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Health System Management • January 2017

20 WWW.HEALTHSYSTEMMGMT.COM POPULATION HEALTH HEALTH SYSTEM MANAGEMENT | JANUARY | 2017 “We’ve lost the art of listening. We think we’re saving time because we know best.” William Maples, MD cian relationship. Here are five ways hospitals can improve communication between physicians and patients, according to Maples, who has worked with health systems on improving patient and provider satisfaction scores and medical outcomes. • Understand how patient experience impacts quality, safety and efficiency To effectively drive the transformation from a provider-centered focus to a patient-centered, team-based approach, hospital and health system leadership teams need to facilitate an in-depth understanding of how the patient experience impacts both reimbursement for patient experience scores and the culture of the organization. Putting the patient’s perspective first will improve their experience as well as their outcomes. • Invest in providing physicians and caregivers with the skills they need Learning and nurturing the fundamental skill of communication is not unlike learning the science behind medicine, Maples explained. To foster improvement, training in these foundational skills must be performed in an experiential learning format, so physicians and caregivers can actually practice and successfully incorporate communication skills into their daily workflows. Though the process of building the infrastructure to nurture effective communication may be uncomfortable for physicians as it strays from traditional science-based knowledge learning, the return on investment for patients, caregivers and healthcare institutions trumps any learning pains. • Engage physician leadership “The effort needs to be led by the caregivers themselves, not dictated to them,” Maples told HSM. “Physicians have often been left out of the equation to create an exceptional experience for patients and caregivers.” Identifying physician leaders who support initiatives to improve communications — and training them to facilitate skills-based work with their peers — will nurture a culture of trust and enhanced communication. • Be patient As healthcare is continually transforming, an optimal time to implement best practices for communication in healthcare will never exist, Maples noted. “Leaders who make the deep commitment to nurture a culture built on relationship-based, patient-centered communication can expect a 5-1 return on their investment,” he told HSM. But, he advised, do not expect a quick turnaround, as “it can take nine to 12 months to observe a measureable impact and up to four years to realize the maximum benefit.” • Plan to engage every single person on the caregiver team All employees — including physicians, nurses, allied health staff and administrators — need to participate in communication training and hold each other accountable for creating a team with the patient at the center. Training together as a team fosters a spirit of collaboration and cooperation. IMPACT ON CAREGIVER BURNOUT Boosting communication with patients not only works to improve the patient-physician relationship; it also aides in preventing caregiver burnout. “If you don’t communicate well, the chance for preventable errors occurring increases every day,” Maples noted. By 2025, demand for physicians will exceed supply by a range of 46,000 to 90,000, with shortfalls of between 12,500 and 31,000 primary care physicians and 28,200 and 63,700 non-primary care physicians expected.4 According to Maples, 40% of surgeons are currently experiencing some aspects of burnout right now; 30% have depression; and 15% have alcohol or drug dependence. “Building a meaningful relationship with patients puts joy back into the practice of medicine,” said Maples. “Physicians have said to me: ‘Thank you; I rediscovered the meaning to why I went into healthcare. I almost was ready to give up.’” 1. DeCamp M, SugarmanJ and Berkowitz SA. Meaningfully Engaging Patients in ACO Decision Making. Am J Manag Care. http://www.ajmc.com/journals/ajac/2015/2015- vol3-n2/meaningfully-engaging-patients-in-aco-decision making 2. Maples, W. Communication in Healthcare. The Institute for Healthcare Excellence. http://info.prccustomresearch. com/communication-in-healthcare-white-paper 3. Crowley MJ, Grubber JM, Olsen MK and Bosworth HB. Factors Associated with Non-Adherence to Three Hypertension Self-Management Behaviors: Preliminary Data for a New Instrument. J Gen Intern Med. 2013 Jan;28(1):99-106. 4. Physician Supply and Demand Through 2025: Key Findings. Association of American Medical Colleges. https:// www.aamc.org/download/426260/data/physiciansupplyanddemandthrough2025keyfindings. pdf WEBEXTRA For a look at the trends that drive physician engagement as discussed in this story, read “Most Physicians Not Engaged” at www. HealthSystemMgmt.com


Health System Management • January 2017
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