Teach Back as an Effective Patient Education Tool

by Edward Leigh, MA

A patient tells you they understand everything you said about their treatment plan.  You feel good about this patient visit and are ready to close the meeting.  The patient stated they understood, but did they really?

Problem with “Do you understand?” question

There are serious issues associated with the question, “Do you understand?”  Just because the patient says, “Yes,” does not mean they truly understand.  How can you be sure they understand? Use the powerful “teach back” method.

Teach back is a powerful communication tool to assess a patient’s understanding. After the professional shares new medical information with the patient, the patient is asked to “teach back” what they just heard, verbally or in the form of a demonstration. This allows the professional to correct misunderstandings and provide additional information, if necessary. (In some cases, the patient’s caregiver may be the person “teaching back” the information.)

Factors to consider

If the teach back strategy is not properly set up it could actually backfire leading to a worse patient experience.

Patients may feel you are questioning their intellectual abilities. I have interviewed thousands of patients regarding their experiences with healthcare professionals.  For example, I asked one patient if she was familiar with teach back. She stated she was not familiar with the strategy. She also asked, “Is that for people with learning disabilities?” Upon further discussion, she said if a healthcare professional asked her to repeat back what she heard, she would feel that they think of her as dumb. This example illustrates that the set up to the discussion is critical.  It is vital that patients know the strategy is useful for everyone.

This strategy is not a like a pop quiz you had in school. Don’t simply tell a patient, “Repeat back what I just said!”  This comment will put them on the spot and cause anxiety.  They will feel like a school kid who was just told to clear their desk for an unannounced pop quiz.

To avoid these potential issues, ask the patient certain types of questions. View sample questions in the next section.

Sample of open-ended questions to assess understanding

There are many ways to assess patient understanding via teach back. The questions below provide a friendly and comfortable manner to assess understanding.

Focus on “I” Language. It is important to remember teach back is a way to test our abilities at explaining. In other words, we are actually testing ourselves, not the patients. Using “I” language takes the stress off the patient.

• “I want to be sure I explained everything clearly. Can you explain it back to me so I can be sure I did?”
• “Please show me how you will use the device, so I can be sure I have given you clear instructions.”

Focus on how they would tell other people in their lives.

• “How would you describe your health condition to a friend?”
• “When you get home and your spouse asks about your treatment plan – what will say?”

Possible reasons for patients not being able to teach back

If the patient is not able to repeat back their medical situation this may be an indication the professional needs to rework their teaching approaches. There could be several factors reducing the ability of a patient to teach back.

Excessive use of medical jargon. If patients do not understand what professionals are saying, they will not be able to repeat back what was said to them. Use everyday language.  For example, do not say, “NPO after midnight.” Rather, state, “Do not eat or drink anything after midnight.”

Too much information presented too quickly.  The “chunk & check” strategy is a tool to avoid this scenario. Provide a “chunk” of information and then “check” with the patient for understanding.

Patient anxiety.  Regardless of how skilled the professional is at explaining to the patient their medical situation, if the patient is very tense, the material will not be absorbed.  In this case, use empathy. Mention that you understand their feelings of anxiety.  You may want to engage in brief deep breathing exercises with the patient to help them feel calmer so they are better able to take in the information.  The exhale should be longer to achieve maximum relaxation. For example, inhale on a count of four and exhale on a count of six. A few deep breathes goes a long way!

If the patient was not able to repeat back, do not repeat – re-phrase.

Benefits of teach back

Improves outcomes. According to the Joint Commission, research indicates that the teach back technique is effective, not just for improving patients’ understanding, but also for improving outcomes. For example, patients with diabetes whose physicians assess their comprehension and recall with the teach back technique have significantly better diabetes control than patients whose physicians do not use the technique. (Schillinger D, et al. Closing the loop: physician communication with diabetic patients who have low health literacy. Arch Intern Med. 2003;163:83-90.)

Can ultimately save time. Professionals often feel they have no time for the teach back method.  It actually does not take very long to assess a patient’s understanding.  Think of how much time it will take if the patient has to call back or visit again.

Enhances patient safety. If a patient does not understand their medical issue, they are at risk. A patient’s medical situation is not nice-to-know information, it is need-to-know information!

Unity Point Health, Des Moines University and other organizations collaborated to develop an excellent Teach Back Toolkit.  Click on the link for more information on this very helpful toolkit.

http://www.teachbacktraining.org/

After giving it – be sure they get it!

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication. The Center focuses on increasing patient satisfaction, improving compliance and decreasing the risk of medical errors. The Center offers high-impact training, consulting and one-on-one coaching. Edward Leigh’s new book, Engaging Your Patients, is due out in late 2014.  http://www.CommunicatingWithPatients.com or 1-800-677-3256

Opening a Patient Interview: Part II, Your Powerful First Few Questions

by Edward Leigh, MA

After you have greeted the patient / guest(s) and introduced yourself, now it is time for your opening questions / statements.

Start with a general question. The literature suggests that even if you know the exact reason for the patient’s visit (e.g., “upset stomach”), it best to still keep the opening question general, such as, “Tell me what brought you here.”  The initially stated chief compliant may not be the underlying reason for the visit.  This is especially true if the underlying reason for the visit is of a sensitive nature (e.g., substance abuse or sexuality issue).

BEFORE asking any details of the first issue, ask the patient, “What else?”  There may be no other issues, however asking this question in the beginning will reveal all the issues to avoid the dreaded late-occurring “Oh by the way” issues.  Excellent article on the subject:

“Two words to improve physician-patient communication: what else?” Link below http://www.meddean.luc.edu/lumen/meded/ipm/IPM1/TwoWordsBarrierArticle.pdf

Example

Clinician: “Tell me what brings you here?”

Patient: “I have been having stomach pains.”

Clinician: “What else?”

Patient: “Well, sometimes, my toes feel numb.”

(If the patient has no other issues, then ask about the stomach pains.)

Too many issues and not enough time. If the patient has multiple issues and there is not sufficient time to discuss everything, this situation has to be handled delicately to retain an excellent patient experience. Do not say, “I don’t have time to discuss all those items.”  Instead, use an “I wish” statement, such as by stating, “I wish we had time to discuss everything that is going on.  How about if we discuss two issues and schedule an appointment to discuss the other items? How does that sound?”

Mute Yourself.  Once you begin the information-gathering phase, DO NOT interrupt. MUTE YOURSELF! Give the patient 1-2 minutes to fully tell you their story and then ask for details. In the classic study by Beckman and Frankel, they found that physicians prevented patients from completing an opening statement 77% of the time and interrupted their patients in a mean time of 18 seconds. (Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med. 1984;101:692–6.)

Start your patient interview with impact through the use of powerful questions!

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication. The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. The Center offers high-impact training, consulting and one-on-one coaching. Edward Leigh’s new book, Engaging Your Patients, is due out in the Spring of 2013. http://www.CommunicatingWithPatients.com or 1-800-677-3256

Opening a Patient Interview: Part I, What to Say BEFORE Your First Medical Question

by Edward Leigh, MA

The first few moments of the patient interview sets the tone for the patient experience — what happens in the first 10-20 seconds makes or breaks the experience.

Sequence of events for seeing a NEW patient: (in chronological order)

(Before you walk in the room, take a deep breath to recharge yourself! One more item, if you just had an onion-filled sandwich, please pop a mint in your mouth!)

Say patient’s name (e.g., “Hello, Mrs. Smith”). If you are unsure of pronunciation — ask FIRST before attempting to state name.  You may also want to check with colleagues about pronunciation before entering the patient’s room.

State your name & role (e.g., “Hello, I am Mary Smith. I will be your nurse.”).  Recent research has shown that patients prefer hearing both the first AND last names of the professional.

Meet the guests.  If possible, ask patient to introduce you so you can learn relationships (e.g., “This is my daughter, Carol.”). Repeat name after meeting (e.g., “Hello Carol, a pleasure to meet you.”). Remind them to feel free to add information and ask questions. It is vital to establish a great relationship with the patent’s guests.

Provide your photo / business card, if applicable. It is important to provide the card at the beginning, otherwise part way through the interview, the patient may state, “So who are you?”  I have seen this happen many times.

Signpost.  This word means to tell people what’s coming next in the interview (i.e., providing direction). Explain to them what will be happening relieves their anxiety. For example, you can say, “Today, we’ll first talk about what brought you in, then I will examine you and discuss treatment options.”

What about the handshake?  There are many opinions on this subject, often divergent. Should you shake the patient’s outstretched hand? Should you initiate the handshaking gesture? Gregory Makoul and his colleagues at Northwestern University’s School of Medicine in Chicago wrote an article in the Archives of Internal Medicine on this subject. Of the patients surveyed, 78.1 per cent wanted physicians to shake their hands. This study seemed to indicate the handshaking is desired among physicians, however it is unclear if this behavior is desired among other healthcare professionals.  I look at this topic on a case by case basis. For example, a handshake would be more of an expected gesture for a middle-aged man as opposed to a teenaged girl. Overall, from a patient experience perspective, I would suggest shaking hands. A physician recently asked me, “I always gel up before seeing each patient. If I see a patient who I suspect has the flu, if they initiate a handshake, what should I do?”  I suggested they shake the patient’s hand and then quickly gel up again. Not shaking an outstretched patient’s hand will severely damage the relationship.

Look for Part II soon … “Your Powerful First Few Questions.”

Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. The Center offers high-impact training, consulting and one-on-one coaching. Edward Leigh’s new book is Engaging Your Patients is due out in the Spring of 2013. http://www.CommunicatingWithPatients.com or 1-800-677-3256

Virginia Tech Carilion School of Medicine Assesses Students Communication Skills Before Admitting

By Edward Leigh, MA

Have great grades?  Excel in science?  Thinking of medical school?  Think again!  Medical schools are now realizing that excellent academics are not enough to become a great doctor.  Communication skills and the ability to work in teams are vital.

Virginia Tech Carilion, located in Roanoke, Virginia, is one of the newest US medical schools (the school opened in August 2010).  Their medical school admission interviews go beyond the typical questions, “Why do you want to be a doctor?” The medical school has added a communication component to their admission interview process.  Great grades alone will not prepare prospective students for this part of the interview process; great “people skills” are needed.

Communication skills are more than “bedside manner.”  These skills also directly impact patient safety. According to the Joint Commission, “An estimated 80 percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed-off.”

This is how the medical school interview process incorporates communication skills:
• Candidates stand with their backs to doors.
• A bell rings and they turn around and read a sheet of paper taped to a door. The paper will have a scenario that requires communication and teamwork skills. (The school requests that the actual scenarios be kept secret.)
• After two minutes, the bell rings again and the candidate enters the room to discuss the ethical issue with an interviewer.
• The candidate has eight minutes to discuss that room’s issue. The interviewer scores each candidate with a number and sometimes a brief note.
• The process is then repeated several times.

The school administrators created questions that determine how well candidates think on their feet and their ability to work in teams. The interviews closely assess how well they respond when someone disagrees with them.  This is a critical skill in working with teams.

According to the school, “Candidates who jump to improper conclusions, fail to listen or are overly opinionated fare poorly because such behavior undermines teams. Those who respond appropriately to the emotional tenor of the interviewer or ask for more information do well in the new admissions process because such tendencies are helpful not only with colleagues but also with patients.”

“We are trying to weed out the students who look great on paper but haven’t developed the people or communication skills we think are important,” said Dr. Stephen Workman, associate dean for admissions and administration at Virginia Tech Carilion.

Dr. Harold Reiter, a professor at McMaster University in Hamilton, Ontario, developed the system. He states, “Candidate scores on multiple mini interviews have proved highly predictive of scores on medical licensing exams three to five years later that test doctors’ decision-making, patient interactions and cultural competency.”

The emphasis on communication and teamwork does not end with the medical school interviews.  Medical students at Virginia Tech Carilion are required to take team-based classes.  The school also requires students to become involved in community projects.

The mini interviews help shift the discussion away from personal narratives (that are usually rehearsed) to focus on the student’s problem solving abilities.

For more information about Virginia Tech Carilion’s innovative medical school application process, please contact Dr. Stephen Workman at SMWorkman@carilionclinic.org

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. The Center offers high-impact training, consulting and one-on-one coaching. Edward Leigh’s newest book is Engaging Your Patients (due out in early 2012).
http://www.CommunicatingWithPatients.com or 1-800-677-3256

My Mother’s Recent Emergency Department Experience: Lessons for Learning

My mother, Julia, is part of a clinical trial, which involves monthly infusions.  The clinical trial protocol requires periodic blood work, scans, x-rays, etc.  Last week, the physician leading the clinical trial called me at my office and said that my mother has atrial fibrillation and they will not proceed with the monthly infusion. They also noticed that one of my mother’s legs was red and swollen; they were concerned about a possible blood clot. They suggested calling an ambulance and having my mother taken to the closest Emergency Department (ED). I agreed to this action. They then called the ED to inform them of the atrial fibrillation and possible clot.

I called the ED to mention that my mother is on her way and also told them that before leaving my office I will fax over my mother’s medical history information. I have a two-page summary of my mother’s pertinent medical information (e.g., medications, hospitalizations, allergies, etc.).  I told the ED that my brother and I would be there shortly.

Overall, everyone at the hospital was very friendly. However, there were several parts of the experience that could have been improved. This article is a summary of the issues with suggested changes.

Problems with hand off. When my brother and I arrived at the ED, we went to my mother’s room and the nurse told us that their tests did not find atrial fibrillation and that my mother was going to be discharged now.  I asked about the issue with mom’s leg.  They said, “What issue?” In spite of the fact that the clinical trial physician clearly stated the leg needs to be evaluated for a possible DVT, that information never made it to the ED records.  After discussing the leg issue, my mother was scheduled for an ultrasound.  (As an FYI, the ultrasound revealed no clots.) To avoid these botched communication episodes that could seriously harm patients, professionals should engage in “repeat back.” After the information is shared the receiver must “repeat back” the information to verify accuracy.

No partnership statements.  The relationship between the patient and professional is not about giving orders; it is about forming a partnership. Upon admission to the ED, all patients should be asked, “What would make this an excellent experience for you?” What does great care mean to you?” We need to immediately understand the patients’ needs. If we are to be truly patient centered, we need to understand the needs of the patient.  In order to work as a team, we need to understand the patients’ needs.  Working as partners leads to quality improvement and better clinical outcomes.  Of course, this partnership approach leads to higher patient satisfaction.

Use of medical jargon. The people at the ED did not know I was a healthcare professional. They often used medical jargon that I understood, but what if I was not in the field?  When they scheduled the ultrasound, we were told Mom was being evaluated for a DVT. The abbreviation, DVT, was never explained. This is a serious problem in healthcare — the constant use of medical jargon that patients often do not understand.  This is known as a problem with “health literacy.” (The term literacy could mean problems with reading, however it often refers to the ability to understand the language of medicine.)

No signposting. This is a communication strategy in which people are given an overview of what will take place during their stay.  Streets have posts with signs on them (street names) hence the term “signposting.”  These posts with signs give people direction; that is exactly what we want to do with patients, give them direction.  In other words, tell then what will be coming up in regard to their care. This could as simple as saying, “First we will assign you to a room, run some tests and have you seen by one of our highly-qualified doctors. Based on the results of the tests, we will let you know how long you will be here.”  Patients should also be told that we are here to help you and make your stay as pleasant as possible.  There was one significant fact not revealed to our family that could lead to serious damage with patient satisfaction scores.  After being in the ED for approximately 1 1/2 hours, I asked our nurse, “When do you think my mother will have the ultrasound?” She then smiled as though she was about to laugh!  She said the average time for an ultrasound is 4 1/2 hours, but it could be up to 8 hours! This fact should have immediately been told to us.  (As an FYI, we had the ultrasound done in about 3 hours.)

Lack of hourly rounding.  After my mother was in the ED an hour, I expected someone from the medical center to check in on Mom.  No one came to see how Mom was doing.  Hourly rounding is a critical tool for many reasons.  This process helps prevent potential falls by asking patients if they need anything, such as a trip to the bathroom.  Many patients are seriously injured each year because they have to use the restroom and no one is coming to check on them. They try to get up on their own and sometimes fall.  The rounding also has a psychological benefit in that you are reassuring patients that you are thinking of them and working on their care.

No empathy. Going to an ED is a very stressful experience. During my mother’s time in the ED not one person directly stated an empathic response.  I would have liked to hear at least one person say, “I know it is scary being here. However we are here to help you.”  This comment should often be followed by a partnership statement, such as, “We will work together with you to find out what is going on as soon as we could. We will periodically check on you, but if you ever need anything, please feel free to let us know. We are here for you.”

Directions — don’t just tell, show!  When I arrived at the ED, I asked the person at the front desk what room my Mom was in and they told me. I asked for directions. The directions were very complicated due to ongoing construction. The person at the desk said something to this effect, “Go down this hall, turn right at the first hallway, then make an immediately left, go down the corridor until you get to a desk, then make a slight right, etc. What? Huh?  I then asked, “Could you have someone take me there?”  They agreed. When people ask directions, don’t simply give directions; take them to their requested destination.  This is an excellent customer service tip all hospital staff should incorporate into their work with patients and their family members.

Teach back technique not utilized.  After the ultrasound was completed, we were given discharge instructions.  Being in healthcare, I understood all the directions, however what if I was not in the field? Saying to a patient, “Do you understand?” is not sufficient.  In order to determine if they indeed understand, you must use the communication technique called, “teach back.” Ask the patient to summarize the information you provided. This could be as simple as asking, “Tell me what you will do when you get home.”

In summary, all of the hospital staff members were quite pleasant.  However, there were some very significant problems that could have negatively impacted my mother’s health. Based on a poor hand off, the ED was unaware of the leg issue.  Fortunately, my mother did not have a DVT. But what if she did?  This medical center needs to have staff development training covering communications skills, rounding techniques, educational strategies and customer service. These techniques are more than “bedside manner” tips; rather they are skills to avoid potentially serious medical errors.

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!  http://www.CommunicatingWithPatients.com or 1-800-677-3256

Edward Leigh’s new book, Engaging Your Patients, is due out in June 2011!

Stop Devaluing Your Patients! The Illusion of “Patient Centered” Care

In healthcare, we always talk about, “patient-centered care.”  I do believe healthcare organizations have the best intentions, however, in reality, I find just the opposite both in my work as a healthcare speaker / consultant and with my own experiences as a patient.

“Just a Patient”

I have been a healthcare professional for over 20 years, however in 1999 I became a patient after being diagnosed with Stage III Colon cancer (I am well today). After treatment was completed, I recall going to my oncologist’s office for a follow up visit. I was wearing a suit as I was on my way to a client meeting. In the office, I was talking to a pharmaceutical representative. During my conversation, a nurse ran up to the representative and said to him, “You don’t need to talk to him. He is just a patient.”  Immediately another nurse (who knew me), ran up to the nurse who made the comment and said, “I can’t believe you said that him! He teaches healthcare professionals how to communicate with patients and now he will use us as a bad example!”  The second nurse then said to me, “You aren’t going to mention this story, are you?”  I told her, “Of course I will not mention the story.”  Ha!

Are the people you serve, “Just patients?”

Discouraging Patients from Taking an Active Role in Their Care

In healthcare, we discuss patients being their own advocates and taking an active role in their care.  Once again, what is said and reality are often not the same.  In my work at coaching healthcare professionals, I have seen patients bring print outs from their Internet research, only to be told, “Don’t worry about the Internet, I know what is best.”

When patients come to you with Internet print outs, the first words out of your mouth should be, “THANK YOU!”  We need to encourage people to take an active role in their health, not discourage them.  The conversation should then follow up with a discussion of legitimate websites (e.g., NIH) versus quack websites.

Patients Matter

When I speak at healthcare events, I always position myself as a healthcare professional who also happened to be a patient.  For one event, I made the mistake of first discussing my patient experiences and then I saw just how poorly patients are seen in the healthcare system.  The meeting coordinator said to me, “How nice you want to share your story. However, this is a program for professionals only. No patients are invited.”  Even though I explained I was a healthcare professional, once they saw me as a patient, I immediately had no value. I felt like I was verbally patted on the head and told to “run along.”

Let’s stop talking about putting patients first and just do it!

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

Match Your Patients Energy Level

 

When people come into the healthcare system, it is a safe bet that they are not doing cartwheels in your hallways. They don’t feel well and their energy levels are probably low.  However, if we are high energy (which is great!), that would actually overwhelm people. Patients may be turned off by healthcare professionals that are busting at the seams with enthusiasm. A friend of mine told me her daughter who was hospitalized with pregnancy complications. Her daughter was in significant pain.  The daughter mentioned one nurse who used to bounce in the room full of energy; the daughter found this boundless energy too much for her.

It would seem to make sense that energy and enthusiasm are excellent characteristics of a healthcare professional.  They are!  However, when establishing rapport with patients we have to think about matching energy levels.  If our energy level is very high and  the patent’s energy is very low, we could experience a communication disconnect. This is exactly what happened with my friend’s daughter. The nurse though being high energy would be a good way to establish rapport.

We need to meet patients where they are. We need to meet then at their level of energy. Does this mean that if a patient is depressed and low energy we need to become depressed? Of course not!  However, what we need to do is lower our energy a bit so we do not cause a communication disconnect.

Mirroring and matching are techniques used to establish rapport at the unconscious level. This is created by becoming like the person with whom you need to make a connection. We need to make a connection with patients! When talking to patients look at their gestures and vocal inflexions. In a subtle way try to “match” these behaviors.  Subtle is the key word; we do not want to make it obvious or the patient may think we are mocking  them. People feel more comfortable with people who act like them.  For example, if your patient uses a lot of certain hand gestures, you may need to increase your level of these hand gestures.

If you look at people in the workplace or social situations who seem to be very engaged, notice they most likely have similar body language and tone of voice.  They are in sync.  We need to be in sync with our patients through the the strategies of matching and mirroring.

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

Study Reveals HUGE Communication Gap Between Patients and Physicians

The Archives of Internal Medicine recently published a study that surprised many physicians who thought they were communicating effectively with patients. A group of Yale researchers study results are very concerning.

Several findings revealed a very significant communication disconnect between patients and physicians.  The gap is alarming.  Here are two examples:

Physician Name — Study found that:

Patient Survey: More than 80% of patients did not know the physician taking care of them.
vs.
Physician Survey: The majority of doctors thought the patients knew their name.

Admission Diagnosis — Study found that:

Patient Survey: About  50% of patients did not know their admission diagnosis.
vs.
Physician Survey: The vast majority of doctors thought the patients had understood their diagnosis.

These results indicate significant works need to be done to narrow the gap between what healthcare professionals say and what patients understand.  This comes through education.

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

MD Anderson Cancer Center Offers Innovative Patient-Professional Communications Program

The Interpersonal Communication And Relationship Enhancement (I*CARE) programs are excellent educational tools developed to enhance the communication skills of oncology professionals. The program is part of MD Anderson’s Department of Faculty Development. The program developers strongly believe that “skillful communication is a competency that can be taught and learned.”

The I*CARE program mission: “Most cancer clinicians have not had the opportunity to develop their skills in managing difficult patient encounters such as those where there are strong emotions, stressed families or uncomfortable conversations when transitioning a patient to palliative care or discussing end of life. Oncology providers want to extend their role beyond treating disease to establishing a therapeutic and supportive alliance with the patient and family. Our goal is to assist you in sharpening the skills necessary to manage these challenging encounters.”

I*CARE PROGRAM INITIATIVES

I*CARE Website

The website, http://www.mdanderson.org/icare, contains the MD Anderson Cancer Center’s Video Library of Clinical Communication Skills and is an educational resource for communication skills development. The video library helps with understanding the basic principles of communication and advanced skills such as discussing end-of-life issues and error disclosure by providing specific protocols that can be used and illustrating them with video re-enactments.  Free Continuing Medical Education (CME Ethics credit is available) and Risk Management credits are available to physicians enrolled in The University of Texas Professional Liability Insurance Plan. People may download materials for teaching purposes.

Programs

There are many program options, including fellow & faculty forums, interactive workshops, train-the trainer sessions, conferences and the quarterly Achieving Communication Excellence (ACE) lecture series.  One program, “On Being An Oncologist,” features actors William Hurt and Megan Cole who assume the personas of various doctors. Using dialogue gathered by physician focus groups, they share their feelings about the stress of caring for patients with life-threatening illness; the time pressures; the challenge of breaking bad news; the need to keep hope alive; the balancing of sympathy and empathy and keeping personal boundaries, as well as dealing with both the patient’s and their own emotional reactions.  A workbook with reflective exercises can be downloaded for both teaching and learning purposes.  In the Spring of 2011, there will be a new program launched for patients and families to learn how to communicate their needs to their medical team, and specific information on the cultural aspects of communicating with patients. 
One-on-one Coaching

Trainers observe healthcare professionals with patients and feedback is provided.

Research Opportunities

There are many ongoing research projects such as assessing aspects of the patient / oncologist relationship through audio taping clinical encounters and the impact of empathic statements on a patient’s emotional state.
These outstanding initiatives are making a big impact in helping oncology professionals successfully connect with patients on an interpersonal level.

Walter F. Baile, M.D., is the I*CARE Program Director and Cathy Kirkwood,
M.P.H., is the I*CARE Project Director. For more information about I*CARE, visit: http://www.mdanderson.org/icare

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256

Houston’s St. Joseph Medical Center offers Innovative Method to Communicate with Non-English Speaking Patients

St. Joseph Medical Center (http://www.sjmctx.com) recently became Houston’s’ first hospital to use a unique translation system.

A special phone is set up with two handsets, one for the patient and one for the professional.  Based on the language requested, a trained medical interpreter is immediately brought on the line to help the patient and professional communicate.

The phone system is produced by CyraCom (http://www.cyracom.com) and offers interpreters specializing in 150 languages.  The trained interpreters are familiar with medical terminology, which is critical when speaking about healthcare topics.

If the language is not immediately obvious, patients review a card attached to the phone that has questions in their language. They can use this card to select their language.

Every patient room at St. Joseph has one of the phones. The sets are also located in the medical records department, triage and the front desk. There are a total of 400 phones throughout the hospital.

In healthcare, clear and concise communication is critical. This innovative tool helps avoid language-related issues to provide the best care to patients.

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Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. We offer high-impact training, consulting and one-on-one coaching. Contact us today!
http://www.CommunicatingWithPatients.com or 1-800-677-3256