Wenatchee Valley Medical Center is using a communication model called Listening Well to train physicians and staff to improve the efficiency of doctor/patient communication. The training includes building rapport with the patient, setting the agenda for the visit and acknowledging social or emotional cues. The ultimate goal of Listening Well is not only better communication, but ultimately better patient outcomes and higher patient satisfaction.
Wenatchee Valley Medical Center’s Listening Well Program
Doug Wilson, MD, Family Medicine physician at North Valley Family Medicine, a branch of Wenatchee Valley Medical Center (WVMC), chose an elective during his senior year of medical school that focused on communication skills. “I recognized that communicating with patients is one of the primary tools that we have for helping people to be well,” says Dr. Wilson, “So I chose to do an elective for a month with Larry Mauksch.”
Mauksch, a clinical associate professor in family medicine at the University of Washington Family Medical Center, created a communication model called Listening Well. Dr. Wilson and Mauksch found themselves working together again when WVMC adopted the model in 2006.
Six physicians trained with Mauksch, and in turn became trainers for physicians and staff. Dr. Wilson is the lead physician trainer, joined by Dr. Lisa Stone, Dr. Alan Smith, Dr. Jeff Monson, Dr. Cici Asplund, and Dr. Marcus Kubosumi. Casey Brown, RN and Sarah Battis Johnson of the WVMC Quality & Education department facilitate the trainings along with the physician trainers. They quickly realized that the model applied to all staff, not just physicians. “We saw a lot of similarities between what we were trying to do with standard rooming and standard work,” says Sarah.
The Listening Well model is based on the review of literature over a thirty year period. Three domains emerged that may enhance the efficiency of provider/patient communication:
- rapport building
- up-front agenda setting, and
- acknowledging social or emotional cues
At WVMC, the program is rolled out in three phases. Phase One introduces the basic concepts and model. Training videos (featuring our own physicians and staff) demonstrate key skills and levels of expertise. Peer Observations, where the observer learns to categorize someone else’s behavior, are introduced. Observations help develop an ‘observer self’ in order to reflect on and refine your own communication skills.
Phase Two teaches skills to involve patients in setting a shared agenda at the beginning of the visit. “It’s how to structure a visit,” says Sarah.
“You have to be ready to contain and negotiate the patient’s agenda with them, up front, early in the visit,” says Dr. Wilson.
Between Phase Two and Phase Three there are more observations, but they’re interdisciplinary this time. Physicians observe receptionists, nurses observe physicians, etc. It’s a real team-building process.
Phase Three includes brainstorming and reflection on the entire process: what was learned; what worked well; ideas for continuing and improving communications skills; and implementing them into practice.
Departments have completed the initial training and the observations process is on-going. The ultimate goal of Listening Well is not only better communication, but ultimately better patient outcomes and higher patient satisfaction. Although it may not be directly related to the program, Consumer Reports named Wenatchee Valley Hospital as the number one hospital in Washington State in the area of communications, specifically how well doctors and nurses communicate with patients.
Keywords: care teams, communication, patient support, treatment, Washington, Wenatchee Valley Medical Center
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