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Explaining K.I.D.S. – Four easy steps to demonstrate respect to patients

Updated: Jul 15, 2020

Young man holding a page upside down
An Aaron Waddingham outtake

I’ll never forget hearing Juliette Schlucter speak at a pediatric health conference many years ago. She shared the concept of K.I.D.S. from the Children’s Hospital of Philadelphia. Staff were encouraged to remember the acronym K.I.D.S. to demonstrate patient centred care to patients.

K.I.D.S. is applicable for all staff! Nurses, environmental services folks, students, residents, nutrition staff, physicians…everybody who works in health care can use it as a guide. K.I.D.S. is not just for pediatrics. It works just as well in adult health care settings.

K.I.D.S. is an easy-to-remember term to remind students or staff what to do before they enter a patient or clinic room.

This acronym has stuck in my head forever. My most recent lesson plan for my course material from my Bird’s Eye View book is all about K.I.D.S. You can access the Lesson Plan here, free of charge and new Lesson Plans are added every month. As an added bonus, this one features a video with my actor son Aaron explaining the K.I.D.S. acronym. Click through to the Lesson Plan to see the video:

1. Knock

As a patient, when I've been waiting in a hospital room or clinic, I've noticed that staff sometimes forget to knock on the door before they come in. This can startle me!

There’s a chance I’m not finished changing into a gown when they come in and this could jeopardize my privacy. Knocking and waiting to be asked to come in gives me a moment to compose myself before the visit begins. It gifts me a wee bit of control to decide when people enter my space.

An added bonus: Knocking and waiting is good for health professionals too. It gives you a chance to close your eyes for a moment and take a breath before entering a patient’s room. This can keep you centred on the present and the person you are about to see.

If there’s no door and only a curtain, you can rustle the curtain a bit and say ‘hello’ and wait to be invited in instead.

Any form of knocking helps reframe the physical space into a more patient centred one, with health professions as guests in the patient space, instead of the other way around. Particularly when patients live in a spot for some time – as happens when we are inpatients in the hospital – showing this easy courtesy is really important.

2. Introduce Yourself

The concept of introducing yourself and saying your title and role is a simple but often overlooked one.

I can remember sitting in a curtained pod a few years ago, an anxious mess while I was waiting to be prepped for surgery. I counted six different staff members swoosh in through the curtains, not introducing themselves, and proceeding to do various things to me, like ask me to sign a consent, start an IV, write on my body with a marker (!) etc.

Many staff in hospitals dress in a similar fashion, in street clothes, scrubs or a lab coat. It could be anybody walking in my room – the technician to fix my television set or the medical student to take my history. Patients don’t know who you are unless you tell them.

I know people wear name tags, but often those name tags are on lanyards, which sometimes flip over. If you are wearing a name tag, don’t assume patients can read the print on the tag, which can be small, or that they are able to pronounce your name. Please don’t rely on name tags to replace introductions!

Also, consider re-introducing yourself even if you have done it already – sometimes patients have a multitude of people visit them and can forget people’s names. That’s why white boards are so awesome in hospital rooms – people can write their name and role down on a white board that’s up on a wall – to help us feel less awkward if we’ve forgotten someone’s name.

I firmly believe it is not just about common courtesy, but it runs much deeper. Introductions are about making a human connection between one human being who is suffering and vulnerable, and another human being who wishes to help. They begin therapeutic relationships and can instantly build trust in difficult circumstances. - Dr. Kate Granger

Associated with ‘I’ in the K.I.D.S. acronym, Dr. Kate Granger’s #hellomynameis campaign explains how introductions are crucial.

The #hellomynameis is an ongoing campaign is specifically about the importance of introductions in health care. Kate created this hashtag to raise awareness about compassion in health care when she was terminally ill with cancer. She died four years ago on July 23, 2016.

Dr. Granger’s work continues today through her husband Chris Pointon. Many hospitals encourage staff to introduce themselves to patients through the #hellomynameis campaign at events to honour Kate Granger on July 23 of every year.

3. Describe What You are Going to Do

Health care settings can be an overwhelming place for patients. Many people come in and out of our space. Sometimes I have no idea who they are or what they are there to do to me. They know why they are there, but I do not know unless they tell me!

This makes me more anxious than I already am. It seems unfair that everybody in the health care setting knows my name, my deeply personal health information and what I'm there for, but I have no idea what their names are or why they are there. This is imbalanced.

Dignity comes into play here too. Say a man wearing scrubs enters my patient room holding a tray with a needle and medication on it. I don’t know who he is and the sight of him makes me anxious. Not knowing what is going to happen next can be a reason for heightened patient anxiety in health care settings.

Perhaps I’m feeling too sick or intimidated to ask the man what his name is or what he’s doing. He proceeds to inflict pain on me by poking me with the needle and leaves. I feel violated by this injection and the imbalance of power between professional and patient is evident. I feel helpless and even more vulnerable now. This could have been solved if the man had simply introduced himself and his role and explained what he was there to do.

4. Slow Down

I know staff are often rushed. The key to being patient centred is to not appear rushed, even if you are.

It helps to take a deep breath before you walk into a patient’s space. Minimize distractions like cell phones. Sitting down also supports people to slow down. Ask permission before rearrange furniture (and put it back when you leave!) or perhaps sit on the patient’s bed. Being focused on the moment is key – try to put aside what just happened before you went into the room, or what you have to do next in order to be fully present. Making eye contact and smiling at a patient also guides you to connect and be there with them.

If staff are rushed, I can feel it. They move about the room too fast. They look at their phones or the clock. They don’t look me in the eye. It makes me feel less important, like a task that needs to be done instead of a real human being that needs care.

The reality of health care is that being rushed is encouraged because health care is run like a business – even here in publicly-funded Canada – and efficiency is king.

But patients are stressed out too. We might have been waiting forever for the ap

pointment, been worried about test results, or concerned our parking meter is going to run out. Staying calm with patients helps us be calm. If you only have five minutes, try taking the entire five minutes and dedicate it to the patient in front of you. Give options for follow-up if you run out of time. Lean on team members to supplement your visit if you have to leave. All these little things helps patients feel like they matter, like they aren’t a bother or just another checkmark in a task list.

Feeling seen and heard is a big part of patient centred care. It really does start with a knock and hello.

Head back to my lesson plan here to watch the short video from my son Aaron, check out the supplemental reading and contemplate a few questions. Remembering the K.I.D.S. acronym is easy and one small step towards enacting true patient centred care.


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