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ENGAGING PHYSICIANS MAKING IMPROVEMENTS IN PATIENT EXPERIENCE

February 18, 2009 PHYSICIANS MEDICAL GROUP OF SANTA CRUZ

Nancy Greenstreet, MDMedical Director

Linda MuhoberacQuality Improvement

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DOCTOR PATIENT COMMUNICATION

Teach principles of Agenda Setting  2 Workshops on Improving Doctor Patient

Communication Dr. Dan O’Connell – workshop leader Agenda Setting Article, Agenda Setting form Buy-in – Set a tone of collaboration, be flexible Teach one, try one, evaluate/praise, spread

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EFFECTIVE TECHNIQUES

Demonstrator site meetings Meet with one or two physicians at demonstrator sites  Bring lunch  Discuss CQC Collaborative and Agenda Setting

  PMG is involved in a state wide collaborative and we are learning about some interesting things that can make a PCPs life easier. One of them is Agenda Setting. It is so cool. It’s a way of structuring the office visit so the patient and the doctor feel they accomplished something. Basically, most doctor visits are a doctor-centered visit, a patient- centered visit or a patient-centered visit with agenda setting. A patient centered visit with agenda setting is more like a partnership, rather than the patient or the doctor running the show. (tone of collaboration)

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Review Agenda Setting http://www.aafp.org/fpm/20080300

Promote Workshops

Soon, we are having an expert come to town to hold a workshop on a Saturday to talk in more detail about how to do Agenda Setting. If you think about this you will see how it can work for you. (buy-in)

What happened One meeting was set up with 2 PCPs2 other PCPs decided they wanted in on the meeting – we all shared the food

Hint: bring plenty of food and extra handouts in case other PCPs ask to join (be flexible)

Repeat – Continue to meet with PCPs and introduce concepts of Agenda Setting

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Workshops with Dan O’Connell

Improving Clinician/Patient Communication Difficult Clinician/Patient Relationships

 

Marketing

 Not enough PCPs could attend because of family issues (be flexible)

 PMG opened the workshops to specialists as well.

 Emailed and mailed invitations

 Phone call follow-ups to non-responders

 CME credit and $200 honorarium

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Follow-up After Workshops

  Email physicians about their success with implementation

Keep in mind each person’s comments as to what first step they would take

Respond to email comments

When visiting offices for other reasons, ask PCPs how agenda setting is working for them to tie agenda setting into their every day work flow

One “Champion” sounds just like Dan O’Connell

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ACCESS Teach principles of Open Access

Dr. Neil Solomon Workshop on Open Access

Teach tools to track physician availability in office3NA (third next available appointment)

Open Slots/Fill Times

Meet with all physicians in one practice site Share data and graphs

Buy-in by practice site

Look for champions

TOOLS FOR IMPROVING PATIENT EXPERIENCE

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Re: Doctor/Patient Communication Workshop

Dear Doctor:

PMG and the California Quality Collaborative are sponsoring a workshop with 4.0 CME credits AND a $200 honorarium for each physician who attends.

Topic: Doctor/Patient CommunicationWhere: PMG Offices, 5200 Soquel Avenue, Suite 103When: Saturday, June 14, 9am-1pm (food provided)

Register TodayThe number of attendees will be limited to make sure all your questions are answered. To save your seat, register with Nancy Greenstreet, MD, PMG Medical Director, via email ngreenstreet@pmgscc.com by June 9, 2008.

About the PresenterOver the last 25 years, Dr. Dan O'Connell has worked as an educator, consultant, clinician, department chair and executive director in medical, behavioral health and educational settings. Dr. O'Connell teaches in the Residency Programs at the University of Washington School of Medicine and maintains a coaching and consulting practice.

Discuss and use 4 components of good patient communication:

Engage, Empathize, Educate, Enlist

 

Happy Patients, Happy Doctors.

Nancy Greenstreet, MD Medical DirectorPhysicians Medical Group of Santa Cruz CountyT: (831) 465-7819E: ngreenstreet@pmgscc.com

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Testimonials from PMGSCC Physicians

“The (Dan O’Connell) workshop was wonderful. I have used it daily and itseems to work really well with most of my patients. Agenda setting works! Itcan be a challenge at times with those patients who like to talk, but not anymore challenging than the prior interactions. What I have found is that I haveto let go of my own Agenda unless ample time. This helps me feel lessrushed/anxious/etc. I am Working on Embracing the Chaos!”

“I have definitely used the agenda setting with many of my patients. At first Ifound it much harder than I thought it would be. It disrupts the normalconversation flow of the encounter- which I like to use to help people feelcomfortable. The agenda setting makes me feel like I'm being abrupt, cuttingthem off. But it's getting smoother. People are at first taken aback by my newapproach, but I explain it helps me make sure I don't miss anything they wantto talk about. So when they come up with ‘just one more thing....’ I feel betterabout postponing the issue to another visit.”

Testimonials from PMGSCC Physicians

“I've tried agenda setting with nearly all my patients. It seems to be good tolearn their expectations up front. I certainly don't have the finesse that Danpossessed, but practice makes perfect. I've had less practice with thequestion/pause technique. As a young doc, I still talk more than listen(knowledge/ego/insecurity talks, -- wisdom listens).”

“Dan O’Connell also helped me realize I talk too much. I need to give a briefanswer and shut up while they process it. And I need to accept that I can'treview all major issues at every visit. I have to trust that if they don't tell meabout it, it's probably not acting up. I found that seminar incredibly helpful.”

“I am trying agenda setting with all new patients and now on day four it isbecoming easier and more rote and I don’t feel like I am reading a script.PSH (psychosocial history) I have been doing for some time now andpatients really feel you do connect with them when you can remember anonmedical fact about their last visit. ”