Avoid playing the telephone game when communicating the quality message

March 28, 2018 / By Cheryl Manchenton, RN

As a child, I loved playing the game telephone. It was always hysterical to hear the message that the last person heard as compared to the message the originator sent.

Understanding quality is the same. Many times I have recommended quality education for the troops at the ground level: the CDIs, the coders and the quality staff reviewing records. And I am not forgetting the providers who need it just as much. Here are the reasons I have heard for not providing direct education:

  1. Our staff is too busy
  2. We can’t afford to pull the staff off production for education
  3. We can train the staff on the content (train the trainer)

Although I understand the above reasons make sense on paper, I disagree for the following reasons:

  1. We all need to hear WIFM (what’s in it for me).

Individualized education in front of an audience that can ask questions and find meaning in the content is more effective than merely reading guidelines or watching recorded training sessions. I love interacting with students and watching for their lightbulb moments. Hearing about their frustrations and concerns helps me modify the message so they are engaged, excited and not overwhelmed that an expanded focus on quality will mean more work.

  1. Train the trainer may not be effective.

Like the game of telephone, ”train the trainer” messaging has potential for missed translation and presenter bias. And considering that quality content can be quite confusing and detailed, the messenger might not get—and communicate—the correct message.  Second, the message may not be well received based on the person providing the education—especially when it comes to providers. Providers need to believe they are being listened to and they may be more objective and attentive when listening to an outside voice (training by administration representatives may not be well received given perceptions that they do not have the providers’ best interests at heart). CDI and coding staff may see quality as something they cannot make time for or that it’s “gaming the system.” The message has to be delivered without bias and in a way that explains it isn’t “extra” work to “do” quality. It is an extension of their job and provides additional query opportunities for those who are worried about their query rate.

  1. Organizations cannot afford NOT to get their staff up to speed. Inadequate training can lead to a significant financial impact given the payment adjustments of the various quality programs.

I’ll add one more thought. Quality is always changing, including the metrics and performance rates. Establishing a quality education program with a focus on the most up-to-date and thorough education makes for better learning (and better hospital performance).

Let’s talk!

Cheryl Manchenton is a senior inpatient consultant and project manager for 3M Health Information Systems.