Don't Underestimate Emotional Intelligence

For physicians, emotional intelligence is not about seeming happier around patients. It's about recognizing the best way to give a patient information, which can raise patient engagement levels and affect outcomes.

To meet the demands of healthcare's transformation from volume to value, organizations are increasingly focusing their efforts on how to better manage patients across the care continuum. Some systems are partnering with post-acute care providers, such as home health and skilled nursing facilities while others are investing in these services under their own umbrellas. Regardless of the business arrangement that hospitals and health systems settle on, physicians play a key role in their patients' care transitions.

Last March, Denver-based SCL Health Systems, a nonprofit system with eight hospitals in three states, announced a joint venture with Univita Health, a home care management company. The partnership is one of many examples health systems are turning to with the goal of better managing quality, outcomes, and patient experience.

Rick Lopes, MD, SVP of health networks at SCLHS, says they spent a lot of time picking the right partner. He says leadership got to know one another through workshops and LEAN management events SCLHS hosted. The two organizations also set out clearly defined goals and planned the details of each handoff.

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It's at this transition, whether it's from hospital to home or hospital to rehab or another facility, where a physician can make a big difference in the patient's plan of care, says Christopher Zipp, DO, FACOFP, FAAFP, osteopathic director of medical education for Atlantic Health System, a nonprofit, five-hospital system based in New Jersey.

"With so many different provider touch points, it's harder to manage the patient throughout their continuum," says Zipp. "How do doctors "handshake" over patients? How is information delivered in a culturally competent manner?"

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All key questions that need to be answered when considering not only a partnership, says Zipp, but also within a hospital's walls, from intake to nurse, from nurse to physician, etc. With each transition is an opportunity to win over or lose confidence with patients and their families.

The heightened awareness of patient experience and patient satisfaction has led hospital leaders to focus on communication techniques with patients. White boards in patients' rooms that identify the clinical care staff by name and spell out what to expect in treatment have become a common tool to close the communication gap between the hospital staff and patients.

Physicians' Emotional Intelligence
Paying more attention to patients' needs is a step in the right direction, says Zipp, but thinks that doctors need to go further. He says what medical schools have referred to as cultural competence is now known as emotional intelligence, and his goal is to raise it among the residents he oversees and physicians he works with.

"In the residency program I run, I teach them to consider the patient as a whole," explains Zipp, who tells residents to consider the biological, psychological, and social wellbeing of a patient. "We are all sculpted by our experiences… but I think it is also something that is teachable and learnable."

Residents learn to better communicate with patients by reviewing videos showing them interacting with a staged patient. Focusing on raising the emotional intelligence of physicians who are already in practice is more difficult, admits Zipp. He says the usual approach of going to physicians with data doesn't always work. Instead, Zipp says he tries to find a shared value, which is usually the care of the patient.

"One of the lines I've used before is, 'You may not be aware of how you're perceived, and this is how it affects your patient care,'" says Zipp who explains that it's hard for physicians to know they've missed the mark with a patient because they want to do a good job.

Financially Rewarding Behavior
A doctor who is able to understand the best way to give patients information in a way they will understand and find meaningful will likely be able to take advantage of alternative payment models that are being set up as part of healthcare's transformation.

Why? Because those patients are more likely to be engaged, says Zipp, which leads to better medication and plan of care adherence. It's not a silver bullet, but it could significantly reduce barriers that influence a patient's care when they are out of your hospital.

Zipp says emotional intelligence is not about making physicians seem happier or easier to be around. It's about recognizing the best way to give a patient information. Zipp uses the example of patients who have a paternalistic view of physicians. He says with these patients, it's probably not best to walk in the exam room with five or six options and then ask what he or she prefers. These type of patients expect a physician to be the expert.

"You have to go into with a couple of options and say, 'Here's what I recommend,' " he says. "It really comes down to how physicians relate with their patients and really access a patients' resilience and their ability to overcome or manage their medical condition."

"Patients' responses and [the] ability to read the room is something we can teach physicians to be perceptive of," says Zipp. "It's powerful, and it permits us to reflect upon our actions, and do better the next time."

When it comes to transitioning patients out of the hospital to another provider, Zipp says a doctors' relationship with the patient can impact the outcome.

"I think emotional intelligence speaks to the relationship a patient has with their physician," says Zipp. "It's going to put the patient in the best possible healing environment."

Rick Lopes, MD, SVP of health networks for SCLHS will be talking about the strategies used to pick Univita Health as a partner during our March 14 webcast. He will be joined by Amy Boutwell, MD, MPP, founder of Collaborative Healthcare Strategies. She is also a physician at Newton-Wellesley Hospital (MA) and co-founder of the State Action on Avoidable Rehospitalizations (STAAR) Initiative of the Institute for Healthcare Improvement.