is a critical component of relationship based care. Who wouldn’t want to work in a trusting team that has each other’s back? Are you cultivating relationships at work?
  • Do you manage up every member of the team when possible?
  • Are you conscious of the effects gossip has on each other?
  • Are you giving honest feedback with the spirit of helping others grow?
  • Are you looking team members in the eyes and acknowledging them or are you looking at your phone?
  • The final piece of relationship based care is the relationship we form with patients and families. Are you connecting with every patient/family every time?
  • Here are some tactics to help foster the connection:
  • Become skilled at AIDET (acknowledge, introduce, duration, explanation, thank you) and use it each time you encounter a patient/family.
  • Make eye contact and smile.
  • Sit down when you are interacting with patients and families. It sends the message that you have time for them.
  • Ask patients/families what is the most important goal for them. Review goals frequently.
  • Use the whiteboard to facilitate communication with the patient/family. Update it frequently.
  • Encourage patient and family participation in rounds and nursing change of shift report.
  • Include patients/families as part of the care team. This means discussing options with them, not informing them of options we have chosen for them.
  • Anticipate needs. Nursing hourly rounds focused on pain, elimination, environment, positioning

We hope this discussion inspires you to pause for a moment and consider how relationship based care fits in with your own relationship with yourself, colleagues, and patients.

Thanks so much for all you give,
Karin and Jim

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