"Addressing things like diabetes and weight was not going to touch what was going on with Brenda," he says. "It transcended into shame, fear, guilt, and judgment. How do you doctor in that space?" When patients learn that he will pray with them, patients' eyes "light up; sometimes they cry," says Berry.
"It's common in this population [low-income and uninsured]," he says. "At the end of a visit, I say, 'Do you have a religious preference? I'm a doctor who will pray with you.' When you work with people who are really in need more than the average person, you exercise elements of your personality that you may not have to exercise in other settings." Berry says the training he received helps him connect with patients in a more human way, which earns their trust and helps engage them in their care.
Establishing a solid relationship with patients is not the only factor that can improve patient engagement, but it helps, says Charles Wiltraut, CEO at Mission East Dallas, where Jones followed Berry in 2012. Wiltraut says Mission East Dallas, a federally qualified health center (FQHC), measures patient engagement through satisfaction surveys it administers to patients when they are in the waiting room.
The clinic designed its own survey to find out what its patients wanted. The patients are asked about how well the staff listens and whether the staff is giving advice on how to stay healthy. Patients drop off their completed—and anonymous—surveys in a secure box at the clinic. The number of patients who participate in the survey is relatively low, but that is likely because their health issue has reached an acute stage and their focus is on feeling better. Still, the surveys are an important tool for Mission East Dallas staff to see how they are treating patients, says Wiltraut.
"We have a mission to create exceptional patient experiences," says Wiltraut. "We're not a Medicaid mill. The culture we have here is we listen to our patients. We do warm transfers out of the room. We make eye contact."
Wiltraut says the clinic's most recent monthly survey of 60 patients shows that 92% report that the staff listens, and 80% report that staff members give advice on staying healthy. Another way he says Mission East Dallas tries to keep patients engaged is by having them on the board of directors. "Fifty-one percent of the board must be users of our facility," he says, referring to rules governing FQHCs. "There is no better way to engage patients than to give them a seat on our board."
The biggest cheerleader Mission East Dallas has is Jones, who was elected president of the clinic's board in January. Berry encouraged her to be on the board in April 2014 because of her dramatic story of engagement and improvement.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.