The mission of the Geisinger Health System is “to enhance the quality of life through an integrated health service organization based on a balanced program of patient care, education, research and community service.”
To succeed at its mission, Geisinger began a system-wide effort in 1997 to not only meet, but to exceed the expectations of its patients. By doing this Geisinger is creating a culture of service excellence that makes the Geisinger Health System the provider and employer of choice in central and northeastern Pennsylvania.
Geisinger’s quest for service excellence led it to IHC (formerly, the Bayer Institute for Health Care Communication). Since 1999 Geisinger and IHC have worked together to enhance the quality of health care by improving communication between physicians and patients. In recognition of this commitment, the Bayer Institute has unanimously chosen to present the 2001 Bayer Institute Program Partner Award to Geisinger Health System.
IHC launched its Program Partner Award in 1999. The Award acknowledges and applauds the commitment of the sponsoring organization to the issue of clinician-patient communication. IHC has more than 600 trained faculty members and more than 75 program partners that offer IHC programs to clinicians in every specialty and type of practice in the United States and Canada. Without this involvement IHC would not be able to reach out to as many organizations and clinicians. The hard work of program partners such as Geisinger has opened many doors and minds to the role and importance of communication. The Program Partner Award is IHC’s way to say thank you for recognizing the importance of clinician-patient communication and for bringing the issue and programs into your organizations.
Why Communication?
Patients may not have the scientific and medical background to technically evaluate the quality of care they receive, but every patient is an expert on how they feel about such care. Geisinger also knows that the patient’s relationship with the clinician is the primary driver of patient satisfaction and loyalty.
The physicians at Geisinger are highly skilled. What Geisinger wanted to learn was how to help its physicians become even better at delivering care. How could Geisinger differentiate its organization from other top health systems, and, even more specifically, differentiate its physicians from the physicians of other systems?
The Partnership with IHC
The leaders of Geisinger’s service excellence initiative understood the value and importance of good communication between physicians and patients. There was also interest in the role of communication from a different Geisinger department that wanted to reduce the risk of liability. Based on reading and research, representatives from both groups independently, yet simultaneously, contacted IHC. Both departments reviewed the program offerings and concluded that IHC knew more about the topic of clinician-patient communication than any other organization in the field.
One of Geisinger’s physicians attended IHC Clinician-Patient Communication (CPC) course in 1998. Based on his very favorable report the leaders of the system-wide service initiative decided to use IHC programs throughout the entire Geisinger Health System. During 1999, IHC trained six highly respected Geisinger physicians and the director of the organization’s service initiative as CPC faculty.
Implementing IHC Programs
The CPC workshop was offered to physicians through Geisinger’s existing continuing medical education programming. All Geisinger physicians were notified of the workshop by e-mail and at management meetings. The workshop was offered monthly and held in easily accessible locations. Initially, the attendance was low but gradually increased thanks to the support of key physician leaders.
It is significant to note that the leaders of the Geisinger service excellence initiative continually reported on the progress of the workshops in leadership meetings. These leaders continued to present patient satisfaction results and pushed for the need to create a complete culture of service excellence throughout the organization. They continued to express their philosophical belief that being a “Geisinger doctor” should mean that programs on improving communication with patients were part of a complete CME program. These leaders also expressed their hope that each physician would go through the CPC workshop, then the Difficult Clinician Patient Relationship (DCPR) Workshop the following year, and the Choices and Changes (C&C) workshop in the third year.
Naturally, these philosophical statements generated much discussion. But because the issue and these workshops had the full support of key physicians the program gained acceptance. After approximately 40 percent of the physicians participated in the CPC workshop (as a result of advertising and promotion), the Chief Medical Officer recognized the value of the program and required that all physicians, physician assistants, and nurse practitioners complete the CPC workshop. This increased the monthly attendance significantly and the need to schedule more workshops. Once existing staff had been trained, the CPC workshop was offered quarterly for new staff to attend.
The coordination and funding to train faculty are through the system-wide service excellence initiative.
As of July 2001 the following training has occurred:
Clinician-Patient Communication | 14 |
Difficult Clinician Patient Relationship | 7 |
Choices and Changes | 1 |
Treating Patients With C.A.R.E. | 14 |
Workshops | Physicians’ Trained |
40 CPC | 600 |
12 DCPR | 150 |
Weeklong Intensive Review Course | 10 |
Treating Patients With C.A.R.E. | Launched in August 2001 |
Program Feedback and Benefits
Working with IHC to implement communication programs has allowed Geisinger to hold true to the words of Geisinger’s second CEO, Leonard F. Bush, MD:
“Concern for patients — this is the reason you are here. Take time to know your patients as human beings. Listen and they’ll tell you the story. Remain humble. Make them feel that you are interested in them. Be concerned. Our organization must be composed of dedicated people.”
Physicians, administrators and support staff have all responded very positively to the workshops. The program has created greater awareness of the need to communicate more effectively with patients. In addition, patient satisfaction, which is measured on an ongoing basis, has improved for each of the past two years.
Geisinger has found that the biggest challenge to these types of programs is getting past the notion, on the part of both the physicians and their supervisors that physicians “don’t have time” to attend. Consequently, the Geisinger system has concluded that if a program of this sort is to succeed, key respected physicians must participate as workshop faculty and leaders, and constantly work on gaining organizational support while also engaging in the more straightforward task of conducting programs.
Geisinger Health System
Located in Danville, Pennsylvania GHS is a 691-bed physician-lead, integrated health system that includes Geisinger Medical Center, Geisinger Wyoming Valley Medical Center, the 550 physician Geisinger Clinic, 57 Community Practice sites, Marworth Alcohol & Chemical Dependency Treatment Center, Geisinger Health Plan and Diversified & Community Health Services. The motto of the health system is “Heal. Teach. Discover. Serve.”