It's not uncommon for communication expert Krista Hirschmann, Ph.D., to be called to consult with a practice and learn that many of the team members don't even know one another's names.
"In many practices, a relational foundation is just not in place. With all the work to be done, it's hard to make the time and to justify that there is a financial incentive for actually being in connection with one another," Hirschmann, director of the Center for Interprofessional Collaboration at Lehigh Valley Health Network, said during a Tuesday morning session at the Medical Group Management Association annual conference in Nashville.
As with a building, relationship foundations are also invisible, she noted. "You don't see it until a crisis comes along."
Although the session title was, "Improving patient-provider communication," much of Hirschmann's presentation dealt with the healthcare team itself. "From a systems perspective, focusing on just the physician-patient dyad is not going to get us where we want to go."
In other words, for patient-care processes to work, they need to be executed by people sharing strong relationships. What happens too often, she explained, is that people make assumptions about one another, rather than taking the time to have simple conversations that save everyone a lot of grief in the long run.
Employees may be misinformed about what other team members actually do on a daily basis, for example, based on titles alone. Or employees may be unsure of how to share feedback with physicians about the practice, letting easily addressed issues pile up and cause dissatisfaction.
Toward the end of the presentation, attendees demonstrated what they'd learned by compiling lists of questions they might ask of people with whom they work to set the groundwork for an optimal relationship. Examples included:
- How should we help each other avoid mistakes? If I'm unsure of a medication you're prescribing, for example, how would you like me to tap you on the shoulder and let you know?
- What is your understanding of your role and mine?
- What do I need to know about you so we can work well together?
These conversations, when paired with an office culture that invests in relationships, are critical for practices to rise to the challenges set before them today, including the need to adapt to new models of care.
"And remember, office culture is not a big, hairy animal that shows up once a year," Hirschmann said. "Culture is in the micro-moments."