Newswise, February 13, 2017 – In an article to be published in
the Jan. 5 edition of the New England Journal of Medicine, a Henry Ford
Hospital critical care medicine physician describes in candid detail about how
her own near-death experience inspired an organizational campaign to help
health professionals communicate more effectively and demonstrate more empathy
to their patients.
Rana Awdish, M.D., director of the hospital’s Pulmonary
Hypertension Program, writes in “A View from the Edge: Creating a Culture of
Caring” that as a patient “I learned that though we do many difficult,
technical things so perfectly right, we fail our patients in many ways.”
In 2008 Dr. Awdish nearly died when a tumor ruptured in her
liver, leading to multisystem organ failure. The care team worked frantically
to save her but could not save the baby she was carrying. Her recovery would
include five major surgeries and multiple hospitalizations in intensive care.
She also experienced something unexpected: a kind of casual indifference.
“I was privy to failures that I’d been blind to as a
clinician,” she says. “There were disturbing deficits in communication,
dis-coordinated care, occasionally an apparently complete absence of empathy. I
recognized myself in many of those failures.”
Dr. Awdish says her patient experience inspired her to
champion a shift in culture for helping health professionals talk more
effectively with their patients at Henry Ford Hospital and throughout its
parent organization, the Detroit-based Henry Ford Health System. She used her
experience to drive home the point to leaders and others that “everything
matters, always. Every person, every time.”
Henry Ford’s Physician Communication and Peer Support
curriculum, launched in 2013, is guided by empathy and compassion, beginning
with an understanding of what matters most to patients and aligning them with
patient values. It’s geared for physicians, residents, fellows, nurses and
other health professionals. Courses include:
• CLEAR Conversations. CLEAR stands for Connect, Listen,
Empathize, Align and Respect. A course in which health care workers test their
communication skills in stimulated conversation exercises with Detroit-based
improvisational actors who portray patients and family members. It teaches how
to navigate difficult questions and respond to expressions of emotion. These
exercises are videotaped, allowing for immediate feedback. A mobile app offers
easy access to tips and videos for effective communication.
• A skilled communication workshop based on the 4 Habits of Effective Physician Communication model.
• Real-time shadowing. A trained observer shadows the provider during a series of patient interactions. Best practice behaviors and empathic communication skills are evaluated, and best practice feedback is shared during a one-on-one debriefing.
• New-hire orientation, during which employees are taught their value and purpose within the organization, not just to their job. Discussions emphasize learning to recognize avoidable and unavoidable forms of patient suffering. New employees are tasked with reducing avoidable suffering.
• A skilled communication workshop based on the 4 Habits of Effective Physician Communication model.
• Real-time shadowing. A trained observer shadows the provider during a series of patient interactions. Best practice behaviors and empathic communication skills are evaluated, and best practice feedback is shared during a one-on-one debriefing.
• New-hire orientation, during which employees are taught their value and purpose within the organization, not just to their job. Discussions emphasize learning to recognize avoidable and unavoidable forms of patient suffering. New employees are tasked with reducing avoidable suffering.
“My experience changed me,” says Dr. Awdish, who also serves
as medical director of Care Experience, which directs the patient
communications initiative across the health system. “It changed my vision of
what I wanted our organization to be, to embody.”
She says her experience is a teachable moment across the
spectrum of health care as the focus shifts to respecting patients as more than
just someone with an illness or disease.
“By focusing on our missteps, we can ensure that the path
ahead is one of compassionate, coordinated care,” Dr. Awdish says.
“When we are ashamed, we can’t tell our stories. In the wake
of painful experience, we all seek meaning. It is the human thing to do, but it
is also the job of great organizations. The stories we tell do more than
restore our faith in ourselves. They have the power to transform.”
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