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By William Maples M.D. Patients visit their physician/advanced practitioner when they are most vulnerable, and they need to have trust and confidence in their physician/advanced practitioner, especially when they discuss some of the most intimate details about their lives and families. However, when it comes to the physician/advanced practitioner-patient relationship, the two parties are not always aligned. “Often physicians/advanced practitioners don’t understand what their patients want from them. It’s really quite simple — what matters most to patients is to be respected and listened carefully to by their physician/advanced practitioner,” says William Maples, M.D., President and Chief Executive Officer of The Institute for Healthcare Excellence (IHE). When physicians/advanced practitioners build a trusting relationship with patients, it ultimately improves outcomes. On average, 50 percent of patients treated for chronic disease do not take their medicine as prescribed, a study on the success of high blood pressure treatments reported. And many times, that decision to take or skip a dose is significantly influenced by the physician/advanced practitioner-patient relationship. “If you’re not really engaged with somebody and don’t trust them, and they recommend that you do something, would you do it? Would you follow through?” Dr. Maples says. “We jeopardize our patients’ safety and our patients’ outcomes if we do not develop a trusting, healing relationship between the patient and physician/advanced practitioner.” Here are ways to improve the physician/advanced practitioner -patient relationship, according to Dr. Maples, who has worked with some of the nation’s top hospitals on these very efforts. 1. Understand how patient experience impacts quality, safety and efficiency. Hospital leaders need a deeper understanding and awareness of the impact that patient experience has, both on patient experience scores and the culture of the organization. “Achieving excellence in patient experience is more than achieving a top score or top reimbursement through initiatives such as Value Based Purchasing. It’s really about how we show up to work each day and the conversations we have between our patients and each other,” Dr. Maples says. 2. Transform the care model from a provider-centered approach to a patient-centered, team-based approach. Although physicians/advanced practitioners and caregivers work in teams, each and every decision is often made without consideration of the patient’s perspective. According to Dr. Maples, putting the patient at the center of every decision will improve their experience, as well as their outcomes. “The culture of our organization is determined by the moment-to-moment conversations we have with patients and with each other,” says Dr. Maples. “By focusing on relationship-centered skills that foster a meaningful connection with patients and each other through recognizing emotions and responding appropriately, we can close the gaps in what patients want and what they receive.” 3. Provide an experiential skills-based learning platform. Learning in a skills-based format, where physicians/advanced practitioners and caregivers are actually practicing skills they need and use daily, can position a healthcare organization for improvement on all levels. Without addressing these foundational skills, Dr. Maples says an organization’s transformational journey will be slow and ineffective. 4. Engage physician leaders in the experience culture journey. Physician leaders are not always part of the conversation on how to improve the patient and staff experience, but it is necessary to invite them to lead this effort. “How in the world can we change a system if we don’t engage the leaders?” Dr. Maples says. “Engage physician leadership and believe in them…Their desire to help others, to improve a patient’s life, is really at their core. It’s why they went into medicine in the first place and it’s what they really want to deliver.” The key to successful culture transformation, says Dr. Maples, is identifying physician leaders who support the effort to rekindle relationship-based tools. Once identified, train them to facilitate skills-based work with their colleagues to enhance the entire team’s journey. Respected physician and allied health facilitators creating a safe place to practice, and nurture relationships enhances the learning and helps incorporate these skills into everyday conversations. “There is no shortage of physicians/advanced practitioners and caregivers who are willing to help improve the physician/advanced practitioner-patient relationship, as long as they know that leadership embraces the work and there is a commitment to supply the resources needed to do the work. We just have to nurture that and bring it forward,” Dr. Maples says. The Institute for Healthcare Excellence partners with healthcare organizations to nurture relational skills necessary to create a culture that embraces trust, respect, compassion, and teamwork - creating an environment where quality, safety, and efficiency can flourish. Through this work, physicians, nurses, and the caregiver team reconnect to purpose and restore joy to the practice of medicine. The result of the culture-transforming work is a restoration of humanity to medicine.

By William J. Maples, M.D. and Timothy A. Poulton, M.D. If you have been in the workforce for a while, you have probably experienced a few types of leadership styles. If you supervise others, what style of leadership do you want to be known for? How do you inspire others? Do you listen and connect with people? The Institute for Healthcare Excellence (IHE) would like to get you thinking about human-centered leadership. “Good leaders are efficient in getting the best out of their team,” says Tim Poulton, M.D., faculty member at IHE and a family physician at Mission Health in North Carolina. “They facilitate their team forming strong bonds amongst themselves, and strong connections with the people they serve.” Leaders who avail themselves to human-centered leadership, lead by example and set the tone for how the team interacts, creating a culture where people want to work hard and want to be successful. “They convey a message of openness and they are receptive to input,” says Dr. Poulton. Using human-centered leadership skills, healthcare teams can be more connected, more cohesive, enthusiastic and appreciative of the opportunity to work together. The result is a connected, motivated and energized team. Human-centered leadership is a set of skills that can be taught and practiced. “When you get immersed in your work sometimes you don’t have the skills distilled and ready to use, and an opportunity might slip away,” observes Dr. Poulton. Good leaders are effective in recalling and using the skills and understand the importance of human-centered leadership. William Maples, M.D., President and CEO of IHE takes us one step further: “The key to leadership is to understand to the best of your ability the strengths, gifts and talents of the team, and capitalize on those to move forward the vision and goals of the organization.” Dr. Maples explains that it starts with you. The ability to understand the team begins with understanding your own strengths and weaknesses as a leader. Only then can you connect with other individuals to create trust. “The ability to connect with an individual to create trust and safety within the work environment is very important; If we skip over this step it becomes hard to fully understand the strengths and gifts of the team,” says Dr. Maples. Is it possible to lead without building relationships? “The answer is yes, but the effectiveness of your leadership will be severely compromised,” says Dr. Maples. A team’s ability to reach its maximum potential can be hindered following traditional leadership models. Many leaders simply think it is more efficient to get “right to the heart of the matter” while bypassing the emotional connection. “In healthcare, we want to be fixers: we want to swiftly diagnose and treat the problem,” says Dr. Maples. “Our default setting is “what’s wrong?” and we overlook what’s right, potentially missing the strengths and the opportunities, including opening up and allowing people to bring their gifts to the table.” Nurturing human-centered leadership skills produce leaders who feel more connected to their workforce, teams that are more connected to their mission, and a deeper connection to purpose across the organization. “We’ve seen empathy and compassion in the healthcare setting improve and burnout lessen,” concludes Dr. Maples. “We’ve also seen culture shifts where trust, respect and teamwork are embraced by all members of the team.” Learn more about human-centered leadership at healthcareexcellence.org, or attend the Regional Summit on Friday, October 5, 2018 in Raleigh, NC.    
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