This was my first non-clinical rotation, and I think the timing of this rotation at the half-way mark of my residency is very fitting. It was very eye-opening to see the layers of management and leadership behind ensuring that all the operations, clinical services and strategic plans run smoothly.
Through shadowing Mits, and having discussions and daily reflections with Mits, I had the opportunity to learn and observe about his management and communication styles.
Some clinical pearls I learned were:
- Communicating with SBAR
Prior to this rotation, SBAR was something I had only seen on a nursing communication sheet at MSJ. SBAR stands for Situation, Background, Assessment and Recommendation – it follows a similar order that SOAP does. When addressing a management issue, Mits had me practice how I would explain this particular issue through SBAR and I was also able to observe how Mits used SBAR to explain the same issue to a medical director. One difference between the way I explained SBAR and Mits was that he included parts of the “R” in my “S” to allow the receiving end to understand the purpose of the conversation. I think this tool will be a very systematic and effective way for me to communicate issues to other health care team members and my colleagues.
- Communicating with OWTF and using “I” language
OTFW is communicating by talking about what I observed, what I think, what I feel and want. The order doesn’t have to exactly follow OTFW, but the key is to touch on all of them when bringing up an issue. Communicating with OWTF and using “I” language will help others understand your perspective, communicate in a non-confrontational manner and provide others with the choice of helping you (versus demanding for assistance on the matter).
Implementing and ensuring successful change requires going through all 5 steps of ADKAR. On my last day, we attended a leadership forum at Burnaby Hospital where managers, coorindators, PCCs, LPNs and executive directors presented and discussed about the health care report card, different initiatives taking place at BH, the successful patient stories and steps to take and are being taken to ensure successful change. This forum was also great example of another communication tip that Mits taught me and that was to ensure that everything communicated does a 360. If there is an issue, ensure that those who brought up the issue are made aware of the status of the issue (e.g. email, verbal communication, interim reports). This forum provided an opportunity for the leaders in BH to provide feedback and input, as well as, ask questions to president of Fraser Health, Michael Marchbank. Overall, it was a great end to my rotation to see ADKAR being applied in practice!
- The Donut Model
The Donut Model consists of 3 layers – the inner most represents what you can directly affect (e.g. what you can wear)?, the second layer represents what you can influence and the third layer represents what you can’t control (e.g. weather, the past). It is important, in my residency year and the rest of my career, to be aware of these different layers and avoid putting my energy into things I cannot control.