Nurses at Cleveland Clinic Akron General Receive Autism Training

When a patient on the autism spectrum was admitted to Cleveland Clinic Akron General earlier this year, the nursing team contacted the group home where she lives for input on how to best interact with the woman. One of the suggestions was to provide the patient with bubble wrap. “We gave her bubble wrap for her to click, and that really helped calm her,” recalls Claire Wilson, DNP, RN, Nurse Manager in Akron General’s inpatient oncology unit.

This exchange between nurses and the group home to benefit the patient is the result of a training program implemented at Akron General in 2017. The goal is to raise awareness about autism and instruct nurses and other frontline staff on what to look for in patients on the autism spectrum and what support they can offer to provide quality care.

“It’s very important for nurses to have an overview of autism and be able to relate to individual patients with the developmental disorder,” says Wilson, who is one of approximately 14 facilitators of the training program. “Patients can’t get the care they need unless we understand what’s going on with them.”

Components of the training program

The program was created following a panel discussion held by Akron General’s Disability Focus Employee Resource Group on the ability of patients with developmental and physical disabilities to navigate their hospital experience. “One of the things that came out as a result of the panel was a heightened awareness of our deficiency when it comes to patients on the autism spectrum who are transitioning from pediatric medicine to adult medicine,” says André Lessears, MBA, IDI QA, Director of Diversity & Inclusion at Akron General. “That conversation skyrocketed to the surface, and we started engaging the Autism Society of Greater Akron.”

Together, the hospital’s Office of Diversity & Inclusion and the Autism Society developed a two-hour program, which has trained nearly 800 caregivers since its inception, including nurses, nurse technicians, physicians, administrative and registration staff, safety and security personnel, and dietary and food services employees. More than 350 nurses have participated in the training, which includes the following:

• Discussion of the importance of people-first language – The emphasis is on identifying the person, not the diagnosis. “For example, instead of saying ‘someone who has autism’ we say ‘someone who is on the autism spectrum,’” says Lessears. “That little difference makes a tremendous impact on our patients’ experience.”
• Consideration of system gaps – “Where are the deficiencies in our processes, and what supports can we develop for our patients and our caregivers so we can have a mutually beneficial relationship?” says Lessears.
• Experiential activities – “We share real scenarios that happened in our healthcare system, then unpack what happened,” says Lessears. “Where were the signs that the patient was possibly on the autism spectrum, what questions could we have asked to navigate a better outcome and what resources are available to serve the patient and caregivers?”
• Video testimonials – The training program ends with videos from the national Autism Society on what constitutes a culturally-competent healthcare experience and how it benefits patients and caregivers.

Due to the COVID pandemic, the Office of Diversity & Inclusion is currently revamping the program into a 75-minute virtual training session.

Fulfilling the mission to offer culturally-competent care

One of the most impactful parts of the programs is when facilitators – many of whom have family members on the autism spectrum – share their personal experiences. Wilson, who has been a member of the Disability Focus Employee Resource Group since it began, eagerly volunteered to serve as a program facilitator in part because she has a 25-year-old granddaughter with an intellectual disability. In the past, she has served on boards for the social services organization United Disability Services and a disabilities arm of the Stow City Council.

“I am so proud of our program,” says Wilson. “We are a small group of people who share a passion about the subject, and we’ve been able to cultivate an autism-friendly hospital. That’s amazing!”

Lessears adds that the training program is a primary example of Cleveland Clinic’s commitment to providing not only world-class care, but culturally-competent care. “Too often, we think of cultural competency through a very narrow lens – gender, race, sexual orientation. This program acknowledges the culture of those patients living with developmental and physical disabilities,” he says. “We’re giving our caregivers the skills to react in real-time to the person in front of them, meeting their individual needs. That’s what equitable healthcare looks like. That’s the core of who we say we are at Cleveland Clinic.”