Monday, December 30, 2013

Clinican communiction skills: Patient satisfaction in hospital-based care

     I just read this great article Michael Solomon: miracle-cure-driving-patient-satisfaction-for-hospital-and-healthcare-customers/ .  And I agree with everything Michael says,  I also recognize the real barriers to changing culture.  As of now hospitals are trying to change and change rapidly from a clinician-centric delivery model to a patient-centered model.  Hospitals are trying to standardize and decrease costs, while at the same time, deliver individualized patient centered care.  So much of this change in how we relate to patients is really occurring in the interactions between clinician and patient and the culture of the organization.  The challenge that leaders face today is that training clinicians to communicate better is not done with a power point or a sign.  It isn't taught with online modules or posters.  Changing is going to take real investment.  One just needs to look at the evidence and research on the matter.  Communication skills are learned through a process of role modeling and coaching with feedback.  Other especially effective methods include the use of video feedback with coaching.  The coach/educator has to have very good skills at observation, questioning and guiding people to their own realizations.  It is a delicate dance between understanding each person's unique relational style and language and professional communication.  Another innovative method that I have found to be very effective is the use of patients as teachers.  Asking patients to volunteer as "patients" for teaching communication skills.  (It takes a special person to volunteer for this "patient" role in that they should have some experience in teaching and learning.)  This fun way to teach communication skills involves asking clinicians to engage in a communication activity and receive feedback from the patient's perspective.  When clinicians have this opportunity to see themselves through the patient's eyes, it can be very impact-full.   Making it real this way is relevant, in that these patient actors are likely to pick up on medical terminology and assumptions about health literacy.  The next level of improving communications with clinicians and patients is going to take a commitment to evaluating systems and infrastructure, and determining what forces in hospital culture and systems deter clinicians from taking adequate time and energy to sit down with patients.  Identify organizational forces that deter clinicians from sitting down with patients and drive rushing through discharge and education.  I love the idea of introducing nursing's caring theory to an organizations nursing model of care.  This helps to reinforce the patient centered models inside the education and culture of nursing within an organization.  Evaluate what needs to change and push for new incentives for patient-centered care.  Once clinicians see the outcomes of their energies through feedback about readmission and population health, culture change will take off.  According to Kotter, the change process involves dedicating meaningful time and education resources to effective training and marketing the new ideas.  I believe hospitals are on the edge of a real paradigm shift.  I cant wait to see what happens!

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