Lisa Juliar story

CAN YOU IMAGINE?Your willingness to empathize can help — or hinder — a patient’s emotional healing.

WWhen Lisa Juliar learned that she didn’t have breast cancer after all, four months after undergoing a lumpectomy at age 34, the bewildering mix of anger and relief she experienced also ricocheted through her family, prompting her youngest daughter, age 5 at the time, to exclaim:

“You mean we made all those cards for nothing?!”

It was easier for Lisa to understand her daughter’s reaction than the response of a risk manager who met with her a short time later.

“I don’t know why you’re so mad,” she recalls the woman saying. “You don’t have cancer. It hasn’t affected your life that much.”

But it had, of course. And the inability or unwillingness of the risk manager to empathize with the range of emotions Lisa was experiencing prevented her from providing the kind of support that might have made a deeply unsettling event less distressing.

This article is reprinted with permission from MMIC. It originally appeared in the Summer 2015 issue of Brink. To view this, and previous issues of Brink, visit MMICgroup.com.

A better wayFortunately, another person who took an

interest in Lisa’s case — Robert Moravec, MD, Medical Director at HealthEast’s St. Joseph’s Hospital in St. Paul, Minn. — was able to provide her with the empathy she needed.

“I was really fortunate that he was involved,” she said. “He’s really a pioneer in transparency and disclosure.”

In a video produced by HealthEast, Dr. Moravec shares his philosophy: “I’m convinced that the disclosure process for an adverse event really is the start of healing in a person or a family.”

Dr. Moravec and his colleagues explained to Lisa what had happened: Her biopsy sample had been mixed up with another patient’s, a mistake that only came to light at a tumor conference when another physician, interested in the type of cancer Lisa had been diagnosed with, asked for another sample of the biopsy tissue and noted that it didn’t match the first.

Understanding how the mistake had occurred was one important part of Lisa’s recovery. Another part was simply being asked by Dr. Moravec what else would help her. She expressed a desire to meet with the full care team and asked for an opportunity to share her story with hospital staff as a part of team training. Both requests were honored.

Speaking from experienceThis dramatic series of events started Lisa

on a new path as a patient advocate. She began speaking at events sponsored by the Minnesota Alliance for Patient Safety, and a year and a half ago she began serving as a patient and family engagement consultant for the Minnesota Hospital Association.

These opportunities have given her a chance to share her experiences and to help care providers understand what patients need from an encounter with medical personnel. Often, she says, it’s just to know the physician cares.

Yet another traumatic medical experience further informs Lisa’s unique point of view. Nine months before the biopsy mix-up, Lisa had given birth to her fourth child and knew from the beginning that something wasn’t right. After six anxious weeks spent consulting specialists and pursuing false leads, she recalls sitting in the exam room waiting for her pediatrician.

“He came in with a resident and said, ‘It’s the worst thing you can imagine. He has Cri Du Chat syndrome. He probably won’t walk or talk or eat well or learn much.’ Then he said something about putting in a feeding tube and running some more tests on his organs. And he left the room.”

Lisa was stunned. “When you hear bad news, it’s like you’re in a tunnel. You don’t see or hear very well.”

Fortunately, another pediatrician in the practice reached out to her the next day. “She said, ‘I just heard about the diagnosis, and I just came to give you a hug. How can I make this easier?’ I said, ‘You can be his doctor, to start with.’”

“She gave me her home phone, she gave me her cell phone, she gave me her cabin phone,” Lisa says, smiling as she recalls her sense of being buoyed by the physician’s support. That patient-doctor relationship has now lasted for 13 years.

Patients at the tableIt’s being able to share the good as well as

the bad experiences of being a patient that drives Lisa in her current role. “It’s extremely difficult for patients to break through the system,” she says, noting that patients can bring a fresh perspective. “And they really want to help,” she adds.

Lisa encourages organizations to give patients a place at the table in discussions on hospital safety, and to trust that good things will come of it. She recalls a recent discussion in which an organization evaluating safety metrics in one area noted that the numbers hadn’t budged. Lisa suggested that the group involve patients in its efforts to move the needle.

“Absolutely not,” she recalls the organiza-tion’s quality manager insisting. “We have to get the numbers better before we bring patients to the table.”

Lisa countered, gently, “The numbers may not get better unless you bring patients to the table.”

Making a difference Two years after Lisa’s biopsy mix-up, she

entered the medical system again, this time at the side of her mother, who also needed a biopsy. Lisa recommended that they return to the same hospital where she had gone for her procedure. This time, things were different. Lisa was invited to observe the new processes in place to prevent the kind of error she had experienced.

“We followed her biopsy to the lab. The lab tech went through every step, showing me how the samples were marked and how they were kept separate from other samples so there was no chance of mixing them up.”

“It had made a difference,” Lisa said of her efforts to make care safer. “It’s why I’m doing this work. And why I can’t wait to do more of it.”

TO LEARN MORE ABOUT HOW CARE PROVIDER EMPATHY

AFFECTS PATIENT OUTCOMES AND HOW EMPATHETICS®

EMPATHY TRAINING CAN BENEFIT YOUR ORGANIZATION,

SEE WWW.EMPATHETICS.COM.

LYNN WELCHSenior Communications Consultant, MMIC [email protected]

Brink / Summer 2015