Provider Ambassadors: Angela Nelson, MPH, APRN, CNM | D-H Stories | Dartmouth-Hitchcock
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Provider Ambassadors: Angela Nelson, MPH, APRN, CNM

Provider Ambassadors: Angela Nelson, MPH, APRN, CNM

Provider Ambassadors for Patient Experience—all Dartmouth-Hitchcock (D-H) providers themselves—provide coaching and peer-to-peer support in a collaborative nature. Through peer-to-peer observations and mentoring, the ambassador team partners with a provider in a reflective, thought-provoking and creative way to observe, talk through, inspire, or simply make small changes in style or behavior that can have a significant and lasting impact on the relationship with his or her patients and colleagues. (More information about the program is below.)

Angela Nelson, MPH, APRN, CNM, D-H Concord Obstetrics & Gynecology, says when she heard about the Provider Ambassador program, she thought it was a great idea for providers to help other providers communicate with their patients. She’s been involved in the program for about three years.

“My favorite part is working with providers who need to improve their personal connection with patients,” she says.

Nelson remembers one of her first coaching experiences, which has helped her guide subsequent providers. “I was still fairly new at coaching, and this physician’s specialty was in an area I knew nothing about. I admit I felt intimidated at first. This physician was clearly brilliant and quite intelligent, but patients repeatedly said they felt a lack of a connection.” she says. “When I shadowed her with several of her patients, she came across to me as very shy and reserved. She was quiet, business-like and never smiled at her patients or co-workers. I believe this can be interpreted as cold and not caring. After spending a day with her and talking, I came to understand that she truly did care about her patients, and invited her to come and shadow me with my patients.

Shortly after, her supervisor said they saw a complete change in this clinician with her co-workers and her patient satisfaction scores improved quite a bit. At first, I had been intimidated, so getting this feedback from her supervisor was really encouraging to me.”

Nelson says when she is assigned to coach a provider, she will look over their patient satisfaction scores and patient comments to get a sense of how the provider is perceived by his or her patients.

“Then I reach out to the provider, [and in cases where the provider has been referred] and tell them that their supervisor asked me to work with them to see if we can help them to improve their patient satisfaction scores, their time management, etc. We’ll spend time reviewing their patient satisfaction scores and comments, and I try to get a sense of what they think the issues are or the barriers are to care. After this, I’ll shadow them with several patients, and try to get a sense of a typical patient visit and interaction. After shadowing, we set up a time to meet, and I give feedback, suggestions on areas of improvement and tell them what I think they do really well on.”

As a nurse practitioner, Nelson says one of her favorite patient experience tips has to do with the way to start and end an encounter with a patient.

“At the start of every visit, I’ll ask the patient what he or she wanted to make sure we talked about that day/visit. I want patients always to feel like their needs are being listened to or met. To wrap up the appointment, I ask if there was anything else they wanted to talk about that day,” she says. “Another tip to providers is to write down something personal about the patient. You may know that the patient is getting married or expecting a first grandchild—and the next time you see that patient, you can ask them about this event. This makes the visit feel personal, and the patient to feel important.”

During her time as a provider ambassador, Nelson says she reminds all the providers she’s worked with that everyone needs coaching; just like professional athletes have coaches. Even great clinicians can benefit from coaches. 

“We all can be better. I enjoy coaching because when I coach someone else, I always pick up a tip or an idea that can make me a better provider. I make sure the provider knows that we’re not judging them clinically, but more just observing the patient interaction. We want this not to feel punitive but to be helpful for everyone involved,” she says. “I also always offer providers the opportunity to shadow me as well. This is a really beneficial program, and I love being a part of it.”

Ambassadors for Patient Experience: A Peer-to-Peer Provider Coaching Program

Ambassadors help to improve:

  • Provider-patient communication/interpersonal skills
  • Patient satisfaction and resulting scores
  • Patient loyalty, adherence, and outcomes
  • Time management and efficiency of practice
  • Co-worker interactions and communications that improve patient experience (i.e., hand-offs, and interactions in front of patients/families)
  • Provider satisfaction and engagement

Many of the ambassadors are specially trained or have worked through solutions themselves or with other providers, on topics ranging from improving patient communication, use of the electronic health record, time management, and improving interactions with co-workers.

Opportunities for coaching are available in person, through observation, following review of patient satisfaction scores, over the phone, or may be as simple as a question sent via email. Individual providers may self-refer on their own, or a department chair or practice manager can make a referral based on needs foreseen by the department’s leader.


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