Decreasing Dialysis Patient-Provider Conflict

Objective:

Activities Required for Diamond Status/Measures:       

• 100% of staff in-serviced on applicable unit policies such as:
        - Zero tolerance
        - Grievance process
        - Treatment re-scheduling
        - Patient comfort
        - Patient care planning
        - Responses to patient non-adherence (i.e., requests to come off the machine early, patient refusal of specific care technician)
        - Other unit-specific issues
• 100% of staff complete the DPC Program Toolkit training.
• Develop/adopt policy and procedure for conflict management.
• Track and trend the number, type, and cause of conflicts in the facility (QI tools are available in the DPC toolkit for reference and use).
• Use trending results in QAPI.

Optional Activities:

• Display Network Grievance Poster along with State Survey contact information in an area easily viewed by patients.
• Display dialysis facility complaint process procedure in an area easily viewed by patients. Debrief staff following acute episodes of conflict (such as verbal outbursts or act of violence) and include a review of what happened, what went well, what didn't, what could have been handled differently, and how to handle going forward.
• Provide, at a minimum, quarterly in-servicing of staff on conflict resolution, which can include the topic of professionalism.
• Display the DPC Toolkit Poster.
• Identify problematic patient issues in staff meetings and develop plan for consistent intervention/management.
   

Tools/Resources:

• DPC Program Documents/Toolkit:
         - DPC Provider Manual
               ~ DPC Brochure
               ~ DPC Pocket Guide
               ~ Decreasing Dialysis Patient Provider Conflict (DPC): An Introduction to the DPC Project (PowerPoint Presentation)
               ~ Decreasing Dialysis Patient-Provider Conflict Tracking Tool and Instructions
               ~ DPC Conflict Pathway
               ~ DPC Tips on Cultural Awareness
               ~ DPC Bibliography
               ~ DPC Poster (also available from the Network Office)

• Improving Communication in Patient-Provider Relations article
• Preventing Conflict in Dialysis: The Value of Customer Service article
• Patient Resources:
         - www.youtube.com/embed/j3q2uxy7IQA - Because You Count video
         - A Guide for Patients Dealing with Difficult Dialysis Staff Members article

• Completed Project Reporting Form
• In-service attendance log
• Copy of de-identified tracking tools for tracking and trending number, type, and cause of conflicts and the QAPI sessions in which trending results were discussed.