PFCC, HOSPITALIST WORKSHOP ‘VERY VALUABLE’

workshop role play 1

By PFCC Advisor Beth Konikoff

On February 17, the University Hospital Patient Family Advisory Council (UH PFAC) embarked on an exciting new project, the Patient and Physician Relationship-Centered Project, developed in conjunction with the UMHS Hospitalist Group. The overall objective of the project was to create a communications toolbox for physicians, allowing them to develop better relationships with their patients.

One hospitalist noted, “I have never been to a meeting or workshop with patients or patient family members. Very valuable.”

Under the guidance of PFCC Program Manager Molly White and PFCC Volunteer Coordinator Melissa Cunningham, the workshop was attended by hospital leadership, 13 hospitalists, nursing staff and many members of the UH PFAC. The featured guest speaker was Dr. Lena Napolitano, MD, FACS, FCCP, FCCM and Winner of the 2015 Adult Services HOPE Award.

In Dr. Napolitano’s remarks, she emphasized how even small changes in words or actions can be very meaningful to patients. The highly energized crowd agreed that by being aware of the tremendous impact these small efforts can have, physicians can help improve outcomes when communicating with patients and their families.

During role-plays, PFCC advisors acted out two typical and often difficult physician/patient interactions: transitioning a patient at discharge and the frustrated/confused patient. The objective of this exercise was to highlight that: 1) When dealing with patients, family members are often also directly impacted and should be included in the conversations; 2) Patients can have difficulty interpreting the structure of the hospital process. One hospitalist said, “We see these situations a lot. Every physician does their own thing. It’s good to know that most providers do almost the same thing.”

workshop michele
Dr. Mark Kolbe with PFCC Advisors Michele Mitchell and Elaine Brock

PFCC advisors also led round table discussions, allowing the hospitalists to share any uncomfortable patient interactions they may have experienced and talk about how those types of situations could be improved. Participants were divided into teams where the lively discussion sparked very insightful and applicable recommendations.

The session was then summarized with key, research-based take-aways. The five themes were the “Teach-back” method, acknowledge suffering & anxiety, connecting with patients as people, active listening, and the Heart Head Heart Method. Molly shared the story of how the Carle Foundation Hospital and Care Physicians Group, in Urbana, Ill., used communication training to move their HCAHPS physician communication composite from the 14th to 63rd percentile over a period of two years.

In part two of the pilot project, PFCC advisors and hospitalists were paired for sessions of rounding.  This opportunity provided the advisor and the hospitalist with the ability to see the implementation of the suggestions and recommendations made during the workshop.

All of the hospitalists felt there was great value to the workshop and to working together as advisor/physician teams. The PFCC Advisors who rounded all said they learned a great deal and had much admiration for the hospitalists.

“[The doctor] maintained excellent eye contact and positive body language,” said PFCC Advisor Wendy Ramirez. “If I were in the hospital, I would want him to be my doctor!”

PFCC Advisor Michele Mitchell said, after rounding with 12 patients in a two hour period, “I was humbled by the experience. She was such a great hospitalist!”

The UH PFAC will be forming a subgroup to work on future communication and empathy workshops and rounding sessions for UMHS physicians. For more information, please contact Melissa Cunningham at missie@med.umich.edu.

workshop round table
Pictured left to right: Dr. Jashan Octain, PFCC Advisor Beth Konikoff, Hospital Medicine Program Manager Julie Wietzke, and Dr. D’Anna Saul

SUMMARY – PFCC PATIENT COMMUNICATION SURVEY

Top three things that made it easier to understand and follow their health care plans:

    • Ability to ask questions
    • The physician’s demeanor
    • Relationship with the physician

Main themes on what patients want from physicians:

    • Listening was number one
    • Make eye contact, be approachable, smile, sit down
    • Show compassion
    • Provide clear, honest details and instructions
    • Don’t be rushed
    • Focus on me, if only for a few minutes

24% said they were never made to feel like they were part of the health care team

64% of patients were only sometimes, rarely or never aware of when rounding would occur

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