Adrienne Boissy1, Amy K Windover2, Dan Bokar2, Matthew Karafa3, Katie Neuendorf2, Richard M Frankel2,4, James Merlino5, Michael B Rothberg6. 1. Office of Patient Experience, Center for Excellence in Healthcare Communication, Cleveland Clinic, 9500 Euclid Ave, NA4, Cleveland, OH, 44195, USA. boissya@ccf.org. 2. Office of Patient Experience, Center for Excellence in Healthcare Communication, Cleveland Clinic, 9500 Euclid Ave, NA4, Cleveland, OH, 44195, USA. 3. Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA. 4. Indiana University School of Medicine, Indianapolis, IN, USA. 5. Press Ganey Associates, Inc., Chicago, IL, USA. 6. Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
Abstract
BACKGROUND: Skilled physician communication is a key component of patient experience. Large-scale studies of exposure to communication skills training and its impact on patient satisfaction have not been conducted. OBJECTIVE: We aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience. DESIGN: This was an observational study. SETTING: The study was conducted at a large, multispecialty academic medical center. PARTICIPANTS: Participants included 1537 attending physicians who participated in, and 1951 physicians who did not participate in, communication skills training between 1 August 2013 and 30 April 2014. INTERVENTION: An 8-h block of interactive didactics, live or video skill demonstrations, and small group and large group skills practice sessions using a relationship-centered model. MAIN MEASURES: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS), Jefferson Scale of Empathy (JSE), Maslach Burnout Inventory (MBI), self-efficacy, and post course satisfaction. KEY RESULTS: Following the course, adjusted overall CGCAHPS scores for physician communication were higher for intervention physicians than for controls (92.09 vs. 91.09, p < 0.03). No significant interactions were noted between physician specialty or baseline CGCAHPS and improvement following the course. Significant improvement in the post-course HCAHPS Respect domain adjusted mean was seen in intervention versus control groups (91.08 vs. 88.79, p = 0.02) and smaller, non-statistically significant improvements were also seen for adjusted HCAHPS communication scores (83.95 vs. 82.73, p = 0.22). Physicians reported high course satisfaction and showed significant improvement in empathy (116.4 ± 12.7 vs. 124 ± 11.9, p < 0.001) and burnout, including all measures of emotional exhaustion, depersonalization, and personal accomplishment. Less depersonalization and greater personal accomplishment were sustained for at least 3 months. CONCLUSIONS: System-wide relationship-centered communication skills training improved patient satisfaction scores, improved physician empathy, self-efficacy, and reduced physician burnout. Further research is necessary to examine longer-term sustainability of such interventions.
BACKGROUND: Skilled physician communication is a key component of patient experience. Large-scale studies of exposure to communication skills training and its impact on patient satisfaction have not been conducted. OBJECTIVE: We aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience. DESIGN: This was an observational study. SETTING: The study was conducted at a large, multispecialty academic medical center. PARTICIPANTS: Participants included 1537 attending physicians who participated in, and 1951 physicians who did not participate in, communication skills training between 1 August 2013 and 30 April 2014. INTERVENTION: An 8-h block of interactive didactics, live or video skill demonstrations, and small group and large group skills practice sessions using a relationship-centered model. MAIN MEASURES: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS), Jefferson Scale of Empathy (JSE), Maslach Burnout Inventory (MBI), self-efficacy, and post course satisfaction. KEY RESULTS: Following the course, adjusted overall CGCAHPS scores for physician communication were higher for intervention physicians than for controls (92.09 vs. 91.09, p < 0.03). No significant interactions were noted between physician specialty or baseline CGCAHPS and improvement following the course. Significant improvement in the post-course HCAHPS Respect domain adjusted mean was seen in intervention versus control groups (91.08 vs. 88.79, p = 0.02) and smaller, non-statistically significant improvements were also seen for adjusted HCAHPS communication scores (83.95 vs. 82.73, p = 0.22). Physicians reported high course satisfaction and showed significant improvement in empathy (116.4 ± 12.7 vs. 124 ± 11.9, p < 0.001) and burnout, including all measures of emotional exhaustion, depersonalization, and personal accomplishment. Less depersonalization and greater personal accomplishment were sustained for at least 3 months. CONCLUSIONS: System-wide relationship-centered communication skills training improved patient satisfaction scores, improved physician empathy, self-efficacy, and reduced physician burnout. Further research is necessary to examine longer-term sustainability of such interventions.
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