John Wooden’s Spirit Alive and Well at MedStar Health

This week I again had the pleasure to hear Paul Levy (Not Running A Hospital) speak at a MedStar Health Quality & Safety retreat. Paul’s gentle reminder–that transparency in healthcare is something all of us have to own, not necessarily because someone is watching, but because we hold ourselves accountable to higher standards–was motivating. He quoted John Wooden–the great UCLA men’s basketball coach, reminding healthcare leaders in the room that, “If they haven’t learned it, you haven’t taught it.” As an athlete and coach myself, Coach Wooden has long been a virtual mentor for me. Wooden’s gentle giant approach and his unwillingness to settle for anything but the best effort everyday is an example of excellence in and of itself, but he was also a committed teacher and knew that if his students/players didn’t “get it”, his job was far from done.

Paul’s talk this week also reminded me that leading culture change in healthcare isn’t easy, and requires all of us to recommit to the principles we value–like transparency–even when it’s not necessarily the popular or easy choice. Wooden is a wonderfully invoked example of a leader whose commitment to his own foundational values of hard work, friendship, loyalty, cooperation and enthusiasm, led to unmatched success on the collegiate basketball hardwood.

What is our pyramid of success for healthcare, and can we stand firm–gently, calmly, confidently–because we know it’s the best way to achieve the safest, most cost-effective care for our patients?

And finally, here is a link to a previous Transparent Health blog invoking John Wooden’s spirit–this time around a Telluride Educational Roundtable discussion on the lack of training in informed consent and shared decision-making for resident physicians.

The Need For Better Communication in Medicine

“If they haven’t learned it, you haven’t taught it.”

I love this John Wooden quote–and John Wooden for that matter. Both Dave Mayer and I have blogged about Wooden’s leadership on and off the basketball court, and how medicine could benefit from his example of leadership. I was again reminded of this Woodism, last week after following a Tweet to Dr. Tyeese Gaines’ post, “Doctors and moms: Speaking Different Languages”  in Health on TODAY. In her post, Dr. Gaines speaks to the need for better communication skills among care providers. This same need was voiced by the American Hospital Association’s Physician Leadership Forum, and highlighted in a July 2012 white paper on: “the core competencies needed to deliver coordinated, team-based, value-driven care and recommendations for how hospitals and physician-associated organizations can develop these skills in the next generation of physicians.” In the white paper, core competency #6 was defined as Interpersonal & communication skills where physicians should be able to:

  1. Demonstrate skills that result in effective information exchange
  2. Work effectively with other members of the health care team

The gap in the need for good communication skills among medical professionals and the existing skill set around the same was named as a strategic imperative by the Physician Leadership Forum moving forward–a positive step toward thwarting the miscommunication among care providers thought to play a major role in medical error.

Returning to Dr. Gaines’ post, I can’t help but once again think of John Wooden. Physicians and patients, including Moms–unless they’re involved in medicine, often do speak different languages. When you add a sick child to the equation, you amp up the stakes and the ability to comprehend the information shared by a care provider decreases significantly. Education level, anxiety level, previous experiences with healthcare providers, frame of reference–all factor into that complex social interaction. And I can’t help but return to a health psychology class, many years ago, where the one statistic that has stayed with me over time is that patients comprehend 30% of what is said in any given conversation with a healthcare provider. If “they haven’t learned it”, maybe the information has yet to be taught in a way that bridges that expansive 70% gap? Wooden had practice time with his players daily, and it still took time for them to acquire a new skill. A 20 minute appointment on a new health topic under stress without “practice” time is a challenging learning environment for both teacher and student.

Even when the news communicated was positive, Dr. Gaines shared her frustration with the story of a Mom who refused to believe her child was healthy and ready to leave the ER. Rory Staunton, the young boy whose death was attributed to sepsis missed in an ER, and cases like this, may contribute to communication challenges even around positive results. With social media and the intensified scrutiny on all aspects of healthcare, every miss of magnitude is brought to the public for evaluation. “It’s just a rash” or “it’s just a virus” uttered by care providers no longer commands the same level of trust it once did, and as such, those conveying the positive findings may still have to battle against medical errors of their peers to gain the trust of patients once given without question. How can care providers most effectively convey this complex, sometimes charged, information in a way that makes sense and sticks with patient and family? Please share your thoughts!

Medicine has indeed become a team sport, and everyone on the care team has to be on board–fully aware of their contribution to a successful outcome.