The Stanford Patient-Physician
Communication Project
Graduate Medical Education
Stanford University Medical Center
Ann M. Dohn, MA
Designated Institutional Office
Nancy Piro, PhD
Education Specialist / Program Manager
Department of Graduate Medical Education (GME)
Why Are We Doing This?
• Because we have to?
Department of Graduate Medical Education (GME)
ACGME requires
(IV.A.5.d).(4)
• Residents must:
– systematically analyze practice using quality
improvement methods, and implement changes
with the goal of practice improvement;
Department of Graduate Medical Education (GME)
Why Are We Doing This?
• Because we want to?
Department of Graduate Medical Education (GME)
Patient Satisfaction Data
• The Picker survey demonstrated need for better
communication between physicians and patients…
Department of Graduate Medical Education (GME)
Added factor
New CEO…. “Healing humanity through science and
compassion, one patient at a time”
C-I-C-A-R-E
C - Connect with patients by addressing them as Mr./Ms. or by
the name that they prefer
I - Introduce yourself and your role
C – Communicate what you are going to do, how long it is going
to take, and how it will impact the patient
A – Ask and anticipate patient needs, questions or concerns
R – Respond to patient questions or requests with immediacy
E – Exit courteously and/or with an explanation of what will
come next (what you will do for them next)
Department of Graduate Medical Education (GME)
The Charge to the Chief Residents:
• Design and implement a quality improvement
project that impacts or involves the majority of the
residents and fellows.
– 1% salary bonus as an incentive
Department of Graduate Medical Education (GME)
Chief Residents and GME’s
Collaborative Solution
• Create “teamcards” to identify residents/fellows to
patients
• Develop a BRIEF training module on
resident/patient communication
• Pre Interview of Patients:
Do they know their residents’ names?
Department of Graduate Medical Education (GME)
Effectiveness Research
• A sample of 300 Patients were interviewed prior
to Teamcard Distribution and Implementation by
GME and Process Excellence Staff
Department of Graduate Medical Education (GME)
Data Sheet: Teamcard Chief Residents’
Project
Data #
PRE
Age:
Gender:
Dx of Cognitive Impairment:
YES
Is yes, DSM Dx: ______________
POST
No
Do you know the name of your primary resident physician?
YES
No
__________________________________ (Name Given)
Additional Comments:
Department of Graduate Medical Education (GME)
What did our PRE-Initiative Survey
Show?
• 98% of the patients interviewed did not know the
name of their resident physician.
• Many did however know their attendings’ names.
• Many patients told us they thought it was a “great
idea” …I can take home with me and it will help
me remember my physicians’ names….. nurses
need these, too
Department of Graduate Medical Education (GME)
Chief Residents QI Project
“Teamcards” Goals
–
–
–
–
To improve communication with patients
To better identify the care team
To improve patient engagement
To better connect with patients
Department of Graduate Medical Education (GME)
Implementation Steps
•
•
•
•
Communicate Plan and Project Goals
Announce training
Distribute the cards and implement
Measure effectiveness of new model
– Post Interview of Patients
Department of Graduate Medical Education (GME)
Effectiveness Research
• A second sample of 300 Patients will be
interviewed post Teamcard Implementation to
determine the impact/ effectiveness of using
Teamcards.
Department of Graduate Medical Education (GME)
ACGME Requires
( IV.A.5.e)
• Interpersonal and Communication
– Residents must demonstrate interpersonal and
communication skills that result in the effective
exchange of information and collaboration with
patients, their families, and health professionals.
– Residents are expected to:
• communicate effectively with patients, families, and
the public, as appropriate, across a broad range of
socioeconomic and cultural backgrounds;
Department of Graduate Medical Education (GME)
Teamcards Implementation and Training
GME Announced:
All residents/fellows (including departing
house staff) must take the Teamcards/C-I-CARE (3 minute)
module on Healthstream before June 1, 2011
https://www.healthstream.com/HLC/Login/Login.aspx?organizationI
D=6a27bcaa-71bd-db11-bf7b-000423d6b5c1&bhcp=0
We required 90% compliance with course completion by
ALL house staff to qualify for 1% salary incentive in
late June
D-E-M-O
Department of Graduate Medical Education (GME)
Implementation Details
• Residents/fellows on inpatient rotations at SHC
started using their “teamcards” this month
• “Kick-Off” Meetings were held and cards were
distributed via the departments.
Department of Graduate Medical Education (GME)
What in it for the residents?
* INCENTIVE BONUS*
Department of Graduate Medical Education (GME)
And when will the residents see the $$$?
• Last paycheck in June or their final paycheck if
they are graduating this year!
• GME is keeping the residents updated on the
progress toward the goal of 90% compliance
with the training.
Department of Graduate Medical Education (GME)
Obstacles We Encountered
• The great LOGO debate…
• How many pixels are required for a good photo?
• Aren’t the residents always available for a
professional photographer?
• Can’t visiting residents get their pictures taken, too
and get cards?
• Are visiting residents like community physicians?
• Once the initiative took off, it was no longer the Chief
Residents’ Project
• Faculty Teamcards, too
Department of Graduate Medical Education (GME)
Even our Faculty Wanted Teamcards
Department of Graduate Medical Education (GME)
Summary
CICARE
C-I-C-A-R-E
Department of Graduate Medical Education (GME)
Questions?
CONTACT INFORMATION ~
Ann M. Dohn, MA
Designated Institutional Official
adohn1@stanford.edu
Nancy Piro, PhD
Education Specialist/ Program Manager
npiro@stanford.edu
Department of Graduate Medical Education (GME)