INDEX
Please note that index links point to page beginnings from the print edition. Locations are approximate in e-readers, and you may need to page down one or more times after clicking a link to get to the indexed material.
Acceptance, in motivational interviewing, 88
Active listening, 38–40, 81–82, 89, 140, 154–155
Addressing of team members, 161, 164
African Americans, 150, 154, 155, 162
Agency for Healthcare Research and Quality (AHRQ), 125
Agenda setting, 18
and EHRs, 81
and feedback, 112–113
and negotiating a shared agenda, 32–33
for teams, 129
Anesthesia, 20
Ankylosing spondylitis, 28
Antidepressants, 47–48
Apologies, 43
Appreciative coaching, 115–123
and core requirements for coach, 116
debriefing stage of, 122
live observation stage of, 120–122
and organizational change management, 117–118
pre-briefing stage of, 118–120
role of empathy in, 116–117
Appreciative inquiry (AI), 130
and appreciative coaching, 122
breaking bad news with, 66–67
and culture/diversity, 157
with distrustful patients, 71–72
with feedback, 111–112
in motivational interviewing, 90
in role-play, 173–174
and talking with colleagues, 144–146
and unmet patient expectations, 68
Assumptions, and conflict, 140–143
Bad news, breaking, 65–67
Badges, caregiver, 162–163
“Bedside manner,” 4
Beginning of encounter, 27–33
eliciting list of all concerns at, 28–32
establishing rapport at, 28
negotiating a shared agenda at, 32–33
Body language, 140
Brown v. Board of Education, 154
Burnout, 9
Buy-in, getting, for train-the-trainer programs, 184–185
Cancer, 7
Caring, 13
Center for Excellence in Healthcare Communication (CEHC), 192–193
“Cheat sheets,” role-play, 178
Check-ins, 128–129
Chicago Cubs, 116
Cholesterol, 7
Chronic illnesses, 7
“Chunk and check” approach, 50
Cleveland Clinic (CC), 191–193
Clinical & Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS), 194–195
Closure, 83
Coaching, 10
appreciative, 115–123
in role-play, 177–178
in train-the-trainer programs, 186
Cohesion, team, 126–131
Collaboration, in motivational interviewing, 88
Communication:
in healthcare teams, 131–135
risk, 99–100
and systems design, 21–23
Communication in Healthcare (CIH) course, 191
Communication skills, 10
for beginning of encounter, 27–33
for building trust, 35–45
for delivering diagnoses and treatment plans, 47–57
and explanations to patients, 20–21
importance of, 17–18
patient reflections on, 16–17
Compassion, in motivational interviewing, 88
Confidence, building, 90
Conflict(s), 137–147
and active listening, 140
and assumptions, 140–143
constructive dialogue to ease, 139
fight or flight response to, 138
and interests vs. positions, 144–146
preparing for, 146
principled negotiation as framework for handling, 139–146
relational, 138
and separating the person from the problem, 143–144
Congestive heart failure, 7
Constipation, chronic, 7
Constructive dialogue, 139
Constructive feedback, 111–112
Consumer Assessment of Healthcare Providers and Systems (CAHPS), 14
Conviction, engaging through, 90
Coronary heart disease, 7
Corrective feedback, 110, 178–179
Cultural differences, 8, 149–158
and active listening, 154–155
and addressing barriers, 153–154
and delivery of diagnoses/treatment plans, 157–158
and empathy/respect, 155–156
and greetings, 80
and need for good communication skills, 149–151
and need for trust, 152, 156–157
Customer service, 5
Daemen College, 130
Data gathering:
for organizational change, 204–205
transitioning to further, 44
Debriefing stage (appreciative coaching), 122
Decision aids, 100–102
Decision talk, 98–99
Decision-making:
and emotions, 6
shared, 95–103
by team members, 165–166
Delegation, 167
Dementia, 9
Department of Defense (DoD), 125
Diagnoses, delivering:
and breaking bad news, 65–67
and cultural differences, 157–158
Dialogue, constructive, 139
Difficult patient encounters, 3–4, 61–73
and breaking bad news, 65–67
with distrustful patients, 70–73
emotion-laden, 62–65
and unmet patient expectations, 67–70
Disruptive behaviors, 138
Distracted driving, 78
Distrustful patients, 70–73
“Doctor’s lounge,” 161
“Doorknob” questions, 8, 30, 31
“Educating” patients, 49
Electronic health records (EHRs), 75–84
advantages of, 76
and agenda setting, 81
and building the relationship, 82
clinicians’ perspectives on, 78
communication barriers imposed by, 78
and discussing history of present illness, 81–82
overcoming obstacles presented by, 83
and patient greeting, 80
patients’ perspectives on, 76–78
and prepopulating the chart, 79–80
previewing, 79–80
and relationship-centered care, 79–83
and room setup, 79
and shared decision-making, 82–83
and visit closure, 83
Emergency department (ED), 28, 31
and active listening, 140
in difficult patient encounters, 62–65
and appreciative coaching, 116–117
and culture/diversity, 155–156
responding to patient concerns with, 41–43
Engagement, of patients, 89
Evocation, in motivational interviewing, 88
Expectations, patient, 40–41, 67–70
Faculty-in-Training (FIT) programs, 191
Families, patient, 31–32
Feedback, 105–113
and agenda setting, 112–113
constructive, 111–112
defining effective, 105
and observation, 108–110
reinforcing, 110–111
setup for providing, 107–108
on teams, 131–133
Fight or flight response, 138
First impressions, 27–28
Foundations of Healthcare Communication (FHC), 192
Gawande, Atul, 115
General Hospital (TV show), 4
Halo effect, 110
Healthcare costs, 8
Healthcare teams, 125–135
characteristics of highly functioning, 126
cohesion of, 126–131
communication in, 131–135
conference-room rounds by, 77–78
“Hidden concerns,” 36
Hierarchy, 159–169
and addressing of team members, 164
and creation of just culture, 166–167
definition of, 160
and delegation, 167
in healthcare teams/organizations, 161–163
and holding team members to standards, 168
and implementation of inclusive processes, 165–166
importance of, 160
key methods for managing, 163–164
and reciprocity/mutuality, 167–168
and transparency, 168
Huddles, team, 133–135
Inappropriate conduct, 138
Inclusive processes, implementation of, 165–166
Institute of Medicine, 154
Interests, positions vs., 144–146
Irritable bowel syndrome, 7
ISBAR, 125
Joint Commission, 138
Journal of the American Medical Association, 76–77
Judgmental language, avoiding, 110, 139
Just culture, creating a, 166–167
Kahneman, Daniel, 142
“Keep-stop-start” framework, 110–111
Ladder of interference, 141
Latino patients, 150
Leader engagement, 210
Learning, of skills vs. concepts, 9–10
Lee, Thomas H., on alleviating patients’ suffering, 13
Legitimization, 43
Listening:
active, 38–40, 81–82, 89, 140, 154–155
Live observation stage (appreciative coaching), 120–122
Maddon, Joe, 116
Marcus Welby, MD (TV show), 4
MASTER Classes, 198
Mayo Clinic in Phoenix (MCP), 191
Mayo Shared Decision-Making Center, 100, 101
“Medical Interviewing and Psychological Aspects of Medicine” (seminar), 4
Merlino, Jim, 191
MI (see Motivational interviewing)
“Mid-level providers,” 162
Miller, William, on MI “spirit,” 87–88
Morrison, Toni, 108–109
Motivational interviewing (MI), 85–93
skills required for, 86–87, 89–90
“spirit” behind, 87–88
technique of, 88–92
MRIs, 67–68
Muscle memory, 179
Mutuality, 167–168
Myocardial infarction, 7
Negotiation:
principled, 139–146
of shared agenda, 32–33
Neurological science, 6
New Yorker, 115
Open-ended questions, asking, 38–40
Operating room (OR), 127
Opiates, 3
Opioids, 69–70
Option talk, 98
Organizational change, 201–211
appreciative coaching and familiarity with managing, 117–118
data gathering for, 204–205
generating provisional solutions for, 205–207
planning/acting/adapting for, 208–209
practical considerations when implementing, 209–210
and problem identification, 202–203
Outcomes, and treating to target, 52–54
Pain control, 8
Partnering, 43
Paternalistic model, 6
Patient concerns:
eliciting, at beginning of encounter, 28–32, 40–41
“hidden,” 36
Patient encounters, standardized, 173–174
Patient expectations, unmet, 67–70
Patient experience, 15–16
Patient experience surveys, 14
Patient interactions, number of, 4–5
Patient satisfaction, 15
Patient-centered care, 5
Patients:
distrustful, 70–73
“educating,” 49
EHRs from perspective of, 76–78
engagement of, 89
first contact with (see Beginning of encounter)
PEARLS statements, 42–43, 64, 69–72
and appreciative coaching, 122
and culture/diversity, 155
and feedback, 108
and talking with colleagues, 144
“Personal Best” (Gawande), 115
Personhood, acknowledging, 36
Physicians, addressing, 161
Planning:
and motivational interviewing, 90
for organizational change, 208–209
Positions, interests vs., 144–146
Pre-briefing stage (appreciative coaching), 118–120
Priming, 109
Principled negotiation, 139–146
Problem(s):
organizational change and identification of, 202–203
separating the person from the, 143–144
Program to Enhance Relationship-Centered Care (PERCC), 195–196
Project management teams, 210
Questions:
asking, 29
from coaches, 119
open-ended, 38–40
Rapport, establishing, 28, 107, 118–119
Reciprocity, 167–168
R.E.D.E. Model, 192–193
Reinforcement, 110–111
Relational conflict, 138
Relationship-centered care (RCC), 5–7, 13–14, 79–83
Relationship-centered communication, 15–16, 20
Respect, and cultural differences, 155–156
Respect, showing, 43
Risk communication, 99–100
Role-play, 173–180
ART method in, 173–174
and avoiding humiliation, 177–179
and relevance of scenario, 179–180
Rollnick, Stephen, on MI “spirit,” 87–88
Room setup, 79
San Mateo Medical Center (SMMC), 194–195
SDM (see Shared decision-making)
Service Fanatics (Merlino), 191
Sexual minorities, 150
Shared agenda, negotiating a, 32–33
Shared decision-making (SDM), 95–103
clinician skill at, 96
decision aids for, 100–102
and EHRs, 82–83
and risk communication, 99–100
and Three Talk model, 97–99
Signal transmission:
ART method for improving, 50–54
problematic, 49–50
“teach-back” to ensure proper, 54–56
Sitting, standing vs., 28
Skills:
learning, 9–10
for motivational interviewing, 86–87, 89–90
relationship-centered, 129
teaching the, 173–182
Small group facilitation (train-the-trainer programs), 187–188
Small talk, 28
Smith Barney, 156
The Sound of Music (film), 27
Staffing, medical vs. non-medical, 162
Standardized patient encounters, 173–174
Standards, holding team members to, 168
Standing, sitting vs., 28
Structured interprofessional bedside rounding (SIBR), 21–22
Subtext, and active listening, 140
Support, demonstrating, 43
Surgical teams, 28
Surveys, patient experience, 14
Systems design, 21–23
“Take-charge” attitude, 38
Teach-backs, 54–56
Teaching the skills, 173–182
by direct observation, 174
with role-play, 173–180
with standardized patient encounters, 173–174
with videotape reviews, 174
Team huddles, 133–135
Team talk, 97–98
Teams, healthcare (see Healthcare teams)
TeamSTEPPS, 125
Technology, 76–77 (See also Electronic health records [EHRs])
Texas Children’s Hospital (TCH), 196
Texting, 78
Three Talk model, 97–99
Time-outs (role-play), 178
Training, 10
Train-the-trainer (TTT) programs, 183–200
advantages of hosting, 183
at Cleveland Clinic, 191–193
and communication skills training for future trainers, 186–187
format of, 184–190
gaining buy-in for, 184–185
“going live” with, 188–189
long-term viability of, 189–190
at Mayo Clinic in Phoenix, 191
need for small group facilitation skills in, 187–188
at San Mateo Medical Center, 194–195
and selection of future trainers, 185–186
at Texas Children’s Hospital, 196
at University of Arkansas for Medical Sciences, 197–198
at University of California San Francisco, 197
at University of Maryland, 193–194
at Wake Forest Baptist Health System, 195–196
at Zuckerberg San Francisco General, 198–200
Transparency, fostering, 168
Treatment plans, communicating, 47–57
and outcomes, 52–54
and signal transmission, 49–52, 54–57
Trust building, 35–45
and active listening, 38–40
and asking open-ended questions, 38–40
and culture/diversity, 152, 156–157
and eliciting the patient’s ideas/expectations, 40–41
and responding with empathy, 41–43
and transitioning to further data gathering, 44
TTT programs (see Train-the-trainer programs)
Typing (keyboard), 81
Unequal Treatment (report), 154
University of Arkansas for Medical Sciences (UMAS), 197–198
University of California, San Francisco (UCSF), 197
University of Maryland, 193–194
Unmet patient expectations, 67–70
US Supreme Court, 154
Verghese, Abraham, 77
Videotape reviews, 174
Wake Forest Baptist Health System, 195–196
White, Maysel Kemp, 50
Whyte, W. H., on need for listening, 47
Zuckerberg San Francisco General (ZSFG), 198–200