Healthcare organizations can teach clinicians and nurses compassionate communication skills, including deep listening, clarity, and understanding patients' perspectives.
Compassionate communication is essential to establish trust between clinicians and their patients. Trust is foundational in creating meaningful connections and working relationships with patients.
"What we teach is all about the communication and connection between clinicians and patients," says Evonne Kaplan-Liss, MD, MPH, director of the Center for Compassionate Communication at the UC San Diego Sanford Institute for Empathy and Compassion. "An emotional connection between a clinician and a patient is established in the first two minutes of a clinical encounter."
There are several essential elements in compassionate communication, according to Kaplan-Liss.
"In compassionate communication, the receiver feels heard, taken care of, and understood," Kaplan-Liss says. "The skills required for compassionate communication are deep listening, clarity, understanding the receiver's perspective, and authenticity."
Evonne Kaplan-Liss, MD, MPH, is director of the Center for Compassionate Communication at the UC San Diego Sanford Institute for Empathy and Compassion.
How the fellowship program works
The UC San Diego Health Sanford Compassionate Communication Academy Fellowship program uses exercises grounded in the arts and humanities along with role playing to teach clinicians and nurses the skills necessary to communicate compassionately.
"We use journalism skills, improvisation skills, visual arts, and narrative medicine exercises to help clinicians connect with patients and communicate with compassion," Kaplan-Liss says. "As a patient myself with chronic conditions, I have seen firsthand how ineffective communication impacted my health. I have been on the receiving end of bad communication."
Journalism skills are helpful for clinicians to communicate compassionately and effectively with patients. The use of jargon is a huge problem for healthcare providers and patients, according to Kaplan-Liss.
"In journalism, people are trained to avoid the use of jargon and to connect with audiences at a sixth-grade level," Kaplan-Liss says. "So, we focus a lot on avoiding the use of jargon and distilling messages to patients. We want clinicians to put the most important information first when they are talking to patients, which is like a journalist focusing on the lead of a story."
To help clinicians gain an appreciation of patients' different perspectives, the fellowship program uses visual arts exercises.
"We have fellows view the same piece of artwork, and many of them see the artwork differently," Kaplan-Liss says. "There are elements of the artwork that people do not see or see differently. This is an important exercise because it encourages the fellows to slow down and helps them understand that something can be seen in many ways."
Role playing is a primary component of the fellowship program. Clinicians not only role play with other clinicians, but also with theater artists, and they receive feedback from the artistic lens of actors.
"The beauty of role playing is getting to practice outside of your normal environment as well as getting feedback from colleagues and artists," Kaplan-Liss says. "Clinicians can try communicating in ways that are different from the ways they are normally communicating with patients."
The feedback from role playing exercises gives clinicians insights into how they are communicating with patients.
For example, during one role playing exercise between a physician and an artist, the artist noticed during the exercise that the physician's body language and facial expressions were not matching what the physician was saying. The physician looked intense, and the news that was being conveyed came out more intense than it needed to be delivered.
"With in-the-moment feedback during a role-playing exercise, a clinician can gain insight about their facial expressions and eye contact," Kaplan-Liss says. "These are important bits of information that a clinician can learn from and practice."
Role playing also hones listening skills. Listening involves observation skills to make sure patients feel heard, Kaplan-Liss explains.
"Clinicians should not interrupt their patients," Kaplan-Liss says. "When a physician interrupts a patient, it diminishes trust and lessens the likelihood that a patient is going to answer questions that need to be addressed. Clinicians need to give patients time and space, and they need to avoid cutting off a patient."
The fellowship program teaches clinicians and nurses about the nonverbal elements of compassionate communication.
"We teach fellows about the importance of body language, eye contact, facial expressions, and where they should be physically in an exam room," Kaplan-Liss says. "We teach physicians, advanced practice providers, and nurses about where they should be in a room when there is a computer in the room that they must use. We teach fellows about where they should sit and the level where they are positioned when they communicate with patients."
Roles for advanced practice providers include care coordination, patient education, and patient navigation, according to this CMO.
Advanced practice providers (APPs) such as nurse practitioners and physician assistants are playing a growing role on cancer care teams, according to the CMO of the American Oncology Network.
Oncology care is complex, with multiple care providers working with patients in clinic and hospital settings. APPs have the potential to coordinate care, close multiple gaps in care, and relieve pressures on physicians.
"It takes a village to shepherd a patient along their journey," says Stephen "Fred" Divers, MD, CMO of American Oncology Network (AON). "Most healthcare providers have recognized the significant value that APPs bring with respect to the patient care experience."
Divers points to survey data collected by the Oncology Care Index launched by Johnson & Johnson earlier this year.
"If you look back at surveys conducted in 2024 that launched the Oncology Care Index, nine out of 10 healthcare providers saw a significant improvement in patient satisfaction related to the involvement of APPs in the patient experience," Divers says.
Divers added that the Make It HAPPen program, which Johnson & Johnson launched in collaboration with the Advanced Practitioner Society for Hematology and Oncology, is one of the ways AON is elevating role that APPs play in oncology care.
APPs can free up physicians to have meaningful personal interactions with patients, which boosts patient satisfaction, according to Divers, who adds APPs help generate a positive patient experience.
"The APPs enable the clinical delivery team to have that feel and approach," Divers says. "Having APPs on cancer care teams not only allows for more patient touches in the clinic but also allows for care in an efficient manner to move patients through a clinic seamlessly."
Reliance on APPs at AON reflects their growing roles on oncology care teams across the country.
"There was a time less than 10 years ago when AON had few APPs working within our oncology clinics," Divers says. "Now, within our network of more than 340 providers in nearly two dozen states, about half of our providers are APPs."
Stephen "Fred" Divers, MD, is CMO of American Oncology Network. Photo courtesy of American Oncology Network.
How APPs are working on cancer care teams
APPs are playing several important roles on oncology care teams and in the entire range of cancer care, Divers explains.
"They are helping with initial patient intakes whether that is in a clinic for a new patient visit or in a hospital with a new diagnosis," Divers says. "APPs are involved from Day 1 in gathering and collating information as well as integration of data within the electronic health record."
APPs provide continuous cancer education for the patients and their families throughout the care delivery process as well.
"Typically, they see patients before, during, and after a visit with a healthcare provider," Divers says.
Once a patient is diagnosed, there are numerous appointments and clinic visits that must be coordinated. At many hospitals and oncology clinics, APPs conduct patient navigation duties.
"There is monitoring for side effects and toxicity, which falls to APP navigators in many cases," Divers says. "So, there is following up with patients after treatment and making sure that patients understand the side effects of their medications."
APPs are also working with cancer patients in the survivorship phase of their care journey.
"We have APPs who are functioning in a survivorship role by providing ongoing follow-up for patients because they have established relationships with those patients," Divers says.
APPs as leaders and their relationship with physicians
At AON, the network of community oncology practices has elevated APPs to leaderships roles, since many of them have spent years perfecting the craft of oncology care delivery.
"We recognize the ability of APPs to play leadership roles and have created a track for APPs to continue their education," Divers says. "Clearly, we recognize the value that APPs provide and want to elevate them to leadership roles whenever possible."
Lastly, the relationship between physicians and APPs on cancer care teams varies by what physicians need, according to Divers.
"For example, the nurse practitioner who works with me in the clinic works side-by-side with me all day making sure I do not forget anything and making sure all the data has been reviewed appropriately as well as making sure that care plans have been documented," Divers says. "At the end of the day, we meet and make sure that the patient inbox has been reviewed and everything has been taken care of."
Healthcare organizations should not rely on workarounds to set up and complete follow-up imaging, this CMO says.
Follow-up imaging can require complicated processes to set up studies and make sure they are completed, with multiple clinicians often involved in a patient's care. Establishing standardized processes is crucial, and artificial intelligence has the potential to improve radiology workflows.
That's why St. Tammany Health System is using high reliability organization principles and artificial intelligence to make sure follow-up imaging is conducted for patients.
"The need for follow-up imaging is a potential risk for patients because follow-up recommendations may not be completed or they may not be in keeping with the provider team's intent for what they had planned for images," says Patrick Torcson, MD, senior vice president and CMO of St. Tammany Health System. "The traditional approach that has been used is a series of workarounds; historically, there has not been a hard-wired process for how follow-up imaging occurs."
The health system is using a high-reliability approach to follow-up imaging to hard wire the process, so it does not rely on the memory of care team members or some type of workaround.
"It is part of the workflow process that goes with the scheduling, registration, completion of the study, and the interpretations of the imaging that patients expect to get," Torcson says. "It is a complex process that occurs over several sites and over time, so we are reducing risk with standardization to make sure the follow-up imaging occurs."
One of the principles of high-reliability organizations that St. Tammany Health System has embraced for follow-up imaging is the difference between individual accountability and system-level accountability.
"In the past when it comes to functions such as follow-up imaging, we have relied on individual accountability, whether it has been relying on the patient's role in receiving follow-up imaging or relying on an ordering physician such as a primary care doctor," Torcson says. "What we have learned is that follow-up imaging requires a system-level process."
Patrick Torcson, MD, is senior vice president and CMO of St. Tammany Health System. Photo courtesy of St. Tammany Health System.
AI tool adoption
Using an AI tool to improve the follow-up imaging process is part of St. Tammany Health System's efforts to establish high reliability in this area of care. AI offers a great opportunity to integrate with current radiology technology and the electronic health record to make sure that patients get the follow-up imaging that is needed in multiple sites of care, Torcson explains.
"It is a complex process to arrange follow-up imaging," Torcson says. "It is more complex than human-focused appointment scheduling and should not rely on memory."
AI can help standardize and automate the follow-up imaging process.
"We are partnering with a third party, Inflo Health, which has an advanced platform that is going to be integrated with our radiology workflows to improve completion of follow-up imaging," Torcson says.
The AI tool automatically identifies studies requiring additional imaging or consultation, then relays the information to referring clinicians, which streamlines communication between imaging centers and clinicians. It also continuously tracks open follow-ups. By offering follow-up management with the AI tool, imaging centers can position themselves as partners with referring clinicians and contribute to better patient care.
"AI provides an augmentation for the workflow that makes the follow-up imaging process hard wired, so it occurs consistently and non-ambiguously," Torcson says. "It also helps create a standardized process. With AI, we can establish a process that exceeds human cognitive capacity, especially when you factor in different sites of care and different providers."
While individual interventions for residents such as resiliency initiatives are important, HCA Healthcare believes creating a supportive workplace environment is crucial.
At health systems and hospitals, burnout among physicians and residents is a national problem.
A study published by Annals of Medicine and Surgery found that burnout among residents may be linked to long work hours, high educational demands, lack of autonomy, a high level of work-home interference, a shortage of benefits, and insecurity about the future.
To combat burnout among residents, HCA Healthcare is training clinical leaders and medical faculty to create a supportive workplace environment for the health system’s residents.
The health system’s research on resident well-being and assessment of external research has determined that resident well-being is grounded in five factors: efficiency of practice as defined by job demands versus available resources, autonomy, belonging, competence, and whether the workplace environment supports a sense of meaningful work.
"We did a study last year with 2,029 residents and found that we could predict burnout with those five pillars," says Gregory Guldner, MD, vice president of academic affairs at HCA Healthcare.
HCA Healthcare has defined these five factors as follows:
Efficiency of practice: Making the practice of medicine for residents as efficient as possible is a function of hindrance job demands and challenge job demands. An example of a hindrance job demand is a broken piece of equipment in an exam room. An example of a challenge job demand is asking residents to speed up and see more patients.
Autonomy: Residents should feel a sense of endorsement in the work that they do. It is not about freedom or lacking supervision. It is the sense that what a resident does throughout their day is chosen volitionally. They feel they do work is done because they have the choice to do it or because their supervisors endorse what they are asking residents to do.
Belonging: Residents should have a sense of feeling understood and accepted by their coworkers and supervisors.
Competence: For residents, competence has two elements. First, it is a sense of mastery—that a resident can do and affect things in their workplace environment. Second, it is a sense that there is an opportunity for growth—that there is a pathway to grow.
Meaningful work: Faculty members should encourage residents to step back and reflect on the impact of the care that they are providing. For example, if a resident is involved in a procedure that provides life-saving care, a faculty member should tell the resident that they have played a meaningful role in saving a life because of the resident’s training and involvement in care.
Although HCA Healthcare has initiatives that provide residents with resources to help boost their well-being and resiliency as individuals such as therapy and coaching, addressing the workplace environment through the lens of these five factors is essential to reducing resident burnout, according to Guldner.
"We are much more interested in how we work with leaders, faculty members, and the C-suite to create a work and learning environment that supports resiliency," Guldner says. "Our research shows that one of the best ways to support an individual’s resiliency is to create a work and learning environment that addresses psychological needs."
Gregory Guldner, MD, is vice president of academic affairs at HCA Healthcare. Photo courtesy of HCA Healthcare.
Training clinical leaders and medical faculty
HCA Healthcare has a workshop program to train clinical leaders and medical faculty to promote a supportive workplace environment for residents.
"We bring in our faculty, program directors, directors of graduate medical education, and other leaders to work with our organizational psychologists," Guldner says. "This is a change from how you build a resilient person, which is great and important, to how you build an organization with a supportive environment."
Part of the workshop curriculum involves training faculty on how to communicate with residents to support autonomy as opposed to just telling residents what to do when they are providing care.
"With autonomy, our residents may have supervisors say, 'Just do this.' That is a common scenario in graduate medical education," Guldner says. "That approach does not make residents feel they have a lot of ownership or autonomy. We teach our faculty to say things like, 'What do you want to do?' If a resident wants to admit a patient to the hospital and that seems reasonable, faculty member will say, 'If that is what you want to do, let's do that.'"
A focal point for the workshops is self-determination theory, which is an organizational well-being theory.
"We talk about how the ways you behave and the ways you set things up in the environment with policies and procedures support autonomy, belonging, and competence," Guldner says.
In addition, the workshops train clinical leaders and faculty to identify hindrance job demands and address them quickly. Guldner cites the example of a broken otoscope in an exam room.
"From a workplace standpoint, if a resident is in an exam room caring for a child with an earache and the otoscope is broken that is a hindrance job demand," Guldner says. "They have to stop what they are doing to find a working otoscope. Those are exactly the type of things that we want to address quickly because there is a direct connection between hindrance job demands and workplace burnout."
This week's edition of HealthLeaders' The Winning Edge program featured a four-member webinar panel that focused on strategies to improve physician engagement and clinical efficiency.
Physician engagement is essential to drive positive clinical outcomes for patients as well as to achieve physician satisfaction. Clinical efficiency is crucial for healthcare organizations to establish an effective workplace environment and to control costs.
Click on the video below to view the webinar session. Click here to read a HealthLeaders story that highlights some of the key takeaways from the webinar.
This webinar was sponsored by QGenda.
The Winning Edge series is an extension of theHealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Please join the HealthLeaders Exchange community at our LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.
Sharing strategies for boosting clinical efficiency was a central theme for this week's edition of The Winning Edge, which is a healthcare provider-focused HealthLeaders program.
Clinical efficiency is crucial for healthcare organizations to establish an effective workplace environment and to control costs.
This week's webinar for HealthLeaders' The Winning Edge series was centered on the topics of improving physician engagement and clinical efficiency. The webinar featured a four-member panel of experts: Ruric "Andy" Anderson, MD, MBA, chief medical and quality officer at RWJBarnabas Health; Thomas Balcezak, MD, MPH, chief clinical officer at Yale New Haven Health; Patrick Hunt, MD, CMO at QGenda and CMO of acute care at Prisma Health; and Ghazala Sharieff, MD, MBA, corporate executive vice president and chief medical and operations officer for acute care at Scripps Health.
View the infographic below to get four tips on how to improve clinical efficiency. Click here to read the accompanying HealthLeaders story on key takeaways from the webinar.
The webinar was sponsored by QGenda.
The Winning Edge series is an extension of theHealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Please join the HealthLeaders Exchange community at ourLinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us atexchange@healthleadersmedia.com.
A four-member panel of experts shares how to successfully engage physicians and boost clinical efficiency.
Physician engagement is essential to drive positive clinical outcomes for patients as well as to achieve physician satisfaction. Clinical efficiency is crucial for healthcare organizations to establish an effective workplace environment and to control costs.
The latest webinar for HealthLeaders' The Winning Edge series was held yesterday on the topic of improving physician engagement and clinical efficiency. The webinar featured a four-member panel of experts: Ruric "Andy" Anderson, MD, MBA, chief medical and quality officer at RWJBarnabas Health; Thomas Balcezak, MD, MPH, chief clinical officer at Yale New Haven Health; Patrick Hunt, MD, CMO at QGenda and CMO of acute care at Prisma Health; and Ghazala Sharieff, MD, MBA, corporate executive vice president and chief medical and operations officer for acute care at Scripps Health.
Enlisting medical staff to drive efficiency and cost savings
The panelists said CMOs and other clinical leaders need to engage medical staff to boost efficiency and achieve cost savings.
Physicians and the choices they make have a pivotal impact on efficiency and costs, according to one of the panelists. CMOs and other clinical leaders need to tap into physician expertise and experience to launch successful efficiency initiatives and control costs, the panelist said.
Health systems, hospitals, and medical groups should establish care pathways and standardized order sets to give physicians insights into cost-effective treatments, such as low-cost medications that are as effective as high-cost medications, as well as gaining insight into clinical efficiency, one of the panelists explained.
To improve physician efficiency, health systems, hospitals, and medical groups should optimize physician scheduling, according to one of the panelists.
To improve clinical efficiency, CMOs and other clinical leaders should encourage a medical staff to focus on access to care. An important part of this strategy is to help physicians use their time efficiently to boost access, the panelists said.
Another strategy to boost clinical efficiency is to improve patient throughput in the hospital setting by making sure physicians are working effectively with other clinical care team members such as nurses and technicians, according to the panelists.
To help control costs, CMOs and other clinical leaders should enlist service line clinicians to work with medical device vendors to secure the best deals for a health system or hospital, one of the panelists explained.
Care team communication strategies
CMOs and other clinical leaders can employ multiple strategies to communicate with physicians, nurses, and other care team members to help drive patient safety and care quality improvements, the panelists said.
One communication strategy is for clinical leaders to emphasize with physicians and nurses the importance of accurate and complete clinical documentation. Ensuring that clinical documentation is accurate and complete avoids reimbursement penalties.
CMOs and other clinical leaders should focus on communicating clinical data with clinicians, one of the panelists explained. This data should be actionable, transparent, and meaningful. Sharing data on clinical outcomes that shows how clinicians are performing can spur the competitive spirit among clinicians to perform at the highest level.
Additionally, CMOs and other clinical leaders should set goals for their communication with care team members and target particular patient outcomes. By setting goals and targets, communication can be meaningful for clinicians and help drive improvements in patient outcomes, the panelists said.
Engaging physicians in strategy decisions and technology adoption
CMOs and other clinical leaders should be intentional in engaging physicians about strategy decisions and technology adoption, the panelists said. Physicians should be queried about their pain points and should be consulted when potential solutions are identified.
When CMOs and other clinical leaders are considering the adoption of new technology, they should include physicians in the planning stage and have physicians play a role in pilots that test the technology.
Lastly, when there is a change in strategy or adoption of new technology, CMOs and other clinical leaders must provide physicians with a concise and compelling explanation for why change is necessary, according to the panelists. For example, a change in strategy or adoption of new technology may result in better patient outcomes or improved physician experience.
This webinar was sponsored by QGenda.
The Winning Edge series is an extension of theHealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Please join the HealthLeaders Exchange community at our LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.
In the latest webinar of HealthLeaders' The Winning Edge series, a four-member panel will explore ways to boost physician engagement and clinical efficiency.
For CMOs and other clinical leaders, managing physician engagement and improving clinical efficiency are top priorities.
To learn about strategies to improve physician engagement and clinical efficiency, tune in on Aug. 5 from 1 to 2 p.m. EST for the latest webinar of HealthLeaders' The Winning Edge series. You can register to attend the webinar at this link.
The webinar features a four-member panel of experts:
Ruric "Andy" Anderson, MD, MBA, chief medical and quality officer at RWJBarnabas Health;
Thomas Balcezak, MD, MPH, chief clinical officer for Yale New Haven Health;
Patrick Hunt, MD, MBA, chief medical officer of QGenda and chief medical officer of the acute care division at Prisma Health;
Ghazala Sharieff, MD, MBA, corporate executive vice president and chief medical and operations officer of acute care at Scripps Health
This one-hour webinar will focus on eight discussion topics:
What are the primary strategies for effectively communicating with medical staff in clinical care scenarios such as in time-critical situations?
What part does your medical staff play in driving efficiency and cost savings?
What are the primary care team communication strategies to help drive quality and patient safety improvements?
How do you engage physicians in strategy and technology decisions?
What are some high-impact strategies for investing in medical staff through operational innovation such as effective clinical communications through modernizing scheduling and on-call management?
What are the primary strategies for optimizing physician scheduling?
How can healthcare leaders align technology, culture, and clinical operations to create a more sustainable and efficient care environment?
How can you reduce electronic medical record alerts and make alerts more actionable?
This webinar is an opportunity to learn from the best in the business and take away strategies you can implement at your healthcare organization. Join us as we explore physician engagement and clinical efficiency in depth.
The Winning Edge series is an extension of theHealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Please join the community at our LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.
The American Diabetes Association (ADA) has established standards of care for diabetes patients in the hospital setting.
Three dozen hospitals across the country have been recognized for providing care to diabetes patients based on the ADA guidelines.
For diabetes patients in the hospital setting, hyperglycemia, hypoglycemia, and glucose variability have been linked to adverse outcomes, including morbidity and mortality, according to a study published by the Journal of Clinical Endocrinology and Metabolism. The ADA says hospitals that follow their guidelines can improve outcomes, shorten hospital stays, and reduce hospital readmissions and emergency department visits.
In this episode of HL Shorts, Harpreet Pall, MD, MBA, CMO of Hackensack Meridian Jersey Shore University Medical Center, which is part of Hackensack Meridian Health, shares why CMOs should be focused on the care of hospitalized patients who have diabetes. Click here to read the accompanying HealthLeaders story.
Telehealth services deliver value for health systems and patients in several ways, according to the new chief physician officer of MulitCare Health System.
Todd Czartoski, MD, was named chief physician officer of MultiCare in June. Prior to being named chief physician officer, he served as president and CMO of the health system's Neuroscience Institute and virtual health service. Before joining MultiCare, he served as chief executive of telehealth and chief medical technology officer at Providence.
View the infographic below to learn about the three primary ways that Czartoski says telehealth generates value for healthcare providers and patients. Click here to read the accompanying HealthLeaders story.
Patrick Torcson, MD, is senior vice president and CMO of St. Tammany Health System. Photo courtesy of St. Tammany Health System.
Gregory Guldner, MD, is vice president of academic affairs at HCA Healthcare. Photo courtesy of HCA Healthcare.
