Innovations in Communication with Patients and Families: Communication Coach Curriculum

Innovations in Communication with Patients and Families: Communication Coach Curriculum

Academic Year:
2017 - 2018 (June 1, 2017 through May 31, 2018)
Funding Requested:
$9,285.00
Project Dates:
-
Applicant(s):
Chair Uniqname:
Overview of the Project:
Communication and partnership with families is paramount in providing quality medical care and achieving positive patient outcomes. We propose a unique communication coach model and curriculum which would pair individual pediatric physician trainees with two communication coaches (a faculty member and a parent advisor). Coaches will meet with physician trainees for the duration of their residency training to provide direct, real-time feedback on communication skills with patients and families in both the inpatient and outpatient setting. Coaches will participate in a communication and observation feedback workshop twice per year. In the iterative nature of quality improvement, feedback will be received from both the physician trainee participants as well as communication coaches to evaluate the strengths and weaknesses of this model. Data will also be collected on the patient experience via the CARE measure and chart review both before and after implementation to assess for measurable outcomes. If successful this program will be continued annually with new classes of pediatric trainees and also be expanded to other residency training programs throughout our institution.
Number of Graduate Students Affected Annually:
100 graduate students
Additional Supporters:
<p>Heather Burrows, armadill@umich.edu</p>
Final Report Fields
Project Objectives:
1. Provide direct, real-time feedback on communication skills with patients and families in the inpatient and outpatient setting. 2. Help residents to identify communication weaknesses and strengths with tangible goals for improvement. 3. Facilitate longitudinal communication growth. 4. Enhance the patient experience with our health system by improving communication with physicians in training.
Project Achievements:
The major achievements of this project include the creation of a coaching curriculum which directly impacts pediatric resident physician’s communication with patients and families. Residents reported that they appreciated the direct and real time feedback from both their parent and faculty coach and were able to apply lessons learned from their coaching sessions to numerous other patient encounters. Objectively, residents had statistically significant improvements in their confidence in their communication skills. Residents in the control group for this intervention also had a higher percentage of positive change compared to the control group in areas that where notable to be particularly coachable behaviors including: creating and sustaining a relationship that is therapeutic and supportive to the family, minimizing distractions in the patient room, positioning in the room to create an inclusive space, sharing information without using medical terminology, and assessing patient and family understanding of the problem and desire for more information. We also saw some unique gender differences with male residents reporting higher change scores on their self-assessments while simultaneously having more negative scores on both the empathy and trust scales that were completed by families. We also looked at if this communication intervention impacted patients and families time in the hospital. We saw no impact on discharge time or length of stay, however, we saw that increased readmission rates in the control group suggesting that improving communication does not prolong the hospitalization and may result in fewer readmissions. This program has directly impacted our pediatrics program as it shows that real time directed communication training is an effective way to improve communication with patients and families.
Continuation:
At this time we are currently analyzing all of our data from the project from this past year to better understand the successes as well as pitfalls of the communication coach curriculum. Based on the data analysis as well as feedback from the participants we will consider implementation in the outpatient clinic setting as the next phase of the project as well as observing and coaching residents during the senior experiences in their second and third year. We will also consider implementation of the coaching model again for the new first year residents who will begin training in July of 2021.
Dissemination:
Dissemination is occurring through presentation at multiple national pediatric and education focused conferences (AAP and GME). We also are writing two separate academic papers which we hope to publish over the course of this year. The data from the project has also been shared with the pediatric education team as well as others in educational leadership for the institution.