Gullen, David

The doctor’s interpersonal skills are arguably the most important to clinical outcome and patient experience. A peer-facilitated, communication skills-building course for physicians has been provided twice annually since its inception in 2004. The course was designed to increase personal awareness, as well as to help physicians develop new communication and interpersonal skills. Satisfaction data from 3,561 patient surveys on 80 providers who attended the course between 2006 and 2010 were analyzed one year before and one year after course participation. After completing the course, the proportion of “excellent” ratings of provider service (the highest rating on a 5-point scale) increased by 2% to 5.6%. The most notable improvements in service attributes under the provider’s control and covered in the course content were: involving the patient in care decisions (P < .001), explaining medical condition (P=.002), and the provider’s knowing the patient as a person (P = .004). Other improvements were noted in courtesy (by 3.4%, P=.027), listening (by 3.5%, P=.036), and overall quality of care from the provider (by 3.5%, P=.027). Attributes not directly under the provider’s control – nursing quality, teamwork, spending enough time, and likelihood to recommend – were included in the analysis; year-over-year changes in these were not significant. Further, providers who participated in the course, when compared to those who did not, experienced an 18-percent decrease in patient complaints. Improvements in perception of excellent provider communication and other service-related behaviors suggest this training approach may be useful in improving patient satisfaction, patient experience, and payment in value-based models.

In 2002, the Physician Charter on Medical Professionalism was published to provide physicians with guidance for decision making in a rapidly changing environment. Feedback from physicians indicated that they were unable to fully live up to the principles in the 2002 charter partly because of their employing or affiliated health care organizations. A multistakeholder group has developed a Charter on Professionalism for Health Care Organizations, which may provide more guidance than charters for individual disciplines, given the current structure of health care delivery systems. This article contains the Charter on Professionalism for Health Care Organizations, as well as the process and rationale for its development. For hospitals and hospital systems to effectively care for patients, maintain a healthy workforce, and improve the health of populations, they must attend to the four domains addressed by the Charter: patient partnerships, organizational culture, community partnerships, and operations and business practices. Impacting the social determinants of health will require collaboration among health care organizations, government, and communities. Transitioning to the model hospital described by the Charter will challenge historical roles and assumptions of both its leadership and staff. While the Charter is aspirational, it also outlines specific institutional behaviors that will benefit both patients and workers. Lastly, this article considers obstacles to implementing the Charter and explores avenues to facilitate its dissemination.