The Joint Commission’s *Speak Up* program, also referred to as the “Ask Campaign,” is a patient safety initiative aimed at encouraging patients and their families to play an active role in their healthcare. The program emphasizes the importance of open communication between patients, families, and healthcare providers to prevent errors, improve care, and ensure patient safety.
Goals:
The primary objective of the Speak Up program is to empower patients to take a more proactive approach to their own healthcare by asking questions, understanding their care, and speaking up if something seems unclear, unsafe, or wrong. By partnering with patients, this program seeks to reduce preventable errors and improve overall patient outcomes through enhanced communication.
Key Aspects:
The campaign offers education materials, including videos, brochures, and posters, which focus on key topics such as improving communication, preventing infections, medication safety, surgery preparedness, and better understanding hospital discharge instructions.
An acronym has been developed to help people remember the components of the campaign. Videos and other materials can be obtained from the Joint Commission Web Site. Once such video is available here.
**S**: Speak up if you have questions or concerns.
**P**: Pay attention to the care you receive.
**E**: Educate yourself about your illness or treatment.
**A**: Ask a trusted family member or friend to advocate for you if needed.
**K**: Know what medicines you take and why you take them.
**U**: Use a healthcare organization that has undergone proper evaluations.
**P**: Participate in all decisions about your treatment.
Strategies for Implementation:
Conceptually, the idea of encouraging patients to speak up is not difficult. Yet, it is a change in the way things are normally done. There is an upfront cost in time, that hopefully can reap downstream rewards by having the patient and family become allies in what is happening to them during their hospital stay. A few thoughts on implementing this program in your health system (change is always hard, so the themes you see here would likely be of use in any change attempts):
1. Leadership Buy-In and Commitment
– Secure leadership commitment by presenting the benefits of Speak Up, including enhanced patient safety metrics and improved patient satisfaction scores. Leadership support is always a critical element of change. It could be the CEO or even your local Unit Managers.
– Appoint a program leader, committee, or interest group to oversee the implementation.
– Set measurable goals (e.g., increase in patient-reported confidence in communication, reduction in safety events) and track progress.
2. Staff Education and Training
– Conduct training sessions for healthcare providers, emphasizing the advantages of listening to patients and encouraging them to speak up.
– Include educational scenarios and role-playing exercises to simulate patient-provider interactions.
– Ensure all staff understand their roles to foster a culture of openness and respect.
– As the program spreads be certain to introduce Speak Up principles during onboarding for new hires.
3. Engaging the Patient and Family
– Distribute available materials: Make Joint Commission-provided *Speak Up* resources (posters, brochures, videos) available in waiting rooms, patient rooms, and online portals. The Joint Commission allows organizations to tailor materials by including the organization’s logo or specific examples.
– Promote in conversations: Incorporate reminders during patient education sessions (e.g., when explaining treatment plans, medications, or teaching about discharge). Ensure that leadership speaks about this and asks how the program is progressing.
– Building the Culture: Ensure materials and discussions are adapted for diverse patient populations, addressing language, literacy levels, and cultural norms. This type of engagement will be new for most patients, tools need to be developed to help with the transition.
4. Communication Campaign
– Design a communication campaign with the theme of “Your Voice Matters” or “Together for Safety” or something else that speaks to your team. Highlight how speaking up can save lives and foster better outcomes.
– Use tools like posters in clinical areas, digital signage, or messages on patient portals. Display signs saying, “We welcome your questions” or “It’s okay to speak up!”
– Establish protocols for responding to patient concerns—ensuring these are addressed promptly and respectfully.
– Align the campaign with Patient Safety Awareness Week or other health/safety observances to bolster visibility.
5. Technology Integration
– If possible embed prompts in electronic health record (EHR) systems to encourage providers to ask patients if they have questions or concerns during visits.
– Add a “Speak Up Checklist” to patient discharge processes and documentation, encouraging patients to confirm they understand their care instructions.
– Create a feedback loop where patients can report communication gaps or safety concerns via a mobile app, patient portals, or surveys.
6. Monitor and Evaluate Progress
– Implement surveys to measure patient awareness of the program and their willingness to speak up.
– Track metrics such as reports of safety concerns raised by patients (e.g., near-miss events) or patient satisfaction scores in areas of communication.
– Regularly review findings with staff and leadership. Use lessons learned to refine program implementation.
7. Celebrate Success and Encourage Sustainability
– Highlight success stories of patients or families effectively speaking up to resolve safety issues. Use these for promotional campaigns.
– Recognize staff members who actively support the Speak Up principles or engage patients in their care.
– Incorporate Speak Up principles into long-term quality improvement initiatives for the organization and consider ways to reward the highest performers.