Professionalism Training for Staff Enhances Delivery of Care
This is the first in a two-part series about the Center for Professionalism and Peer Support at BWH.
Amid a changing health care environment with increasing regulatory and consumer scrutiny, physicians and researchers, as well as other health care professionals, face significant pressures and shoulder enormous responsibilities.
“At times our sense of efficacy, control and competence can be challenged,” said Jo Shapiro, MD, chief of Otolaryngology and director of the Center for Professionalism and Peer Support. “It is at such times that our attitudes towards each other may be strained and our behavior may be unprofessional.”
Because the professionalism of staff affects the care of patients, BWH leaders created the Center for Professionalism and Peer Support in 2008. The center was founded on the principle that providing excellent patient care requires the highest levels of professionalism, as defined by respect, compassion, integrity, competence and accountability.
“The kind of compassionate and high quality care that we strive to provide to our patients really can only occur in a culture that values and promotes mutual respect, trust and teamwork,” Shapiro said.
The center’s work in fostering professionalism and mutual respect is, according to Joseph Frolkis, MD, nothing short of culture changing.
“Medicine has, for too long, tacitly overlooked behavior that we would never tolerate in other venues,” said Frolkis, the director of Primary Care and associate chief of General Medicine. “It’s the right time to implement a process and use the tools to begin making these changes.”
Shapiro and her team developed professionalism sessions with an employment educational company, ELI, to provide an exploratory and learning opportunity for clinicians, to continue emphasizing the hospital’s commitment to a safe and supportive working environment and to detail the hospital’s program for addressing concerns.
These discussions provide an opportunity for staff to reflect on their own experiences and those shared by colleagues in order to develop strategies to handle stress in a way that maintains respect no matter how significant the conflict. Other educational sessions to help health care team members develop skills in handling communications include: culturally competent leadership, giving difficult feedback and teamwork communication skills.
Shapiro also makes herself available to assist with issues as they arise.
“If, for example, one of my medical directors had an issue, it’s great for me to know that I can call on Jo,” said Frolkis. “She gives us not only tools and support, but also makes it normative to deal with these difficult issues.”
One of the newest components of the professionalism initiative is a program that provides feedback to physicians on how they are perceived by various members of the health care team.
“We believe this is an important step in supporting positive teamwork and ultimately high quality, safe patient care,” said Chief Medical Officer Andy Whittemore, MD.
The center is using a web-based platform, called the PULSE Program, which is a national physician professional development program based on the 360-degree survey feedback process. It enables faculty and staff to provide helpful and anonymous feedback to faculty members about their professional communication and teamwork style.
“The person receiving this feedback can use it to reinforce what he or she is doing well and identify areas for potential improvement,” Shapiro said. “The ultimate goal is for people to see how they treat each other and to treat patients better.”
The program was piloted with select division chiefs in Surgery, under the leadership of Michael Zinner, MD, chairman of the department. Plans include a roll out to the rest of Surgery as well as Rheumatology in 2011.
“I don’t think we always know how we react to our own colleagues—it would be nice to know what the sensitive points are and to try to address them,” said Jonathan Coblyn, MD, clinical director of Rheumatology and the Center for Arthritis and Joint Diseases. “This is a great way for people to provide us with anonymous feedback that gives us a chance to improve.”
The professionalism initiative and feedback on how to improve behavior are especially crucial, given that delivering the best patient care hinges on an entire team of multidisciplinary health care professionals.
“We need everyone to be respectful of everyone on the team to make this an even better place to achieve our mission of patient care, teaching and research,” said Coblyn.
For more information, contact Jessica Perlo, manager of the Center for Professionalism and Peer Support.